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 ground-breaking development in our fight against the disease, and the speed at which researchers have progressed finding an effective treatment is truly remarkable. It shows the importance of doing high quality clinical trials and basing decisions on the results of those trials.”
Study: Dexamethasone Reduces Death In Hospitalized Patients With Severe Respiratory Complications of COVID-19
06/16/2020
Results of a large trial show that the inexpensive and widely used steroid dexamethasone has the potential to save lives in patients with severe cases of COVID-19.
In what some scientists are calling a “major breakthrough” in the coronavirus pandemic, dexamethasone, which is used to reduce inflammation for a variety of conditions, including several ophthalmic applications, was shown to reduce death rates by around a third among the most severely ill COVID-19 patients.
In the UK-based RECOVERY trial, total of 2,104 patients were randomized to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for 10 days and were compared with 4,321 patients randomized to usual care alone. Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).
Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; P=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; P=0.0021). There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75; P=0.14).
Based on these results, 1 death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone.
Given the public health importance of these results, the researchers are now working to publish the full details as soon as possible.
“Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result,” 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 news release. “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.”
Martin Landray, Professor of Medicine and Epidemiology at the Nuffield Department of Population Health, University of Oxford, one of the chief investigators, stated, ‘Since the appearance of COVID-19 6 months ago, the search has been on for treatments that can improve survival, particularly in the sickest patients. These preliminary results from the RECOVERY trial are very clear – dexamethasone reduces the risk of death among patients with severe respiratory complications. 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.”