For nearly four years, Heni Retno Wulan, a doctoral student at the Faculty of Medicine, Public Health, and Nursing of Universitas Gadjah Mada (FK-KMK UGM), conducted research on the use of therapeutic drugs for COVID-19.
During the pandemic, healthcare institutions were encouraged to apply various emergency therapies, including remdesivir and oseltamivir, both of which were administered under the government’s Emergency Use Authorization (EUA). However, the selection of these drugs was based on incomplete evidence, highlighting the need for periodic evaluation.
Wulan decided to conduct an in-depth study on clinical experiences in real-world settings. She analyzed patient data from Dr. Sardjito General Hospital using a retrospective cohort design, reviewing historical data to assess the performance of the antiviral drugs remdesivir and oseltamivir in actual clinical conditions.
Her findings revealed that remdesivir was most effective when administered during the early phase of infection, specifically within the first seven days of symptom onset. At this stage, viral replication remains dominant while the inflammatory response is still limited.
“When administered after seven days, the drug’s effectiveness decreases, especially among patients with severe and critical conditions,” said Wulan, who is also a physician, during her open doctoral defense held at FK-KMK UGM on Wednesday (Oct. 1).
In her dissertation titled “Effectiveness and Safety of Remdesivir Compared to Oseltamivir in Severe and Critical COVID-19 Patients at Dr. Sardjito General Hospital,” Wulan noted that 93 percent of remdesivir binds to albumin, a blood protein.
However, most severe and critical COVID-19 patients suffer from hypoalbuminemia (low albumin levels in the blood).
She recommended that improving albumin levels should be part of the treatment protocol before administering remdesivir.
“For clinical practice, administering remdesivir early (especially within the first seven days of symptoms) helps suppress viral replication more effectively, followed by oseltamivir treatment,” she emphasized.
Reflecting on post-EUA conditions, Wulan underlined that the effectiveness of remdesivir is not superior to that of oseltamivir. Therefore, she suggested that its use be prioritized for specific patient groups or replaced with alternative, more effective therapies.
At the conclusion of the examination, the board of examiners declared Wulan had passed with cumlaude distinction. She officially earned the title of Doctor of Medicine and Health Sciences, becoming the 6,683rd doctoral graduate from UGM.
Her supervisor, Professor Yanri, commended her dedication and perseverance throughout the research process.
“This topic is highly complex, yet she has successfully integrated clinical and pharmacological knowledge. Hopefully, her findings will serve as a template for more accurate assessment and treatment strategies,” said Professor Yanri.
Author: Hanifah
Editor: Gusti Grehenson
Post-editor: Rajendra Arya
Illustration: Freepik