A UK clinical trial has concluded that a cheap and widely available steroid can significantly cut deaths among coronavirus patients.
Giving the steroid dexamethasone reduced deaths by one-third for critically ill coronavirus patients who were on ventilators, the researchers found. It cut deaths by 20 percent among patients with COVID-19 who were getting extra oxygen.
“Dexamethasone is the first drug to be shown to improve survival in COVID-19,” Peter Horby, a professor of emerging infectious diseases at the University of Oxford who was one of the chief investigators for the trial, said in a statement Tuesday. “This is an extremely welcome result.”
He told the BBC it was “a major breakthrough.”
The researchers said the steroid should be used widely to treat coronavirus patients, based on the results of the study.
The trial, known as the Randomised Evaluation of COVID-19 Therapy, began in March.
Its goal was to test a variety of possible coronavirus treatments, and it enrolled 11,500 patients in the UK. As part of the trial 2,104 patients were randomly assigned to get 6 milligrams of dexamethasone once a day for 10 days. The results of their treatment were compared with those of 4,321 patients who did not receive dexamethasone.
Researchers found that dexamethasone improved survival among patients on ventilators and patients who needed oxygen. For patients who didn’t need help breathing, the steroid offered no benefit.
“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,” the National Health Service’s medical director, Stephen Powis, said in a statement.
“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.”
Hours after the results of the study were announced, the NHS announced immediate authorization for dexamethasone to be used as a standard treatment for COVID-19 patients.
“From today the standard treatment for COVID-19 will include dexamethasone, helping save thousands of lives while we deal with this terrible virus,” Health Secretary Matt Hancock announced.
The UK approval of the medicine comes before the study’s data has been published in a peer-reviewed journal. Some doctors have raised concerns about releasing scientific results via press release.
The release did not include information on the frequency and severity of side effects from taking these steroids.
A 10-day course of the medicine could raise the risk of infections, said Dr. Taison Bell, an infectious disease and critical care physician at the University of Virginia, said in a Tuesday interview. Bell also said he wanted to see the full data to see if these patients had higher rates of delirium, another potential side effect.
Even with those unanswered questions, Bell said his hospital is considering using the drug before the full data is available, given the urgency of the pandemic. The findings match previous research that found benefits for treating acute respiratory distress syndrome (ARDS) with steroids.
“This is more or less in line with our experience of investigating steroids before in really severe ARDS,” Bell said.
“It seems biologically plausible that you can extend that benefit to patients who have this new cause of the same syndrome,” he said.
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