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A CHEAP STEROID has been hailed as a “major breakthrough” in the fight against Covid-19 in the UK after it was found to reduce deaths by up to a third among patients on ventilators.
The drug, dexamethasone, is readily available in UK hospitals and should now become “standard of care” in Covid-19 patients on ventilators or oxygen, researchers say.
They add that this could be done as soon as later on today, or on Wednesday.
Advice will be going out to all NHS hospitals within the next 24 hours to act on the results, meaning everyone who could benefit from the steroid could get it.
A study found the steroid cut the risk of death by a third for patients on ventilators, and by a fifth for those on oxygen – described by researchers as “statistically significant”.
Researchers estimate that if they had known what they now know about dexamethasone at the start of the pandemic, 4,000 to 5,000 lives could have been saved.
They added that based on their results, one death would be prevented by treatment of around eight patients on ventilators, or around one in every 25 patients requiring oxygen alone.
According to official figures, 395 mechanical ventilator beds were occupied by patients in the UK as of 12 June.
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, described it as “an extremely welcome result”.
“This is the only drug that has so far shown to reduce mortality, and it reduces it significantly. It is a major breakthrough, I think,” he said.
Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.
Martin Landray, professor of medicine and epidemiology at the Nuffield Department of Population Health, University of Oxford, was also one of the chief investigators.
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.”
Prof Landray added: “It’s been around for probably 60 years.
“It costs in the order of £5, £5 for a complete course of treatment in the NHS, and substantially less – probably less than one dollar – in other parts of the world, for example in India.”
Prof Horby said: “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.”
The World Health Organisation has welcomed the initial results.
“This is the first treatment to be shown to reduce mortality in patients with COVID-19 requiring oxygen or ventilator support,” director general Dr Tedros Adhanom Ghebreyesus said this afternoon.
“This is great news and I congratulate the Government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this lifesaving scientific breakthrough.”
Recovery trial
The Recovery trial – which stands for Randomised Evaluation of COVid-19 thERapY – was co-ordinated by scientists from the University of Oxford.
The mortality rate of those who end up on a ventilator is above 40%, but this figure was reduced by a third among those prescribed dexamethasone.
More than 11,500 patients from 175 NHS hospitals have been enrolled on to the Recovery trial since it was set up in March to test a range of potential coronavirus treatments.
In the dexamethasone study, 2,104 patients received 6mg of dexamethasone once a day via either mouth or intravenous injection for 10 days.
Their outcomes were compared with a control group of 4,321 patients.
Over a 28-day period, the mortality rate among those requiring ventilation was 41% and 25% among those needing oxygen.
The mortality rate among those not requiring respiratory intervention was 13%.
However, the study did not see any benefit in those patients who were in hospital with Covid-19, but whose lungs were working sufficiently well.
Prof Landray said: “What we can see is the biggest benefits in those people at the biggest risks, which I guess if you wanted to design a drug is exactly how you’d hope to have the results.”
The researchers warn that the steroid has not been studied in patients in the community, and people should not be taking dexamethasone for Covid-19.
Professor Stephen Powis, NHS England medical director, said: “This is a huge breakthrough in our search for new ways to successfully treat patients with Covid, both in the UK and across the world.
“It is thanks to NHS staff and patients who participated in the trial that from now, we are able to use this drug to dramatically improve Covid-19 survival for people in hospital who require oxygen or ventilation.”
The UK government’s chief scientific adviser Sir Patrick Vallance said: “This is tremendous news today from the Recovery trial showing that dexamethasone is the first drug to reduce mortality from Covid-19.
“It is particularly exciting as this is an inexpensive, widely available medicine.
“This is a groundbreaking development in our fight against the disease, and the speed at which researchers have progressed finding an effective treatment is truly remarkable.”
England’s chief medical officer Professor Chris Whitty said it was “the most important trial result for Covid-19 so far” and “will save lives around the world”.
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This is fantastic news! Well done to everyone involved.
@lambda sensor: Expect more and more treatments to come online in the coming months that will help fight it. Until the vaccine is available this is the best we can hope for.
@Peter Hughes: its a step in the right direction though!
I remember a YouTube video by a guy purporting to be an emergency doc in NYC saying that COVID presented like altitude sickness more than pneumonia. And dex is the thing all the altitude climbers take.
@Crom Cruach: that’s really interesting. well spotted.
@Crom Cruach: Saw that video too, interesting information buddy.
Well done to our UK neighbours on this.
Hat tip to them for that, very welcome news.l
Trump is gonna say he meant dexamethasone all along, not hydroxychloroquine!
