Early Results Show Benefit Of Steroid For Very Sick COVID-19 Patients
Jun 18 2020
"It's on nearly every pharmacy shelf in every hospital, it's available throughout the world, and it's very cheap", said Peter Horby of Oxford University, one of the leaders of the trial that randomly assigned 2,104 patients to get the drug and compared them with 4,321 patients getting only usual care. After the 28-day trial, dexamethasone treatment cut deaths by 35% in patients on IVLs and by 20% in those on oxygen treatment.
Britain's health minister said the state-run health service would immediately start using the drug for the most severe COVID-19 patients and had stockpiled 200,000 courses of the treatment.
Chief investigator professor Peter Horby said, "This is the only drug so far that has been shown to reduce mortality - and it reduces it significantly". Another set of 4,321 patients were given usual care without the dexamethasone.
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".
RECOVERY is a United Kingdom -based pragmatic trial in which hospitalized patients are randomized to various open-label treatments: besides dexamethasone, these include tocilizumab (Actemra), convalescent plasma, azithromycin, and lopinavir/ritonavir (Kaletra); hydroxychloroquine was also being tested until enrollment in that arm was stopped earlier this month, after it failed to show any benefit.
"I assume the majority of people used dexamethasone, but it's not the only one that people could have used", he said.
Dexamethasone was most useful for the ventilated patients; deaths for this group dropped by about one-third with drug treatment.
As of May 30, the CDC cites cardiovascular disease (32%), diabetes (30%) and chronic lung disease (18%) as the most common underlying health conditions among a group of diagnosed COVID-19 patients in the U.S. for whom information on such conditions was available. Corticosteroid medications are also commonly used for treating auto-immune diseases, by reducing the body's inflammatory response.
The World Health Organisation (WHO) expressed its delight over the initial clinical trials of steroid dexamethasone, which has been termed as a scientific breakthrough in the fight against COVID-19 and the results showing that the drug can be used to save critically ill patients. These are the high-risk patients that dexamethasone could help.
The RECOVERY trial organizers say they chose to make their announcement by news release because of "the public health importance of these results". Trial results haven't shown that it can reduce mortality, according to the BBC.
The benefit was only seen in patients seriously ill with COVID-19, and was not observed in patients with milder disease, World Health Organization said. The Oxford results would persuade him to try them for COVID-19 patients needing extra oxygen, he said.
"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".
"The drug is easily available here".
Its goal was to test a variety of possible coronavirus treatments, and it enrolled 11,500 patients in the UK.