Prof helps write global advice on best drug combo
Expert heads up international panel
A Perth professor is at the forefront of new guidelines that rewrite how to save lives in COVID wards globally, crucially identifying the two most effective drugs to give patients.
NHS Tayside consultant and University of Dundee academic Professor James Chalmers heads up an international panel and has been on the frontline in the fight against COVID.
In his role as a respiratory consultant at Ninewells Hospital, he has also seen first-hand the impact the disease has on patients.
Based on an analysis of thousands of studies around the world, Professor Chalmers and colleagues from nine other countries have produced bestpractice guidelines for the treatment of hospitalised COVID-19 patients.
Knowing what doesn’t work is also very important to avoid wasting time and putting patients at risk of side effects Prof Chalmers
They pinpoint an ideal pairing of drugs that can reduce the complications of COVID-19 by up to 40 per cent.
Through the European Respiratory Society’s (ERS) paper, the panel has recommended a combination of two drugs - the rheumatoid arthritis drug tocilizumab used along with the steroid dexamethasone - can greatly lessen
COVID-19 complications among patients who require oxygen or ventilatory support.
They also strongly advise against the use of hydroxychloroquine and a number of other drugs to treat COVID-19.
The panel recommends that all patients should receive blood thinning treatments to prevent blood clots.
And where possible, doctors should use alternatives to ventilators, such as high flow oxygen or tight-fitting face masks.
The panel also recommended against using the HIV drug lopinavir-ritonavir, the antibiotic azithromycin and the gout drug colchicine.
The anti-viral medication remdesivir, which was widely used across the UK last year, is also now not recommended.
Professor Chalmers said: “In the initial scramble to find ways of treating this horrible new disease and, ultimately, save lives, doctors were forced to deploy drugs in the absence of formal guidelines or evidence.
“Because of the contribution of research participants across the world, we now have two drugs that can save lives in hospitals.
“Knowing what doesn’t work is also very important to avoid wasting time and also putting patients at risk of side effects.
He added that “a vast pool” of scientific studies found that hydroxychloroquine does not help COVID-19 patients and it
“may even be harmful” to them.
Of particular concern are patients who experience respiratory failure and require assistance breathing. The panel recommends non-invasive oxygen treatment in the first instance and that intubation and mechanical ventilation should only be used when patients fail to respond to a non-invasive approach.
“Reducing the need for invasive ventilation would be highly advantageous,” continued Professor Chalmers.
He concluded: “ICU resources have been overwhelmed at different stages of this pandemic so we need to be sure that we are using them in the way that will benefit the greatest number of patients.”