This Cheap Steriod Could Treat COVID-19
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Since COVID-19 was first identified, scientists around the globe have been hard at work developing and testing potential vaccines. Despite constant efforts, public health experts have acknowledged that — even in a best case scenario — patients should expect to wait at least several months for a viable vaccine.
In the meantime, other teams are conducting trials to determine whether or not existing drugs can help treat COVID-19. These trials have made headlines while failing to identify a suitable treatment — until last week.
A team of UK researchers now believe they’ve identified a potentially life-saving drug. A cheap and widely-available steroid has been shown to improve outcomes for high-risk patients (those requiring ventilators or additional oxygen). Prime Minister Boris Johnson called the breakthrough, “a remarkable British scientific achievement.”
COVID-19 Drug Trials
Two particular antiviral drugs — hydroxychloroquine and remdesivir — have attracted most of the attention throughout the ongoing trials. The former has proven particularly controversial. In early March, a small French study found some promising results with the drug. President Trump seized on this dubious evidence during a March 20th press conference. Though he called the anti-malaria drug a potential “game changer,” epidemiologists (including Dr. Anthony Fauci) were quick to deflate any enthusiasm. In addition to pointing out the lack of evidence, they encouraged Americans to keep hydroxychloroquine’s potential side effects in mind. Defying their warnings, Trump announced on May 18th that he had been taking the drug for weeks.
Additional hydroxychloroquine trials cast more doubt on the drug’s efficacy. On June 3rd, the New England Journal of Medicine published the results of the first definitive study. Dr. David Boulware and his team of researchers at the University of Minnesota believe they have confirmed that the drug does not, in fact, help treat COVID-19.
Global remdesivir trials have been more promising. Studies have shown the drug may reduce COVID-19 recovery time by as much as four days. Satisfied with the evidence, Britain’s National Health Service has been administering the drug to patients with severe symptoms since late May. Gilead Sciences announced this week that they will soon begin human trials using an inhalable form of the drug.
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Dexamethasone: A Breakthrough
Ongoing since March, the University of Oxford’s RECOVERY Trial is the world’s largest study of its kind. In addition to the aforementioned drugs, RECOVERY’s researchers have administered dexamethasone, a common corticosteroid. The drug has been prescribed for decades to address inflammatory conditions like asthma and arthritis. It may also mitigate some of the damage that COVID-19 does to the infected immune system.
RECOVERY researchers gave dexamethasone to 2,104 COVID-19 patients while offering standard care to a 4,321-person control group. They found that the drug reduced fatalities for both patients on ventilators and patients taking supplemental oxygen. Professor Martin Landray, RECOVERY’s lead researcher, summarized the implications of the trial’s findings:
- Dexamethasone could save 1 in 8 patients requiring ventilators.
- Dexamethasone could save 1 in 25 patients requiring oxygen.
- It costs about £35 ($45.85) to provide a 10-day dexamethasone treatment and potentially save a life.
- If it had been given to COVID-19 patients from Day 1, dexamethasone may have saved as many as 5,000 lives across the UK.
The study has not been published for peer review, but other experts have already praised it as a major breakthrough. Sam Parnia, director of critical care and resuscitation research at New York University’s Langone Health, says, “I cannot overstate how important this is.” He acknowledges the need for a closer look, but remarks that the RECOVERY team is “a very reputable group.”
The fevered discussions around hydroxychloroquine fueled intense speculation. Before long, demand for the drug strained its global supply chain. Many Americans with lupus and other conditions were unable to access the drug while providers reserved it for COVID-19 patients. Experts are already warning that enthusiasm over dexamethasone could lead to similar shortages.
Though the drug is cheap and plentiful, “Hoarding and speculative procurement appear to have already started.” This is according to Emer Cooke, head of regulation of medicines for the World Health Organization. He also notes, however, that it’s still early to know whether a severe global shortage is on the way.
Remember, no drug (dexamethasone included) has been shown to prevent COVID-19. Consult with your doctor before you begin taking any new medications. Take care, too, to keep up with news related to ongoing trials.