The UK Government has permitted the use of the anti-inflammatory drug dexamethasone for the treatment of COVID-19 on the NHS, following the report of positive data from a recovery trial
According to the results from the trial, dexamethasone decreased the risk of death by 35% in patients on ventilation and 20% in patients on oxygen, leading to a 17% reduction in the total 28-day mortality rate.
The drug is said to be the world’s first to result in significant patient mortality reduction, with the recovery trial demonstrating the impact. The trial is funded by the UK government via the National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI).
This comes after the chances of people who have contracted COVID-19 but show no symptoms of the virus infecting others is “very rare”, according to a World Health Organisation scientist.
During the trial, 2,104 patients received dexamethasone compared to 4,321 patients on usual standard of care alone.
UK deputy chief medical officer professor Jonathan Van-Tam said:
“The positive findings on dexamethasone follow the disappointing findings on hydroxychloroquine.”
“Together these two results illustrate the power of properly conducted clinical trials and the inherent danger of assuming things work without robust data.”
“On the dexamethasone findings, this is very encouraging because the signal on reduced mortality applies to many of the patients admitted to hospitals and the drug is comparatively low priced and available worldwide.”
The UK’s National Institute for Health and Care Excellence (NICE) lists the following conditions as common or very common side-effects of all corticosteroids, including dexamethasone:
Anxiety; behaviour abnormal; cataract subcapsular; cognitive impairment; Cushing’s syndrome; electrolyte imbalance; fatigue; fluid retention; gastrointestinal discomfort; headache; healing impaired; hirsutism; hypertension; increased risk of infection; menstrual cycle irregularities; mood altered; nausea; osteoporosis; peptic ulcer; psychotic disorder; skin reactions; sleep disorders; weight increase.
More uncommon side-effects include increased appetite, eye disorders, heart failure, seizure, tuberculosis reactivation and vertigo.
The NICE guidance also says systemic corticosteroids, particularly in high doses, are linked to “psychiatric reactions including euphoria, insomnia, irritability, mood lability, suicidal thoughts, and behavioural disturbances”.
This comes as high streets in England are once again filled with queues of shoppers as non-essentials stores re-open after nearly three months of inactivity.
The discovery of new implications for dexamethasone, the common steroid, as a treatment for COVID-19 has been hailed as a “major breakthrough”.
Having been available for decades, it is readily available and relatively cheap.
The drug has been hailed as a “cause to celebrate” by Prime Minister Boris Johnson, and the professor leading the trial has called the findings “quite remarkable”.
It is a widely used steroid drug, known as a corticosteroid, which works to reduce inflammation the body. It has been in use since the early 1960s and treats a range of conditions, including rheumatoid arthritis and asthma.
The drug can work to prevent the immune system from destroying blood platelets in people with blood disorders and is also used in end-of-life care.
People with a brain tumour may also be prescribed dexamethasone to reduce swelling around the tumour.
