Widely Available Drug Improves Survival From COVID-19

Modesto Morganelli
Июня 16, 2020

It's understandable that these researchers would want to get the news out as soon as possible, given the possibility that dexamethasone could, based on the results, save lives immediately.

Low-dose dexamethasone, a "widely available, safe and well-known drug", is the first medicine to be shown to result in a "significant reduction in mortality" in those with COVID-19 requiring oxygen or ventilation, researchers have said. There was no benefit among those patients who did not require respiratory support.

Deaths in the dexamethasone arm were reduced by one-third (RR 0.65, 95% CI 0.48-0.88, P=0.0003) among patients receiving mechanical ventilation, and by one-fifth (RR 0.80, 95% CI 0.67-0.96, P=0.0021) among patients requiring oxygen versus patients receiving usual care, according to a statement from the study's authors.

The result, should it hold up to further scrutiny, shows the benefit of the strategy of Horby and Martin Landray, the Oxford researchers who designed the study, leveraging the United Kingdom health system to start a study of multiple cheap potential Covid-19 therapies - including hydroxychloroquine, dexamethasone, and also some older HIV medicines.

"This is a result that shows that if patients who have COVID-19 and are on ventilators or are on oxygen are given dexamethasone, it will save lives, and it will do so at a remarkably low cost", said Martin Landray, an Oxford University professor co-leading the trial. These patients were part of a clinical trial called RECOVERY (Randomised Evaluation of COVID-19 Therapy) that looked at potential treatments for infected patients.

"It is a major breakthrough", he said.

Dexamethasone can be administered orally or intravenously and works by reducing inflammation in the body and suppressing the immune system, according to Drugs.com. "This is EXACTLY what we need, instead of a $1000 drug like remdesivir that is just marginally effective for shortening illness but not yet fully proven for mortality". The steroid might not be flawless, but the researchers obtained the statistical evidence they needed to conclude the drug should be used in COVID-19 therapies. "These preliminary results from the RECOVERY trial are very clear - dexamethasone reduces the risk of death among patients with severe respiratory complications". These patients' outcomes were compared with 4,321 control patients who received standard care alone. "There is a clear, clear benefit".

Dexamethasone, which has been used since the early 1960s to treat a wide range of conditions such as rheumatoid arthritis and asthma, is a prescription medication that is available as an oral tablet, oral solution, eye drops, and eardrops. So essentially it costs £35 to save a life.

Chris Whitty, chief medical officer for England, described the development as "the most important trial result for COVID-19 so far", and the government's chief scientific advisor, Sir Patrick Vallance, described the trial results as "groundbreaking".

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