# LOC-IMPAACT Leadership GroupPharmacokinetics and Safety of Remdesivir for Treatment of COVID-19 in Pregnant Women in the US

> **NIH NIH UM1** · JOHNS HOPKINS UNIVERSITY · 2020 · $942,554

## Abstract

PROJECT SUMMARY
Remdesivir, the first drug with preliminary evidence of efficacy for treatment of COVID-19, has recently been
awarded Emergency Use Authorization from the FDA for use in hospitalized patients with documented COVID-
19. There are no documented pharmacokinetic (PK) and limited safety data available regarding use in
pregnancy. The physiological changes associated with pregnancy can have a dramatic impact on drug
disposition, and use of therapeutic agents during pregnancy poses unique safety concerns. The aims of the
proposed Phase IV prospective, open label, non-randomized study are to evaluate the PK (Specific Aim 1) and
safety (Specific Aim 2) of remdesivir provided through a compassionate use program or open access protocol
in 20 hospitalized pregnant women for treatment of symptoms related to COVID-19, using a well-established
study approach and leveraging the extensive infrastructure of the NIH-sponsored International Maternal
Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Network and in collaboration with Gilead Sciences. The
study will be conducted at multiple experienced IMPAACT-affiliated sites in the US with proven access to the
study population. Hospitalized pregnant women >18 years of age with COVID-19 scheduled to receive
remdesivir as part of clinical care will be eligible for enrollment if willing and able to provide informed consent or
if a legally recognized representative can do so on her behalf. The primary outcome measure will be a
comparison of remdesivir PK parameters from study participants (pregnant women) with those in non-pregnant
adults. The primary PK endpoints are remdesivir and its major metabolite, GS-441524, AUC0-24h at Day 1, and
GS-441524 AUCtau after last dose. Intensive and sparse sampling remdesivir concentrations will be used in a
population PK analysis to assess the impact of covariates such as stage of pregnancy and severity of COVID-
19 disease on remdesivir PK parameters. Plasma remdesivir and GS-441524 concentrations will be quantified
in the laboratory being used for ongoing Gilead-supported studies of remdesivir in non-pregnant adults,
ensuring comparability. At entry and after the last dose, safety monitoring will include liver and renal function
tests and complete blood count (if not obtained within 24 hours for clinical care) and medical record abstraction
for other laboratory test results and clinical events. Medical record abstraction for laboratory test results and
clinical events will also be performed at 4 weeks postdosing and after labor and delivery. The proposed study
will provide urgently needed pregnancy-specific clinical pharmacology data that will ensure that remdesivir can
be used safely and effectively in pregnant women as rapidly as possible. This research could also serve as a
model to rapidly provide pregnancy PK and safety data for other COVID- therapeutics as they become
available.

## Key facts

- **NIH application ID:** 10174121
- **Project number:** 3UM1AI068632-14S2
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Sharon A Nachman
- **Activity code:** UM1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $942,554
- **Award type:** 3
- **Project period:** 2020-09-11 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10174121

## Citation

> US National Institutes of Health, RePORTER application 10174121, LOC-IMPAACT Leadership GroupPharmacokinetics and Safety of Remdesivir for Treatment of COVID-19 in Pregnant Women in the US (3UM1AI068632-14S2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10174121. Licensed CC0.

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