The World Health Organization (WHO) plans to update its guidelines on treating people stricken with coronavirus to reflect results of a clinical trial that showed a cheap, common steroid could help save critically ill patients.
The drug dexamethasone was shown to reduce death by about one-third in patients on ventilators and one-fifth in patients who require oxygen, according to initial findings.
The benefit was only seen in patients seriously ill with COVID-19 and was not observed in patients with milder disease, the WHO said in a statement late Tuesday.
British researchers estimated 5,000 lives could have been saved had the drug been used to treat patients in the United Kingdom at the start of the pandemic.
“This is great news and I congratulate the government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this lifesaving scientific breakthrough,” said WHO Director-General Tedros Adhanom Ghebreyesus in the press release.
“This is the first treatment to be shown to reduce mortality in patients with COVID-19 requiring oxygen or ventilator support.”
The UN agency said it will coordinate a meta-analysis to increase the “overall understanding of this intervention”.
‘Best piece of news’
Britain’s health minister on Wednesday hailed the use of the steroid for treating coronavirus patients as the “best news” so far during the outbreak.
Trial results announced on Tuesday showed dexamethasone – which is used to reduce inflammation in other diseases such as arthritis – reduced death rates by about 30 percent among the most severely ill COVID-19 patients admitted to hospital.
“It does increase your chances of survival quite significantly,” Health Secretary Matt Hancock told Sky News. “It is one of the best pieces of news we’ve had through this whole crisis. It reduces your chances of dying when you are on a ventilator. It is brilliant news for everybody.”
He said the drug’s potential was first spotted in February and positive signals led to the government buying it up in April.
US doctors’ scepticism
Despite worldwide optimism, some US doctors expressed scepticism over the British research, saying the recent withdrawal of an influential COVID-19 study left them wanting to see more data.
Global pressure to find a cure or vaccine has accelerated the process of reporting coronavirus study results, feeding confusion over whether therapies have been proven effective.
One influential coronavirus study was withdrawn this month by respected British medical journal The Lancet over data concerns.
“We have been burned before … even pre-COVID, with exciting results that when we have access to the data are not as convincing,” Dr Kathryn Hibbert, director of the intensive care unit at Harvard’s Massachusetts General Hospital, told Reuters.
The British scientists who announced the dexamethasone results said they would work to publish full details as soon as possible.
Hibbert said published data would help her evaluate the findings and see which patients benefited the most and at what dose.
“I am very hopeful this is true because it would be a huge step forward in being able to help our patients,” she said, but added she would not change her treatment protocol at this point.
Steroids can suppress immune systems, warned Dr Thomas McGinn, deputy physician-in-chief at New York’s largest healthcare system, Northwell Health. He said physicians are using steroids on a case-by-case basis.
“We have to see what the study looks like given the current environment of retractions,” said McGinn. “I just wait to see the real data, see if it’s peer-reviewed and gets published.”
University of Washington professor of medicine Dr Mark Wurfel urged the researchers to release the data before official publication.
“That would be very, very helpful in terms of helping us align our patient populations with theirs and decide whether it’s appropriate to apply this therapy to our patients,” said Wurfel.
Anthony Fauci, a leading member of the White House coronavirus task force, told the Financial Times a panel of US experts is now reviewing whether to recommend dexamethasone.
He called the results “important” and “positive” saying the drug “clearly has a significant effect on those individuals who are on ventilators”.
Fauci added it was important that the study was a large, randomised control trial that compared the drug to a placebo. Alongside the positive result from Gilead’s antiviral remdesivir, he said there were signs that “we are making progress”.