Cheap steroid a Covid-19 game-changer
WHO to change guidance after drug shown to cut death rates by third
The World Health Organisation (WHO) said it was moving to update its guidelines on treating people stricken with Covid-19 to reflect the results of a clinical trial in Britain that showed a cheap, common steroid could help save critically ill patients.
Trial results at Oxford University have shown that dexamethasone, used since the 1960s to reduce inflammation in diseases such as arthritis, cut death rates by about a third among the most severely ill Covid-19 patients admitted to hospital.
British Prime Minister Boris Johnson called the result the “biggest breakthrough yet” in treatment of the coronavirus.
“We are seeing the first chink of light,” he said on Tuesday.
“There is a genuine cause to celebrate a remarkable British scientific achievement. We have turned the tide on the virus.”
Scientists at Oxford University who have been conducting trials on a number of drugs since March announced on Tuesday that a 10-day course of dexamethasone lowered the risk of death by a third for people on ventilators.
At present, about 40% of patients with the most severe form of Covid-19 die. It means that for every eight patients placed on ventilators, three people will lose their lives.
But with the steroid, just two will now die. The drug, which can be taken orally or as an injection, also cuts the death rate of people needing oxygen by one-fifth.
The benefit was only seen in patients seriously ill with Covid-19 and was not observed in patients with milder disease.
Sir Patrick Vallance, Britain’s chief scientific adviser, said: “This is a groundbreaking development ... and the speed at which researchers have progressed finding an effective treatment is truly remarkable.”
Scientists said up to 5,000 lives could have been saved in Britain if they had known how effective the drug was at the beginning of the epidemic.
Martin Landray, deputy chief investigator of the trial, from the University of Oxford, said: “The results are sufficiently clear and people can be treated this evening. That’s a major step forward.
“This is not an expensive drug, this is not a drug where there are supply chain issues or manufacturing issues, this is a drug that is globally available, so that is enormously important.”
The results are part of the Recovery trial, which was set up in March.
More than 11,500 patients have been enrolled from more than 175 NHS hospitals, including 2,100 on the dexamethasone trial.
The researchers said the drug should become the standard of care in the most sick patients.
The British government has been stockpiling dexamethasone since March in case trials were successful and there are already supplies for 200,000 patients and enough to cope with a second wave.
The drug, which is commonly used to treat arthritis, severe allergies and asthma, costs just £5 (R108) for a full course of treatment.
The positive news comes as coronavirus infections accelerated in some places including the US and as Beijing cancelled scores of flights to help contain a fresh outbreak in China’s capital.
“This is the first treatment to be shown to reduce mortality in patients with Covid-19 requiring oxygen or ventilator support,” WHO director-general Tedros Adhanom Ghebreyesus said in a statement late on Tuesday.
The agency said it was looking forward to the full data analysis of the study in coming days.
“WHO will co-ordinate a meta-analysis to increase our overall understanding of this intervention.
“WHO clinical guidance will be updated to reflect how and when the drug should be used in Covid-19,” the agency added.
But South Korea’s top health official cautioned about the use of the drug for Covid19 patients.
“It has already long been used in South Korean hospitals to treat patients with different inflammation,” Korea Centres for Disease Control and Prevention head Jeong Eun-kyeong said.
“But some experts have warned of the drug not only reducing the inflammatory response in patients, but also the immune system and may trigger side-effects.
“[The centre] is discussing the use of it for Covid-19 patients. ”—