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Remdesivir study #19 of 21
3/10 Late treatment study
Tsuzuki et al., medRxiv, doi:10.1101/2021.03.09.21253183 (Preprint)
Efficacy of remdesivir in Japanese patients hospitalised with COVID-19: A large observational study using the COVID-19 Registry Japan
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Retrospective database analysis of 1907 hospitalized patients in Japan, using PSM to compare 74 remdesivir patients and 195 control patients, not showing significant differences in mortality and ventilation/ECMO, and showing signifcantly longer hospital stay with treatment. PSM did not fully match the patients, for example 65% of matched remdesivir patients were over 65, while only 55% of matched control patients were.

Tsuzuki et al., 3/10/2021, retrospective, Japan, Asia, preprint, 20 authors.
risk of death, 8.8% lower, RR 0.91, p = 1.00, treatment 9 of 74 (12.2%), control 26 of 195 (13.3%).
risk of mechanical ventilation or ECMO, 17.1% higher, RR 1.17, p = 0.76, treatment 4 of 74 (5.4%), control 9 of 195 (4.6%).
hospitalization time, 27.3% higher, relative time 1.27, p < 0.001, treatment 74, control 195.

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.
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