What do we know so far about dexamethasone as a potential treatment for COVID-19?
What do we know so far about dexamethasone as a potential treatment for COVID-19?
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Dexamethasone is a low-cost, anti-inflammatory medication that is part of the corticosteroid family. Corticosteroids function similarly to the cortisol produced in the body's adrenal glands yet they are synthetically made. Corticosteroids are commonly prescribed to suppress the immune system and reduce swelling and itching common to allergic reactions. Dexamethasone has been widely used since the 1960s, but it has recently been part of several studies exploring potential therapies for COVID-19. In the RECOVERY (Randomised Evaluation of Covid-19 Therapy) Trial at Oxford University (UK), the largest COVID-19 drug trial to date, researchers studied the impact of dexamethasone by comparing the roughly 2,000 patients who received the medication with the 4,000 patients who did not receive the medication. They found that the mortality risk was lowered for patients with severe cases of COVID-19 who were on ventilators or receiving oxygen. For patients with mild cases of COVID-19, beneficial effects were not observed. Dexamethasone has not been approved as an official treatment for COVID-19 outside the United Kingdom thus far, and the World Health Organization (WHO) has urged caution since these results are preliminary, have yet to be evaluated through the peer-review process, and represent findings from only one trial. Despite this, the medication is currently being used in several countries as a part of various treatment strategies for COVID-19. The WHO has also recently added dexamethasone and other steroids into its treatment guidelines for COVID-19. In two other recent studies using corticosteroidal medications (including dexamethasone) as potential treatments for COVID-19, one found a reduction in the number of days patients required ventilator support, and the other found that the corticosteroid medications were associated with an increased duration of illness (among other adverse impacts). Corticosteroids, including dexamethasone, are still an unproven treatment for COVID-19.
Dexamethasone is a low-cost, anti-inflammatory medication that is part of the corticosteroid family. Corticosteroids function similarly to the cortisol produced in the body's adrenal glands yet they are synthetically made. Corticosteroids are commonly prescribed to suppress the immune system and reduce swelling and itching common to allergic reactions. Dexamethasone has been widely used since the 1960s, but it has recently been part of several studies exploring potential therapies for COVID-19. In the RECOVERY (Randomised Evaluation of Covid-19 Therapy) Trial at Oxford University (UK), the largest COVID-19 drug trial to date, researchers studied the impact of dexamethasone by comparing the roughly 2,000 patients who received the medication with the 4,000 patients who did not receive the medication. They found that the mortality risk was lowered for patients with severe cases of COVID-19 who were on ventilators or receiving oxygen. For patients with mild cases of COVID-19, beneficial effects were not observed. Dexamethasone has not been approved as an official treatment for COVID-19 outside the United Kingdom thus far, and the World Health Organization (WHO) has urged caution since these results are preliminary, have yet to be evaluated through the peer-review process, and represent findings from only one trial. Despite this, the medication is currently being used in several countries as a part of various treatment strategies for COVID-19. The WHO has also recently added dexamethasone and other steroids into its treatment guidelines for COVID-19. In two other recent studies using corticosteroidal medications (including dexamethasone) as potential treatments for COVID-19, one found a reduction in the number of days patients required ventilator support, and the other found that the corticosteroid medications were associated with an increased duration of illness (among other adverse impacts). Corticosteroids, including dexamethasone, are still an unproven treatment for COVID-19.
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What our experts say
Dexamethasone is a low-cost, anti-inflammatory medication that is part of the corticosteroid family. Corticosteroids function similarly to the cortisol produced in the body's adrenal glands yet they are synthetically made. Corticosteroids are commonly prescribed to suppress the immune system and reduce swelling and itching common to allergic reactions. Dexamethasone has been widely used since the 1960s, but it has recently been part of several studies exploring potential therapies for COVID-19. In the RECOVERY (Randomised Evaluation of Covid-19 Therapy) Trial at Oxford University (UK), the largest COVID-19 drug trial to date, researchers studied the impact of dexamethasone by comparing the roughly 2,000 patients who received the medication with the 4,000 patients who did not receive the medication. They found that the mortality risk was lowered for patients with severe cases of COVID-19 who were on ventilators or receiving oxygen. For patients with mild cases of COVID-19, beneficial effects were not observed. Dexamethasone has not been approved as an official treatment for COVID-19 outside the United Kingdom thus far, and the World Health Organization (WHO) has urged caution since these results are preliminary, have yet to be evaluated through the peer-review process, and represent findings from only one trial. Despite this, the medication is currently being used in several countries as a part of various treatment strategies for COVID-19. The WHO has also recently added dexamethasone and other steroids into its treatment guidelines for COVID-19. In two other recent studies using corticosteroidal medications (including dexamethasone) as potential treatments for COVID-19, one found a reduction in the number of days patients required ventilator support, and the other found that the corticosteroid medications were associated with an increased duration of illness (among other adverse impacts). Corticosteroids, including dexamethasone, are still an unproven treatment for COVID-19.
