The affordable and accessible drug dexamethasone can help save the lives of many critically ill patients diagnosed with coronaviruses, claim British scientists. According to the researchers, the addition of dexamethasone to the treatment regimen reduces the risk of fatal outcomes by 33% in patients on mechanical ventilation (MV) and by 20% in patients on extracorporeal membrane oxygenation (ECMO).
Clinical trials of dexamethasone in the treatment of patients with coronavirus infection are part of a global effort to identify the most effective drugs among those already available for the treatment of Covid-19. Researchers estimate that up to 5,000 lives could have been saved in the UK if dexamethasone had been used to treat “severe” patients from the start of the pandemic. Because the drug is inexpensive, its effectiveness in fighting coronavirus is particularly relevant for poor countries with a high number of cases.
Statistics show that 19 out of 20 patients with coronavirus infection do not require hospitalization. The majority of hospitalized patients recover, and only a small proportion of patients require lung ventilation or oxygen therapy. According to scientists, dexamethasone shows significant efficacy in the treatment of critically ill patients. Dexamethasone is already used in several inflammatory conditions. Scientists have found that the drug can help minimize damage to the body caused by hyperactivation of the immune system in the fight against coronaviruses. Hyperactivation of the immune system is dangerous because it causes a “cytokine storm” that can be fatal.
In clinical trials of the drug led by researchers at the University of Oxford, approximately 2,000 patients in hospitals received dexamethasone as part of their treatment. The results of their treatment were compared with the results of treatment of another 4,000 patients who were not prescribed dexamethasone. Dexamethasone was shown to reduce the risk of death from 40% to 28% in patients on mechanical ventilation and from 25% to 20% in patients on extracorporeal membrane oxygenation (ECMO).
The drug may help patients in intensive care units. We explain quickly, simply, and clearly what happened, why it matters, and what happens next. The number of episodes should remain the same. End of story. Podcast advertising.
The leader of the Oxford research group, Professor Peter Horby, says dexamethasone has shown significant efficacy: “So far, this is the only drug that has helped to significantly reduce the risk of a fatal outcome. It’s a major breakthrough. One of the leading researchers, Professor Martin Landry, states that one in eight patients on mechanical ventilation can be saved thanks to dexamethasone, and one in 20-25 patients on oxygen therapy. “The course is designed for 10 days of treatment and costs 5 pounds sterling (about 430 rubles) per patient. The average cost of saving a life is 35 pounds sterling. This drug is available worldwide,” says Martin Landray.
According to the scientist, it is necessary to immediately prescribe dexamethasone to seriously ill patients. It does not make sense to use it for the treatment of a mild form of the disease, the expert notes. According to Martin Landray, dexamethasone does not help patients with mild symptoms of Covid-19. It is needed for those who have difficulty breathing.
Trials of existing drugs for the treatment of Covid-19 have been underway since March. These included a trial of an antimalarial drug, hydroxychloroquine. Its use was abandoned due to concerns that it increased the risk of death and could provoke the development of heart disease. Another drug that has been tested is remdesivir, an antiviral drug that is expected to shorten the treatment time for patients with Covid-19 and help them recover faster and return to normal life.
Fergus Walsh, BBC medical correspondent The first drug with proven effectiveness against Covid-19 is not a new and expensive drug. It is an old, cheap glucocorticosteroid. And that is something to be happy about, because it means that patients around the world will now be able to benefit from this medicine. That is why the most important results of the clinical trials were announced immediately. Dexamethasone has been used since the early 1960s to treat a variety of conditions, including rheumatoid arthritis and asthma. Approximately half of patients with Covid-19 who require ventilator support do not survive. Reducing the risk of a fatal outcome by 33% is therefore of immense importance. In the intensive care unit, the drug is administered intravenously, while milder patients take it in tablet form.
Another drug that has been shown to be effective in treating patients with Covid-19 is remdesivir, an antiviral drug previously used to treat Ebola fever. Remdesivir has demonstrated efficacy by reducing the duration of symptoms from 15 to 11 days. However, there are no data to prove the effectiveness of this drug in reducing mortality. Unlike dexamethasone, remdesivir is a new drug with a limited number of suppliers, and its price has not yet been announced.