The UK is to introduce the corticosteroid dexamethasone rapidly into the treatment of seriously ill Covid-19 patients following the success of a clinical trial, it was announced yesterday.
The drug was among a range of potential treatments for Covid-19 tested in the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial, which includes over 11,500 patients at 175 UK hospitals.
It was chosen because of its anti-inflammatory properties and its previous use to treat anaphylactic shock. It is to be used for future care of patients who require respiratory support.
Among the participants, 2,104 were given dexamethasone at 6mg daily for ten days, orally or by injection.
Compared with patients receiving usual care alone, dexamethasone reduced mortality risk by a third for patients on ventilators, and by a fifth for those on oxygen.
The researchers calculate that one death could be prevented for every eight ventilated patients treated with dexamethasone, or every 25 patients on oxygen treated with dexamethasone.
A hydroxychloroquine arm of the study has already been halted because of lack of efficacy. RECOVERY is also examining the anti-viral lopinavir-ritonavir, the antibiotic azithromycin, convalescent plasma and the anti-inflammatory Tocilizumab.
Research leader Professor Peter Horby of the University of Oxford, UK, said: “Dexamethasone is the first drug to be shown to improve 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 standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”
Co-author Professor Martin Landray added: “Covid-19 is a global disease – it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide.”
Dr Nick Cammack of the UK’s Wellcome Trust commented: “This is a major breakthrough: dexamethasone is the first and only drug that has made a significant difference to patient mortality for Covid-19. While this study suggests dexamethasone only benefits severe cases, countless lives will be saved globally.”
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