Dexamethasone is a low-cost, anti-inflammatory medication that is part of the corticosteroid family. Corticosteroids function similarly to the cortisol produced in the body's adrenal glands yet they are synthetically made. Corticosteroids are commonly prescribed to suppress the immune system and reduce swelling and itching common to allergic reactions. Dexamethasone has been widely used since the 1960s, but it has recently been part of several studies exploring potential therapies for COVID-19. In the RECOVERY (Randomised Evaluation of Covid-19 Therapy) Trial at Oxford University (UK), the largest COVID-19 drug trial to date, researchers studied the impact of dexamethasone by comparing the roughly 2,000 patients who received the medication with the 4,000 patients who did not receive the medication. They found that the mortality risk was lowered for patients with severe cases of COVID-19 who were on ventilators or receiving oxygen. For patients with mild cases of COVID-19, beneficial effects were not observed. Dexamethasone has not been approved as an official treatment for COVID-19 outside the United Kingdom thus far, and the World Health Organization (WHO) has urged caution since these results are preliminary, have yet to be evaluated through the peer-review process, and represent findings from only one trial. Despite this, the medication is currently being used in several countries as a part of various treatment strategies for COVID-19. The WHO has also recently added dexamethasone and other steroids into its treatment guidelines for COVID-19. In two other recent studies using corticosteroidal medications (including dexamethasone) as potential treatments for COVID-19, one found a reduction in the number of days patients required ventilator support, and the other found that the corticosteroid medications were associated with an increased duration of illness (among other adverse impacts). Corticosteroids, including dexamethasone, are still an unproven treatment for COVID-19.
Context and background
Dexamethasone has recently been in the news due to its alleged early success in the RECOVERY (Randomised Evaluation of Covid-19 Therapy) trial, led by a team from Oxford University in the UK. This study is the world's largest and was launched in March to test six potential COVID-19 treatments - five pre-existing medications and convalescent plasma from recovered COVID-19 patients - to determine whether or not they can help treat cases of COVID-19. Though this study has received significant media attention since the search for any potential treatments is urgent, no study has been published by the RECOVERY team as of yet and no other countries have approved dexamethasone for severe cases of COVID-19.
Dexamethasone has recently been in the news due to its alleged early success in the RECOVERY (Randomised Evaluation of Covid-19 Therapy) trial, led by a team from Oxford University in the UK. This study is the world's largest and was launched in March to test six potential COVID-19 treatments - five pre-existing medications and convalescent plasma from recovered COVID-19 patients - to determine whether or not they can help treat cases of COVID-19. Though this study has received significant media attention since the search for any potential treatments is urgent, no study has been published by the RECOVERY team as of yet and no other countries have approved dexamethasone for severe cases of COVID-19.
Resources
- Dexamethasone (Oral Route) (Mayo Clinic)
- Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19 (Oxford/RECOVERY)
- Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report (NEJM/RECOVERY)
- WHO urges caution on 'breakthrough' coronavirus drug dexamethasone, citing early data (CNBC)
- U.K. approves use of life-saving coronavirus drug dexamethasone in ‘biggest breakthrough yet’ — it costs £5 per patient (MarketWatch)
- This national clinical trial aims to identify treatments that may be beneficial for people hospitalised with suspected or confirmed COVID-19 (Oxford/RECOVERY)
- Coronavirus: Dexamethasone proves first life-saving drug (BBC)
- Impact of corticosteroid therapy on outcomes of persons with SARS-CoV-2, SARS-CoV, or MERS-CoV infection: a systematic review and meta-analysis (Nature)
- Dexamethasone Treatment for the Acute Respiratory Distress Syndrome: A Multicentre, Randomised Controlled Trial (The Lancet)
- Q&A: Dexamethasone and COVID-19 (WHO)
- Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report (NEJM)
- Dexamethasone (Oral Route) (Mayo Clinic)
- Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19 (Oxford/RECOVERY)
- Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report (NEJM/RECOVERY)
- WHO urges caution on 'breakthrough' coronavirus drug dexamethasone, citing early data (CNBC)
- U.K. approves use of life-saving coronavirus drug dexamethasone in ‘biggest breakthrough yet’ — it costs £5 per patient (MarketWatch)
- This national clinical trial aims to identify treatments that may be beneficial for people hospitalised with suspected or confirmed COVID-19 (Oxford/RECOVERY)
- Coronavirus: Dexamethasone proves first life-saving drug (BBC)
- Impact of corticosteroid therapy on outcomes of persons with SARS-CoV-2, SARS-CoV, or MERS-CoV infection: a systematic review and meta-analysis (Nature)
- Dexamethasone Treatment for the Acute Respiratory Distress Syndrome: A Multicentre, Randomised Controlled Trial (The Lancet)
- Q&A: Dexamethasone and COVID-19 (WHO)
- Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report (NEJM)
