A cheap and widely accessible steroid called dexamethasone has been shown to reduce deaths by up to one-third of hospitalized patients that are seriously ill with Covid-19, according to a trial carried out by Oxford University in the UK.
Even though dexamethasone was only shown to be effective in extremely sick Covid-19 patients, especially those on a ventilator, the researchers claim the drug has the potential to “immediately to save lives worldwide".
“Dexamethasone is the first drug to be shown to improve survival in Covid-19. This is an extremely welcome result," Peter Horby, one of the chief investigators for the trial and a Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine at the University of Oxford, said in a statement.
“The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients," he added, noting "Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”
The findings come from the University of Oxford's RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial, which has carried out a range of randomized clinical trials of potential treatments for Covid-19 on over 11,500 patients from over 175 hospitals in the UK.
As one arm of the trial, a total of 2,104 patients were given a low-dose dexamethasone treatment once per day, either by mouth or by intravenous injection, for 10 days. These patients’ outcomes were compared with 4,321 control patients who received standard care alone. Dexamethasone was found to reduce the deaths of patients on ventilators by one-third, and deaths of patients receiving oxygen only by one-fifth. There was no benefit of the steroid treatment for patients who did not require respiratory support, however.
The RECOVERY trial is also testing out the efficacy of Lopinavir-Ritonavir (commonly used to treat HIV), Azithromycin (a commonly used antibiotic), Tocilizumab (an anti-inflammatory treatment given by injection), convalescent plasma (antibody-rich blood plasma collected from donors who have recovered from Covid-19), and Hydroxychloroquine (a controversial anti-malarial drug that's recently lost its emergency use authorization from the US' FDA).
Dexamethasone is a corticosteroid medication that’s used to reduce inflammation. It’s used in the treatment of a range of immune-mediated inflammatory diseases, such as skin diseases, severe allergies, and asthma. Best of all, the drug is relatively accessible and low cost, raising hopes it could become a viable treatment for Covid-19 in a real-world setting.
“It is particularly exciting as this is an inexpensive widely available medicine,” said Sir Patrick Vallance, the UK Government’s Chief Scientific Adviser.
The results — which have not yet been formally peer-reviewed — have been widely hailed as "extremely encouraging" and "ground-breaking" by independent experts not directly involved in the research. The scientists working on the trial are looking to publish their results shortly and are already sharing their findings with regulators internationally.
“Now we have to wait for the full results to be peer-reviewed and remember that it is not a cure for all, just one more tool," commented Dr Ayfer Ali, an independent researcher specializing in drug repurposing at Warwick Business School in the UK.