Low doses of a long-used steroid known as dexamethasone could be the solution to improving the chances of patients who become seriously ill from COVID-19 infection and require some kind of breathing assistance.
Low doses of a long-used steroid known as dexamethasone could be the solution to improving the chances of patients who become seriously ill from COVID-19 infection and require some kind of breathing assistance.
A recent study conducted by researchers at Oxford University showed that low doses of the common medication provided to hospitalized patients suffering from the novel coronavirus reduced deaths by about one-third in patients who were on ventilators. The drug, which is widely available and has a low-cost, also reduced death by about one-fifth in patients who were receiving oxygen, the researchers said. Patients who did not require respiratory assistance saw no benefit, according to the report.
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In March, Oxford researchers launched the RECOVERY (Randomized Evaluation of COVid-19 thERapY) study to test low doses of the steroid. The study randomized 2104 patients to receive 6 mg of dexamethasone for a period of 10 days. Their results were compared to 4,321 patients who received what has become usual care. The Oxford University research showed that among the patients who used the usual care alone, the 28-day mortality was highest in those who required ventilation, 41%, and intermediate in patients who required oxygen assistance, 25%. The use of dexamethasone cut these rates to 28% and 20%, respectively.
The low-dose steroid reduced inflammation caused by the disease that could lead to the cytokine storm seen in seriously ill patients. Other drugs are being studied to reduce inflammation in COVID-19 patients, including some rheumatoid arthritis treatments, including Eli Lilly’s Olumiant, Roche’s Actemra and Regeneron and Sanofi’s Kevzara.
The benefit of the steroid was lowest among those who did not require breathing assistance, the study showed. Based on these results, the researchers estimated that one death would be prevented by treatment of around eight ventilated patients or around 25 patients requiring oxygen alone, Oxford said in its announcement.
Full details of the Oxford study have yet to be published, but the researchers are planning to do so as soon as possible.
Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine at Oxford and an investigator in the trial, said dexamethasone is the first drug that shows improved survival in COVID-19.
“This is an extremely welcome result. The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become the standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide,” Horby said in a statement.
Martin Landray, another researcher in the study and also Professor of Medicine and Epidemiology at the Nuffield Department of Population Health, said the preliminary results from the RECOVERY trial are clear in showing that dexamethasone reduces the risk of death among patients with severe respiratory complications.
“It is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide,” Landray said in a statement.
