Published on 17 June 2020

Dexamethasone is now available for use after tests showed it reduced risk of death in patients with severe respiratory complications related to Covid-19.

Medical research to find new treatments usually takes years from trials to the process of being certified for use.

However, following the status of Covid-19 being recognised as a worldwide pandemic earlier this year researchers have been hard at work looking for potential treatments – with the end goal being to find a cure.

The NHS this week announced they would be using dexamethasone to treat people on ventilators with severe respiratory complications related to Covid-19.

The availability of the treatment could be welcome news for people with diabetes following a previous report from the NHS that revealed people with the condition could be at a higher risk of severe complications from contracting Covid-19.

A statement from the NHS said: “Thanks to NHS staff and patients who participated in the RECOVERY trial for dexamethasone. From now, we are able to use this drug to dramatically improve Covid-19 survival for people in hospital requiring oxygen or ventilation.”

An image of the Covid-19 molecule.

Sir Simon Stevens, Chief Executive Officer, NHS England and NHS Improvement, said: “NHS hospitals, researchers and clinicians have worked together at breakneck speed to test new treatments for Covid-19, and it is amazing to see work that would normally take years bear fruit in just a matter of months.”

Dexamethasone is a form of steroid, an anti-inflammatory medicine used to treat a range of conditions.

The RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial was established by researchers at Oxford University in March – around the time people around the UK were advised to stay at home where possible as part of lockdown restrictions to prevent further spread of the virus.

The randomised clinical trial set out to test a range of potential treatments for Covid-19, including low-dose dexamethasone (a steroid treatment).

More than 11,500 patients were enrolled in the study from more than 175 NHS hospitals in the UK.

Recruitment to the dexamethasone trials ended on 8th June as the trial Steering Committee recommended that a sufficient number of patients had been enrolled to establish whether or not the drug had a meaningful benefit.

A new treatment is available now for patients with Covid-19 following successful trials

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.”

As part of the randomised study a total of 2,104 patients received dexamethasone 6mg once per day (either by mouth or by intravenous injection) for 10 days and were compared with 4,321 patients randomised to their existing care routine 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%).

A third of deaths were reduced in ventilated patients taking dexamethasone and by one fifth in other patients receiving oxygen only. There was no benefit reported in patients who did not require respiratory support.

Based on these results, one death would be prevented by treatment of around eight ventilated patients, or around 25 patients requiring oxygen alone.

Researchers are now working to publish the full details as soon as possible, given the public health importance of these results.

Martin Landray, Professor of Medicine and Epidemiology at the Nuffield Department of Population Health, University of Oxford, one of the Chief Investigators, said: “Since the appearance of Covid-19 six 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 pandemic – it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide.”

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.”

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