Inexpensive steroid dexamethasone ‘biggest breakthrough’ in treating Covid

Britain's National Health Service (NHS) will on Wednesday start giving coronavirus patients on ventilators a steroid that has cut deaths by a third in clinical trials.

Prime minister Boris Johnson on Tuesday hailed as "the biggest breakthrough yet" in the search for a long-term solution to the pandemic the discovery that dexamethasone, a 60-year-old anti-inflammatory drug that costs just £5 a day, can save lives among those most seriously affected by coronavirus.

A trial of more than 6,000 patients, one third of whom were given dexamethasone, showed the drug reduced deaths among coronavirus patients on ventilators by 30 per cent.

It also reduced deaths among patients receiving oxygen, although not by as big a margin, but had little effect on patients who were not showing serious respiratory symptoms.

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Peter Horby, an infectious disease specialist who is one of the leaders of the trial, said dexamethasone was the only drug that has so far shown to reduce mortality, adding that it reduces it significantly.

“It is a major breakthrough. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide,” he said.

Dexamethasone is one of a number of drugs being investigated by the Recovery study, the world’s largest randomised trial of potential coronavirus treatments. The trial concluded two weeks ago that hydroxychloroquine, a drug praised by US president Donald Trump as a possible treatment, had no beneficial effect on patients hospitalised with coronavirus.

The study found that dexamethasone prevented death in one in eight patients on ventilators, and one in 25 patients requiring oxygen. It compared outcomes of 2,100 patients who were randomly given the drug with those of around 4,300 who were not.

“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,” Prof Horby said.

Full course

The drug is administered for 10 days so a full course of treatment would cost the NHS £50 and the drug is even cheaper in countries such as India. It is already used within the NHS to reduce inflammation caused by arthritis, asthma and some skin conditions.

The fact that it is most effective in treating coronavirus patients on ventilators suggests it may help to stop the damage when the body’s immune system goes into overdrive.

Mr Johnson, who promised 12 weeks ago that Britain would have turned the tide against coronavirus by now, heralded the breakthrough as evidence that this was happening.

“We are now starting to see – with drugs like dexamethasone and the idea that perhaps you could combine that with other things – we are seeing the first chink of light, which I was perhaps a bit dubious about.

“We are seeing the first chink of light, and the hope that there will be preparations, treatments – there already are – that could make a big difference to mortality rates, and we are making big investments in vaccines.”