Can Dexamethasone be the answer for critically ill patients

The United Kingdom government authorised the use of Dexamethasone, a medicine used to treat novel coronavirus disease (COVID-19) patients who are critically ill.

Dexamethasone — a generic steroid used to reduce inflammation — was authorised soon after the Oxford University-led UK Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial announced promising results of using the steroid on June 16, 2020.

A RECOVERY trial press release claimed the steroid reduced fatalities in COVID-19 patients on ventilators by a third.

The steroid also reduced death risk among COVID-19 patients who need oxygen by 20 per cent. The drug was tried on 2,100 critically ill patients in a randomised control trial (RCT).

The participants were given a mild dose of six milligrammes for 10 days.

The recovery of the patients on Dexamethasone was compared to 4,300 patients who were not given the steroid. There was no effect on mildly infected COVID-19 patients.

A peer-reviewed study is yet to be published on the results of the drug trial. Researchers aim to publish the results quickly and share their findings with regulators in the UK and across the world. The RECOVERY trial launched in March is one of the world’s largest RCTs for COVID-19 treatments.

The World Health Organization called it the first treatment to show reduced mortality in COVID-19 patients on oxygen or ventilator support.

The drug — low cost and widely available — could see an overwhelming demand for the treatment around the globe. The UK has increased the amount of Dexamethasone it has in stock to 240,000 doses.

Some investigators, however, expressed apprehensions for treating COVID-19 patients with steroids. The concerns are over the drug suppressing the immune system of severely ill COVID-19 patients to provide relief.

A critically ill COVID-19 patient’s lungs can sometimes be ravaged by an over-active immune response.

But such patients may still need a fully functioning immune system to fend off the virus itself.

Medical experts in India are still reviewing the findings from the RECOVERY trial to understand Dexamethasone’s usability as a part of its COVID-19 treatment protocols.

Executives from the Indian pharmaceutical sector think the drug’s global demand may shoot up, similar to hydroxychloroquine.

The market size for Dexamethasone in India is, however, small: Its active pharmaceutical ingredient largely comes from China.

Around $17.3 million worth of Dexamethasone was exported between April 2019 and February 2020, said a report from the newspaper Indian Express, citing the Union Ministry of Commerce and Industry.

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