An old drug has found a new purpose. Dexamethasone, a corticosteroid used to treat arthritis, may prove to be the affordable, accessible COVID-19 treatment that the world so desperately needs.
What Is Dexamethasone?
Dexamethasone was first approved by the FDA in 1958 as a corticosteroid drug. It’s used to mimic the corticosteroid hormones naturally produced by a person’s adrenal glands, especially when the body fails to produce a sufficient quantity.
Today, dexamethasone is available as a generic drug and under the brand name DexPak. It’s mainly prescribed to treat conditions of inflammation, including:
- Rheumatoid arthritis
- Systemic lupus
- Psoriatic arthritis
- Ulcerative colitis
- Crohn’s disease
Since it’s been used for decades, the safety and efficacy of dexamethasone are well understood. In most cases, short courses of the drug are well tolerated with few and mild side effects.
What Do Clinical Trials Reveal About Dexamethasone?
Dexamethasone has been studied in one arm of the Randomized Evaluation of COVID-19 Therapy (RECOVERY) trial led by Oxford University in an effort to test a range of potential coronavirus treatments. To date, more than 11,500 patients have been enrolled from over 175 NHS hospitals in the UK.
Preliminary results from the Dexamethasone arm of the RECOVERY trial, released in early June, reveal that the drug reduced deaths by one-third among patients on mechanical ventilators, and by one-fifth among patients receiving other forms of supplemental oxygen.
According to the Oxford University research team, “Based on these results, 1 death would have been prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone.” Now researchers believe that dexamethasone may be the key to effectively treating COVID-19 patients with severe symptoms.
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, concluded, ”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.”
Dexamethasone and Remdesivir in Combination to Treat COVID-19
It’s possible that a combined treatment of dexamethasone and remdesivir could prove even more powerful than using one of the drugs alone. While remdesivir slows damage caused by the virus, dexamethasone reduces the hyper-inflammatory state triggered by COVID-19.
Now that the UK government has granted a world-first approval of dexamethasone, clinical trials will begin exploring the potential efficacy of a combined treatment.