Coronavirus: Dexamethasone proves first life-saving drug
A cheap and widely available drug can help save the lives of patients seriously ill with coronavirus.
Oxford University’s Jenner Institute, one of the hubs of the search for a cure to coronavirus.
An anti-inflammatory drug called dexamethasone has been hailed as a ground-breaking treatment for hospital patients seriously ill with Covid-19.
The low-dose steroid treatment dexamethasone is a major breakthrough in the fight against the deadly virus, UK experts say.
The drug is part of the world's biggest trial testing existing treatments to see if they also work for coronavirus.
It cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth.
What is dexamethasone and how does it work?
Dexamethasone is a steroid - a medicine that reduces inflammation by mimicking anti-inflammatory hormones produced by the body.
How does it work?
This drug works by dampening down the body's immune system.
When it comes to Covid-19, both the virus itself and the body's reaction in fighting it off, cause inflammation.
But sometimes the immune system goes into overdrive and it's this reaction that can prove fatal - the very reaction designed to attack infection ends up attacking the body's own cells.
It's only suitable for people who are already in hospital and receiving oxygen or mechanical ventilation - the most unwell.
The drug does not work on people with milder symptoms, and suppressing their immune system at this point would not be helpful.
How effective is it?
According to the scientists who carried out the trials, one in three deaths could be prevented among patients on ventilators.
For patients on oxygen, it could prevent one death in five.
There was no significant benefit for patients who were not receiving respiratory support.
What was the trial?
The results come from the Recovery (Randomised Evaluation of Covid-19 therapy) trial, conducted by the University of Oxford.
It's testing whether existing medicines used for other conditions could also be useful in treating Covid-19.
About 2,100 patients received a 6mg daily dose of dexamethasone in the trial.
Their progress was compared with a random sample of just over 4,300 patients who received no additional treatment.
It is now recommended for adults, not including those who are pregnant or breastfeeding.
How widely available is the drug?
Dexamethasone is a low-cost drug which already exists and is in good supply.
In the UK the treatment will cost £5.40 a day per patient.
It was first made in 1957 and became available for use in the UK in the early 1960s.
What other conditions is it used for?
The drug can help treat various illnesses involving inflammation or swelling in the body, or conditions where the immune system goes into overdrive - for example, severe asthma which can cause inflammation in the airways and lungs, severe allergic reactions or painful, inflamed joints.
Are there any side-effects?
Common side effects of dexamethasone used for other conditions include anxiety, difficulty sleeping, weight gain and fluid retention.
Rarer side effects include eye disorders, blurred vision and haemorrhage.
This is the only low dose medicine which should limit side effects.
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