Very interesting I was very sick with chest and breathing issues in mid January was off work 2 weeks sick it improved but never really went away and at the time my go wasn’t sure what was wrong with me said it maybe a chest infection yesterday I had a consultation with my Gp explained that the issues had never really gone away and still have issues and what did he prescribe for me steroid inhalers after one day I have improved allready
@Bab Read: is it the steroid used for patients receiving chemo for nausea
@Mary Oliver: Not to my knowledge. It is prescribed to complement many chemotherapies, especially those designed for the various lymphomas. It is also a very potent anti inflammatory with uses in patients with tissues inflamed from radiotherapy. Dex is not without its side effects, especially in high doses. Insomnia, psychosis and mania being the worst, in my opinion. Expect significant weight gain and temporary osteoporosis in medium to high doses.
@Mary Oliver: hi Mary I got given 2 inhalers a blue one contains salbutamol a brown one contains beclometasone dipropionste
@Mary Oliver: hi Mary I got prescribed 2 inhalers a blue one contains salbutamol a brown one contains beclometasone dipropionste
@Damien Mc Padden: I think it was prescribed for my late husband when he was getting chemotherapy the side effects were the same.
@Mary Oliver: yes I have looked it up it was the same one he was prescribed
@Mary Oliver: He and I, both. You have my condolences.
@Damien Mc Padden: thanks Damien he died at Christmas last year
@Mary Oliver: yes it is
Has Donald Trump approved it though?
@Al Fresco: Give it a rest dude
@Al Fresco: Doubt you will hear much there is no profit in it.
@WreckDefier: no
Fantastic news indeed, well done folks.
I could be wrong here, but is dexmethasone not a front-line drug for acute respiratory symptoms already? Perhaps the study is proving something we already know.
@Stephen Deegan: You are correct but until now medicine has largely ignored mast esoteric cells.
Medical students are told they are involved in anaphylaxis, involved in allergies but don’t go wrong by themselves except in the case of the very rare mastocytosis and the exceptionally rare and quickly fatal mast cell leukemia. It looks like ignoring mast cells has been an exceptionally folly and COVID-19 has done us a favour by exposing this.
Here’s a paper on why Dexamethasone works….it is a mast cell stabiliser.
Dexamethasone Rapidly Suppresses IL-33-stimulated Mast Cell Function by Blocking Transcription Factor Activity
https://pubmed.ncbi.nlm.nih.gov/27443878/
@Gavin Tobin: Thanks for that…
I thought I was losing my marbles!
@Gavin Tobin: it all makes sense now!
Fantastic news from our UK neighbours in Oxford. Let us hope their success continues with a vaccine.
Just goes to show what what can be discovered if you’re willing to sacrifice your population to get the numbers in.
Why do I not feel a little bit more elated by this news?
@Are You For Real: your name kinda sums it up
Yet another drug used to treat mast cells is proving useful in the fight against COVID cytokine storm syndrome. First it was famotidine, then nicotine, then Vitamin D, then Vitamin C and now it is dexamethasone.
The elephant in the room for COVID19 CSS risk is the ALREADY prevalent Mast Cell Activation Syndrome (#MCAS) ICD10-D89.40 those little mast cells that doctors are taught almost nothing about are actually very significant players in out day to day health and underlying MCAS helps explain the age risk factor too.
University of Bonn has theorised that 17% of population in Germany already have MCAS at levels varying from very mild to very severe.
Here are some very prevalent linked illnesses.
http://mcas.ie/?page_id=89
@Gavin Tobin: really appreciate your brilliant input.
The journal should be publishing a link to actual studies so that we can read it . I read the whole article and I’m non the wiser about actual numbers of people in the group not taking and the group taking it. I’m also non the wiser as to how many in the group taking it died or not. Saying over a third without any numbers is not good enough . Link the studies in future please .
Won’t be cheap for long…….where there’s a pandemic there’s
…..an opportunity
Funnily enough there was a facebook post going around not so long ago that said Italian doctors had got some success out of using an anti inflammatory drug because the covid was not pnuemonia but massive swelling internally of the lungs but the Journal debunked it as a myth… maybe there was a kernel of truth in it after all
@Michael McGrath: Because Facebook and The Journal are good places to seek critical medical opinion and research on medical treatments?
Won’t be cheap for long…….where there’s a pandemic there’s
@Elvis: there is, isn’t there!
Won’t be cheap for long…….where there’s a pandemic there’s
@Elvis: It’s been out for years and it’s as cheap as chips. It’s being used for all kinds of respiratory and allergy issues in adults and children. The patent ran out years ago, and it’s manufactured by hundreds of companies.
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