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A cheap and widely available steroid can help save the lives of patients seriously ill with coronavirus, a trial has found.
The drug, dexamethasone, is a major breakthrough in the fight against the virus, UK experts say. Here’s what we know about it so far.
What is it?
Dexamethasone is a steroid drug that works to reduce inflammation. It has been used to treat a number of different conditions, including rheumatoid arthritis and asthma.
The drug is also used in end-of-life care and can work to prevent the immune system from destroying blood platelets in people with blood disorders.
Patients with a brain tumour may also be prescribed dexamethasone to reduce swelling around the tumour.
When was it created?
The drug was developed in 1957 and was first approved for medical use by the Food and Drug Administration in the US in 1958.
How much does it cost?
Dexamethasone is relatively cheap, with researchers saying the cost of a course of treatment for people seriously ill with coronavirus is about £40.
The NHS now plans to make the drug available to all patients in hospital who will benefit from it. Dexamethasone is also available globally at cheap prices, meaning poorer countries will benefit.
How was the UK trial conducted?
A team from the University of Oxford recruited 2,104 patients who received 6mg of dexamethasone once a day either orally or by intravenous injection for 10 days. Their outcomes were compared with a control group of 4,321 patients.
How big a breakthrough is this?
It was hailed a “major breakthrough” in the fight against Covid-19 by scientists and politicians.
Researchers estimate if they had known what they now know about the steroid at the start of the pandemic, 4,000 to 5,000 lives could have been saved.
What did the trial prove?
The mortality rate of those with Covid-19 who end up on a ventilator is above 40%, but this figure was reduced by a third among those prescribed dexamethasone.
It also cuts the risk of death by a fifth for those on oxygen and was described by researchers as “statistically significant”.
Based on the results, one death would be prevented by treatment of around eight patients on ventilators, or around one in every 25 patients requiring oxygen alone.
Does it help treat coronavirus generally?
There was no benefit in those patients who were in hospital with Covid-19, but whose lungs were working sufficiently well not to need oxygen or a ventilator.
The government’s chief scientific adviser Sir Patrick Vallance said during Tuesday’s Downing Street press conference that the steroid does not stop people from catching coronavirus.
Researchers warned it has not been studied in patients in the community, and people should not be taking dexamethasone for Covid-19.
Will it be widely used?
It’s readily available in hospitals and should now become “standard of care” in Covid-19 patients on ventilators or oxygen, according to researchers.
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.
What do the experts say?
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”.
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.”
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.”
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”.