Evidence map›Paper›PMID 40261493›Full record

Observational studyClinical pharmacokinetics2025

Population Pharmacokinetic Modelling of Remdesivir and Its Metabolite GS-441524 in Hospitalised Patients with COVID-19.

Darren M Roberts, Xin Liu, Suzanne L Parker, Andrew Burke, Jenny Peek, Jane E Carland, Bridin Murnion, Vincent Seah, Steven C Wallis, Chandra D Sumi and 9 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Clinical pharmacokinetics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Darren M RobertsThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia. 1darren1@gmail.com.ORCID 0000-0001-9101-7577
Xin LiuThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
Suzanne L ParkerThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
Andrew BurkeThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
Jenny PeekDepartment of Infectious Diseases, The Prince Charles Hospital, Brisbane, Australia.
Jane E CarlandDepartment of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Darlinghurst, Australia.
Bridin MurnionDepartment of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Darlinghurst, Australia.
Vincent SeahDepartment of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Darlinghurst, Australia.
Steven C WallisThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
Chandra D SumiThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
Saurabh PandeyThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
Hergen BuscherSchool of Clinical Medicine, Faculty of Medicine and Health, St Vincent's Healthcare Clinical Campus, University of New South Wales, Sydney, Australia.
Anthony ByrneSchool of Clinical Medicine, Faculty of Medicine and Health, St Vincent's Healthcare Clinical Campus, University of New South Wales, Sydney, Australia.
Indy SandaraduraCentre for Infectious Diseases and Clinical Microbiology, Westmead Hospital, Sydney, Australia.
David BowenDepartment of Intensive Care Medicine, Westmead Hospital, Sydney, Australia.
Simon HolzHerston Infectious Diseases Institute (Heidi), Metro North Health, Brisbane, Australia.
Adam G StewartThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
Krispin M HajkowiczThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
Jason A RobertsThe University of Queensland Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.

Funding

National Health and Medical Research Council Grant number APP2007007National Health and Medical Research Council Grant number APP2009736Queensland Health Advancing Queensland Clinical Fellowship
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThere are limited data testing whether the licensed dose of remdesivir and its active metabolite GS-441524 achieve target concentrations in hospitalised patients with confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of coronavirus disease-2019 (COVID-19). The objectives of this study were to describe the population pharmacokinetics of remdesivir and GS-441524 in hospitalised patients treated for COVID-19 and develop a model to inform dose optimisation in clinical use.

methodsThis was a prospective, open-labelled, multi-centre, observational study in four Australian hospitals in adults with confirmed SARS-CoV-2 infection. Patients were administered the licensed remdesivir dose. Remdesivir and GS-441524 concentrations were quantified in multiple plasma samples at different times in the dosing interval by ultra-high-performance liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS). Patients were divided into two groups: pharmacokinetic model building and external validation. A population pharmacokinetic analysis was built using non-linear mixed-effects modelling. Monte Carlo simulations were performed to describe the impact of age, kidney function and dosing regimen on drug concentrations.

resultsIn total, 33 patients were enrolled (median age 70 years, estimated glomerular filtration rate (eGFR) 80 mL/min/1.73 m

conclusionsThe licensed remdesivir dose may achieve target concentrations of GS-441524, but higher dosages may optimise outcomes. Dose adjustments are guided primarily by kidney function.

Indexed as

Adenosine MonophosphateAlanineAntiviral AgentsCOVID-19 Drug TreatmentModels, BiologicalAdenosineAdultAgedAged, 80 and overAustraliaCOVID-19FemaleGlomerular Filtration RateHospitalizationHumansMaleAdenosineAdenosine MonophosphateAlanineAntiviral AgentsGS-441524remdesivir

Identifiers

PMID40261493
PMCPMC12064607

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.