A cheap and widely available steroid has been found to save lives of patients hospitalised with COVID-19 in a national trial being led by University of Oxford researchers.
Dexamethasone was one of the drugs being tested as part of the RECOVERY trial, the world’s biggest trial looking at whether existing treatments can tackle the symptoms of coronavirus.
The researchers, who are supported by the NIHR Oxford Biomedical Research Centre (BRC), found that this cheap and widely available drug cut the risk of death by a third for patients on ventilators. For those on oxygen, it reduced deaths by a fifth.
Since it began in March 2020, the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial has recruited more than 11,500 patients across 175 NHS hospitals.
Recruitment to the dexamethasone arm of the trial was halted on 8 June as it was felt that sufficient patients had been enrolled to establish whether or not the drug had a meaningful benefit.
A total of 2,104 patients were randomised to receive a low daily dose of dexamethasone by mouth or intravenous injection for ten days. They were compared with 4,321 patients randomised to usual care alone.
It was found that dexamethasone reduced deaths by one-third in ventilated patients and by one fifth in other patients receiving oxygen only. There was no benefit among those patients who did not require respiratory support.
Based on these results, 1 death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone.
Given the public health importance of these results, the researchers are now working to publish the full details as soon as possible.
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.”
Another of the Chief Investigators, Martin Landray (right), Professor of Medicine and Epidemiology at the Nuffield Department of Population Health and the Oxford BRC’s Theme Lead for Clinical Informatics, 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 disease; it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide.”
Prof Landray said he was “enormously proud of the team who have coordinated the #RECOVERYtrial, from first protocol to first proven benefit in 3 months. An extraordinary effort delivering an important result.”
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.’