By now, most of us have heard of the antiviral medication remdesivir, the first drug that was FDA-approved to treat patients with COVID-19. What many don’t know is that the research that led to remdesivir being identified as a treatment for COVID-19 has an important connection to UAB.

Remdesivir was developed by Gilead Sciences more than 10 years ago, primarily to treat Hepatitis C and respiratory syncytial virus. In 2014, Gilead entered into collaboration with the UAB-led Antiviral Drug Development and Discovery Center (AD3C), headed by Richard Whitley, M.D., distinguished professor at UAB, to study remdesivir against coronaviruses, including SARS and MERS. Gilead provided molecules that were tested at laboratories at Vanderbilt University and the University of North Carolina at Chapel Hill under the aegis of the AD3C. Based on those study results, in 2016-2018, the NIH conducted research of remdesivir against MERS infection in an animal model. These earlier studies enabled remdesivir to more quickly be tested and approved for human use as a treatment for COVID-19 when the 2020 pandemic struck.

Thanks to its UAB connection, UAB was chosen as a site for an NIH-sponsored global clinical trial of remdesivir in March. That same month, Drew McDonald of Trussville, Alabama, started noticing backaches and body pains along with a low-grade fever after dinner on a Friday night. The father of two went to bed and woke up the next morning to a fever of more than 102, and aches that he recalls “hitting” his bones.

“I had just had the flu in February and knew that what I was feeling was just so much more intense and onset than the flu,” McDonald recalls. “I had a gut feeling that it was COVID-19, and after seeking medical attention and self-isolating for several days, it was confirmed that my body was battling this new virus.”

Upon admission to UAB, McDonald was approached by Division of Infectious Diseases physicians about potentially enrolling in the remdesivir clinical trial. “Drew stood out because his immediate inclination when approached about the study was that he wanted to participate to help others who would inevitably be in his position in the future,” says Nathan Erdmann, M.D, who supported enrollment and oversaw the trial during its duration. “The trial process, by definition, involves a degree of uncertainty, and this can be intimidating to potential participants.”

McDonald began an intravenous infusion daily for three or so days before he was healthy enough to be discharged home. Because the trial was randomized, double-blinded, and placebo-controlled, McDonald and his doctors still are unsure if he received remdesivir or placebo as part of his role in the trial. However, McDonald is still glad he could participate in the trial.

“I had confidence in the research being done at UAB. Sometimes we hear conflicting information, whether from social media or different news outlets that we are listening to; but these doctors who are approaching people like me to enroll in a trial live and breathe this every day and truly want to find the answer,” McDonald says. “Helping research in any way, if anyone has the capacity, that’s how we get answers and how drugs get discovered. I’m grateful for all that UAB is doing to help further research and save lives.”

–Savannah Koplon, Adam Pope