Oxford University Trial Finds Dexamethasone, a Widely Available Drug, Reduces Deaths in Critically Ill Coronavirus Patients

Identifying treatments for COVID-19 is a top priority among health researchers. The BBC reports that a recent trial signals real promise for a readily available drug to reduce mortality among seriously ill coronavirus patients. It’s called dexamethasone, and it could reduce deaths for patients on ventilators by as much as one-third. But health experts have cautioned that expectations should be tempered until the full study is released.

The trial was led by a team of researchers from Oxford University as part of the RECOVERY initiative, a national series of clinical trials examining the COVID-19 treatment benefits of drugs currently on the market. In a statement [PDF], chief investigators Peter Horby and Martin Landray said that the randomized dexamethasone trial involved 6425 patients hospitalized for coronavirus symptoms. Of those, 2104 were given the inexpensive steroid medication, which has been in use since the 1960s for rheumatoid arthritis and asthma. The drug was administered at 6 mg daily either intravenously or orally. The remaining 4321 patients received standard care.

For patients on ventilators, the drug cut the risk of death from 40 percent to 28 percent. For patients needing oxygen, the risk of death was lowered from 25 percent to 20 percent.

Researchers said that for every eight patients on a ventilator, one life could be saved as a result of dexamethasone. In patients on oxygen, one in 25 patients could be saved.

The drug’s anti-inflammatory effects may help mitigate the damage when the virus stimulates the body’s immune system to the point it becomes harmful, a condition known as a cytokine storm.

For the majority of those infected with the coronavirus who experience mild to moderate symptoms, there is no evidence that the drug has any benefit. But for those critically ill patients on ventilators where the risk of death is high, the drug seems to have a clear and significant effect.

The RECOVERY statement added that full details of the trial will be published “as soon as possible.”

The UK’s National Health Service will make dexamethasone available to all patients. In the United States, former Food and Drug Administration commissioner Scott Gottlieb, M.D. told CNBC that dexamethasone will likely have an “immediate impact” on patient treatment in intensive care settings and that many physicians are already prescribing it. Further research is needed, Gottlieb said, but he considered the trial “well-designed.” (Full disclosure: Gottlieb is on the board of Pfizer, one of many drug manufacturers that make dexamethasone.)

Currently, the FDA has not approved any drugs for the treatment of patients with COVID-19. Emergency use authorization has been granted for remdesivir, which has been shown to lessen the duration of hospital stays in some patients.