‘Remarkably cheap’ steroid called dexamethasone can improve COVID-19 survival, researchers say

Researchers in England said they have the first evidence that a drug can improve COVID-19 survival: A cheap, widely available steroid called dexamethasone reduced deaths by up to one third in severely ill hospitalized patients.

The results were announced Tuesday and the British government immediately authorized the drug's use across the United Kingdom for coronavirus patients like those who did well in the study. Researchers said they would publish results soon, and several independent experts said it's important to see details to know how much of a difference the drug, dexamethasone, might make and for whom.

But “bottom line is, good news,” said the United States’ top infectious disease expert, Dr. Anthony Fauci. “This is a significant improvement in the available therapeutic options that we have.”

The study, led by the University of Oxford, was a large, strict test that randomly assigned 2,104 patients to get the drug and compared them with 4,321 patients getting only usual care.

Coronavirus need-to-knows:Florida among dozens of states seeing daily increases in cases

The drug was given either orally or through an IV for 10 days. After four weeks, it had reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those only needing supplemental oxygen. It did not appear to help less ill patients.

Researchers estimated that the drug would prevent one death for every eight patients treated while on breathing machines and one for every 25 patients on extra oxygen alone.

“Those are big effects," said one study leader, Dr. Martin Landray at Oxford. “It’s not a cure, but it’s certainly a long way forward.” It's especially good news that the drug “is remarkably cheap, perhaps $20 or $30 for an entire course of treatment,” he added.

Steroid drugs reduce inflammation, which sometimes develops in COVID-19 patients as the immune system overreacts to fight the infection. This overreaction damages the lungs and can prove fatal. The World Health Organization and others advise against using steroids earlier in the course of illness because they can impede clearing the virus.

“Early on, you’re fighting the virus and you want your immune system to be as intact as possible,” Fauci explained. But in the advanced stage of COVID-19, the battle against the virus causes so much inflammation that it “is hurting you more than helping you,” he said. The results seen in the Oxford study make “perfect sense” with that notion, he said.

'Countless lives will be saved globally'

Many hospitals and doctors have been trying steroids to quell the immune system, but there's been no evidence from high-quality studies that it helps for COVID-19.

Until now, the only drug shown to help is remdesivir, an experimental drug from Gilead Sciences that blocks an enzyme the virus uses to copy its genetic material. Remdesivir shortened the time to recovery for severely ill hospitalized patients by 31% to 11 days on average versus 15 days for those just given usual care, in a study led by the U.S. National Institutes of Health.

“We don’t know yet” if remdesivir could be used with dexamethasone or before or after it to give more benefit, Fauci said.

Even though dexamethasone only helps in severe cases, “countless lives will be saved globally,” said Nick Cammack, a virus expert at the Wellcome Trust, a British charity that supports research.

“This is the dream,” because the drug has been used for decades for other conditions, said Cammack, who had no role in the study. “It’s very straightforward to make so there’s no reason this can’t be rolled out for the entire world.”

No information was given on side effects, but researchers said they used a low dose and for a short time, which is generally safe.

Dr. Peter Bach, a health policy expert at Memorial Sloan-Kettering Cancer Center in New York, noted that 41% of those on breathing machines and 25% on oxygen alone died in the study.

“The mortality rate seems to be way higher than it is in the U.S.,” where one recent study found a death rate of 12%, although that was only after two weeks versus four in the UK study, he said.

“We are going to struggle to look at these data and use them for U.S. patients,” he said. But he added that “it’s good news for science that the right studies got done,” and that the drug works and is so affordable and available.

The Oxford study is the same one that earlier this month showed the malaria drug hydroxychloroquine was not working against the coronavirus. The study enrolled more than 11,000 patients in England, Scotland, Wales and Northern Ireland who were given either standard of care or that plus one of several treatments: dexamethasone; hydroxychloroquine; the HIV combo drug lopinavir-ritonavir; the antibiotic azithromycin; the anti-inflammatory drug tocilizumab; or plasma from people who have recovered from COVID-19 that contains antibodies to fight the virus.

Research is continuing on the other treatments. The research is funded by government health agencies in the United Kingdom and private donors including the Bill and Melinda Gates Foundation.

Dr. Stephen Griffin, of the University of Leeds in England, said treatments that can prevent infection and serious illness are still needed.

“Ideally, we will find something that stops the disease from progressing to a more advanced stage,” he said, noting that remdesivir might yet prove to be effective this way. Dexamethasone “is not a wonder pill, but it will lessen some of the nasty effects of COVID-19.”

Contributing: Maria Cheng from London

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

Hydroxychloroquine:FDA pulls emergency use of malaria drug touted by Trump to treat the coronavirus

When there's a vaccine, how will we make sure everyone gets it? That's the job of state immunization registries.

Source: https://www.usatoday.com/story/news/health/2020/06/16/coronavirus-drug-steroid-dexamethasone-reduce-covid-deaths/3197420001/

News Related


Trump’s ‘mission accomplished’ moment is premature and deadly. We have not defeated COVID.

Desperate for crowds and adoration, Trump has put his most fervent supporters at risk of getting a deadly disease. Future historians will be astonished. Read more »

NFLPA president JC Tretter says NFL is putting season, players at risk with its coronavirus approach

NFL Players Association president JC Tretter said Tuesday the NFL is putting the 2020 season at risk with its coronavirus approach, calling on the league to better “prioritize player safety.” “Like many other... Read more »

Brazilian President Jair Bolsonaro says he tested positive for the coronavirus

RIO DE JANEIRO (AP) — Brazil’s President Jair Bolsonaro says he has tested positive for COVID-19 after months of downplaying the virus’ severity. Bolsonaro confirmed the test results while wearing a mask and... Read more »

Venice Film Festival forges ahead amid COVID-19 pandemic with reduced lineup

The show will go on for the Venice Film Festival in September, but with a few modifications due to the COVID-19 pandemic. Organizers said Tuesday that they are pushing forward with plans for... Read more »

Amtrak offers buy-one, get-one promotion on its sleeper trains amid COVID-19 — with a catch

Amtrak wants you to have sweet dreams the next time you travel — so much so that it’s sweetening the deal on its sleeper “roomettes.” The rail service is offering a buy-one-get-one-free discount... Read more »

Florida teen treated with hydroxychloroquine at home before dying of COVID-19, report says

FORT MEYERS, Fla. – The family of a 17-year-old Florida girl who died last month from COVID-19 treated her symptoms at home for nearly a week before taking her to a hospital, a... Read more »

Mookie Betts worried MLB coronavirus testing woes could prevent him from ever playing for Dodgers

During nearly four months away from the game, Mookie Betts said he “stayed away from baseball to keep myself sane.” It’s not hard to understand why. The 2018 American League Most Valuable Player... Read more »

Tom Hanks doesn’t get ‘how common sense has somehow been put into question’ with coronavirus

Read more »

Can Gov. DeSantis force Florida schools to reopen amid the coronavirus pandemic? Some school leaders seem doubtful.

PALM BEACH, Fla. — As concern about the state order spread online, some school leaders said: Not so fast. As Florida educators puzzle over how to start the new academic year, Gov. Ron... Read more »

Texas surpasses 200,000 coronavirus cases after 4th of July holiday weekend

AUSTIN, Texas – Texas reached 200,000 total COVID-19 cases Monday, just 17 days after crossing the 100,000 threshold, a figure that took the state nearly four months to hit. The grim milestone came... Read more »