Trump’s medical team at the Walter Reed National Military Medical Center announced last weekend that the president had taken the antiviral drug remdesivir produced by Gilead, the Regeneron antibody cocktail and the steroid dexamethasone in recent days.
The US president may be the only patient with Covid-19 to receive all three treatments, said Dr. Leana Wen, a former Baltimore health commissioner. She added that this could be due to a phenomenon known as “VIP syndrome”, in which the pressure to treat very important patients can lead to the use of experimental treatments and possible errors.
“During my work in the emergency room, of course, I treated a number of people considered VIPs,” said Wen, an emergency physician and professor of public health at George Washington University.
“These patients are expected to receive the best treatment, but often the result is that they are overtreated and there is a risk associated with this,” the doctor added.
The new drug administered to Trump is Regeneron’s experimental monoclonal antibody treatment, which was offered to hundreds of other patients in a clinical trial and has not yet been authorized by the Federal Food and Drug Administration.
Earlier last week, Regeneron announced that its treatment was relieving symptoms and reducing the viral load in outpatients who had mild to moderate forms of Covid-19. The conclusion is based on the results of a study of 275 non-hospitalized Covid-19 patients.
But the average age of patients in the study was 44, Renegneron said, well below President Trump’s 74 years.
The company said it is still testing the drug to treat hospitalized patients and to prevent infection of people who have been exposed to a patient.
The use of the steroid dexamethasone also raises questions. The cheap and widely available drug has been used in clinical trials to reduce the risk of death for patients with severe forms of Covid-19. But it can increase the risk of death when given to patients who do not have severe forms of Covid-19, according to the World Health Organization.
Dr. Lewis Kaplan, president of the Society of Critical Care Medicine and a surgeon at the University of Pennsylvania Hospital, said VIP syndrome occurs when “there is a deviation from the usual care process.”
However, it is difficult for Kaplan and other outsiders to consider whether this is the case with Trump, given that there are questions about whether the White House administration accurately communicated information about the president’s health, Kaplan said.
If Trump’s illness is serious, then the treatment may be justified, but if the president recovers quickly, then he could be treated excessively, Kaplan said.
“That could mean he’s much sicker than he was, or it’s a judgment based on the fact that he’s the head of state. We just don’t know,” Kaplan said.
Trump’s availability for experimental drugs is well known. At the start of the pandemic, Trump publicly pressured the FDA to urgently approve the use of hydroxychloroquine. The prescription for the 60-year-old drug rose by 2,000% in March. But further studies have shown that the drug hastened the deaths of some patients, and the FDA withdrew its emergency authorization in June.
Trump has not been prescribed hydroxychloroquine to date.