Dexamethasone: Scientists claim low-cost drug saved lives of Covid-19 patients in trial, others seek more data
For the first time, scientists claim to have found a cheap and widely available drug that may rescue the sickest Covid-19 patients. According to preliminary data from a large human trial, the medication cut deaths by a third for patients hooked to ventilators, and by a fifth in those needing oxygen support. The UK scientists evaluated a steroid named dexamethasone, which is used to treat rheumatoid arthritis, asthma, and some cancers, in their trial dubbed RECOVERY. However, some experts said they are yet to see data to support the drug's survival benefits.
"Steroids are cheap. And with more data made available, ICU doctors are likely to employ in mechanically ventilated patients who are not improving. Also, steroids are universally available. So I make an appeal to RECOVERY trial investigators to make the data available as soon as possible" Dr Nahid Bhadelia, an infectious diseases physician and the medical director of Special Pathogens Unit at Boston University School of Medicine, tweeted.
Calling the announcement "tremendous news", the UK Government’s Chief Scientific Adviser, Sir Patrick Vallance, said that dexamethasone is the first drug to reduce mortality from Covid-19. The researchers tested the drug on 2,104 patients, who received a single six mg dose for ten days. Their progress was then compared with 4,321 patients in the control arm. Their results showed that therapy could prevent one death for every eight ventilated patients, and one for every 25 patients requiring oxygen alone. However, dexamethasone did not appear to benefit patients with milder symptoms.
"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," Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial, said in a statement.
Reacting to the development, surgeon, writer, and public health researcher, Atul Gawande tweeted, saying it was unacceptable to "tout study results by press release without releasing the paper." Dr Suraj Saggar, chief of infectious disease at Holy Name Hospital in Teaneck, New Jersey, told NBC News, "I really would like to see the article itself and go through the statistics. When you apply therapies like this to a large number of patients, I want to be certain that there is a therapeutic effect and no adverse effects."
How does dexamethasone help?
An infection with Covid-19 could over-activate the immune system, spelling trouble for patients. In severe disease, inflammation and clotting seem to lead to lung injury, Dr Bhadelia explained. So steroids may help because they tamp down the immune response. But earlier trials on steroids have shown mixed results. What is more, these drugs may lead to secondary bacterial infections and increase the viral load, fear a few experts. To put all doubts to rest, Dr Bhadelia urged the investigators to release their data as soon as possible.
The RECOVERY trial is evaluating a few potential drugs: anti-HIV Lopinavir-Ritonavir, antimalarial Hydroxychloroquine, antibiotic Azithromycin, anti-inflammatory Tocilizumab, and plasma therapy. Over 11,500 patients are a part of the study.