Prospective PSM analysis of remdesivir use in the UK showing statistically significantly lower mortality at 28 days. For unspecified reasons, the study prioritized short-term outcomes. Mortality at 14 days was also lower but not statistically significant. Confounding by indication is likely and may only be partially addressed by the variables included in the PSM.
Arch et al., 6/21/2021, prospective, propensity score matching, United Kingdom, Europe, preprint, 10 authors.
risk of death, 19.9% lower, RR 0.80, p = 0.03, treatment 203 of 1491 (13.6%), control 777 of 4676 (16.6%), odds ratio converted to relative risk, 28 days, PSM.
risk of death, 18.0% lower, RR 0.82, p = 0.12, treatment 140 of 1502 (9.3%), control 565 of 4728 (12.0%), odds ratio converted to relative risk, 28 days, PSM.
risk of mechanical ventilation, 68.0% higher, RR 1.68, p = 0.003, treatment 106 of 1498 (7.1%), control 153 of 4602 (3.3%), odds ratio converted to relative risk, 28 days, PSM.
Effect extraction follows pre-specified rules
prioritizing more serious outcomes. For an individual study the most serious
outcome may have a smaller number of events and lower statistical signficance,
however this provides the strongest evidence for the most serious outcomes
when combining the results of many trials.