Dexamethasone: UK trial hails 'life-saving' low-cost drug for COVID-19

"Dexamethasone is inexpensive and can be used immediately to save lives"

dexamethasone-covid-reuters A pharmacist displays an ampoule of Dexamethasone at the Erasme Hospital amid the coronavirus disease (COVID-19) outbreak, in Brussels, Belgium | Reuters

Dexamethasone, a low-cost steroid-hormone drug often used by athletes to treat pain has been found to be a life-saving treatment for coronavirus patients by Oxford University’s Recovery Trial.

In a statement by the RECOVERY trial—the world’s largest combined effort to find treatments for COVID-19—Chief Investigator Martin Landray says that preliminary results from the trial “are very clear—dexamethasone reduces the risk of death among patients with severe respiratory complications."

According to a news release, of the over 11,500 patients enrolled in the RECOVERY trial, 2,104 were randomised to receive 6mg of dexamethasone once a day (either by mouth or by intravenous injection) for ten days—and this was compared to 4,321 patients randomised to usual care alone.

Noting that among usual-care patients, 28-day mortality was highest among those who required ventilation, the statement says that Dexamethasone reduced deaths by one-third in ventilated patients and by one-fifth in other patients receiving oxygen only. There was no benefit among patients who did not require respiratory support.

“Overall dexamethasone reduced the 28-day mortality rate by 17% (0.83 [0.74 to 0.92]; P=0.0007) with a highly significant trend showing greatest benefit among those patients requiring ventilation (test for trend p<0.001). But it is important to recognise that we found no evidence of benefit for patients who did not require oxygen and we did not study patients outside the hospital setting,” the release said.

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, “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.”

“Based on these results, 1 death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone,” the release said.

Dexamethasone is a well-known and well-stocked drug, costing about £5 a patient according to the BBC. “Essentially, it costs £35 to save a life,” Landray told the BBC.

“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,” Landray said in the release.

UK Secretary of State for Health & Social Care Matt Hancock posted about the trial results on Twitter, saying he was delighted to announce the first successful clinical trial for a life-saving COVID-19 treatment.