A breakthrough in the treatment COVID-19 who called the results of the study of British doctors with dexamethasone. The drug is one third reduces the mortality among patients on a ventilator. But the final conclusion yet to be drawn.
Ramdevpir, hydroxychloroquine, dexamethasone – these are already admitted to using drugs one after the other were considered to be effective means of COVID-19. Everything occurs according to the same scenario: first research Institute published on its website in advance the promising results of the study and makes a press release, then the media pounce on this information, the experts or even the President commented on it, and then people all over the world run to the pharmacy, buy the medication and swallow in hopes of recovery.
And only after that the experts the opportunity to examine and verify the research results. This is followed by disappointment or clarification of conditions under which the drug is really effective. And sometimes it turns out that it may cause severe side effects.
What is known about dexamethasone?
The few data on dexamethasone that are known to date from randomized controlled clinical trials conducted in the UK. In this research verified the effectiveness in the treatment of COVID-19 is already available on the drug market. The study involved more than 11.5 million patients from over 175 hospitals in the UK.
Part of the study, which tested dexamethasone, called Recovery. Was 2.1 thousand people. They were given daily 6 mg for ten days. The control group consisted of 4.3 thousand people, and the treatment they received standard.
Preliminary results not yet published clinical trials suggest that dexamethasone is most effective in the treatment of severe cases COVID-19. Patients on the ventilator, the mortality rate fell by third in comparison with the control group. Among patients who received oxygen therapy, but not exposed to mechanical ventilation, mortality decreased by 20 percent. In the treatment of patients with mild disease receiving dexamethasone did not give any effect.
Immediately after it was published the results of a study in the UK, it was decided to use a dexamethasone as a means of therapy for coronavirus infection.
How does dexamethasone?
The immune system of patients with severe COVID-19 often gives is so powerful that it can cause “cytokine storm” and lead to acute respiratory distress syndrome. The active ingredient dexamethasone belongs to a group of corticosteroids suppresses the immune system while providing anti-inflammatory effect and reducing inflammation.
Dexamethasone is widely known, is inexpensive and it can be easily find in pharmacies and hospitals all over the world. The drug is generally used for inflammatory diseases of the skin and joints, swelling of the brain caused by the tumors and for the prevention of nausea and vomiting during cancer therapy.
As the experts evaluate the research results?
Dexamethasone commotion around the hype, of course, was helped by the fact that the head of the who Tedros Aden Gebreyesus described studies with this drug as a “breakthrough” in the fight against COVID-19. “I congratulate the UK government, Oxford University and many hospitals and patients in the UK who have contributed to this vital scientific breakthrough,” he said.
However, reliable statements about the “new miracle cure” dexamethasone still did no scientist. Despite the fact that this drug has long been known, its efficacy in the treatment of patients COVID-19 is still not really understood.
Any scientific publications on the issue yet either, and the results of controlled clinical studies have not been able to check thoroughly other experts – British scientists have just posted online the initial results of the research for further study.
The German experts with cautious optimism to the few data that are already available. “The results fit well into our current idea of what an over-reaction of the immune system plays a crucial role in disease COVID-19 at a late stage. The results of the study, not yet completely published, speak in favor of the use of corticosteroids in severe infections of the SARS-CoV-2”, – said Professor Dr. Gerd Fatkenheuer (Gerd F?tkenheuer), head of the Department of Infectology of the Cologne University hospital.
A similar view is shared by Professor Maria Werechild (Maria Vehreschild), head of the Department of Infectology, University hospital at the Goethe University in Frankfurt. “Cortisone is a classic way of suppressing the immune system. It is surprising how powerful was the effect of the application of dexamethasone,” she says. However, the final conclusion about efficiency of this preparation can be done only after a detailed study of all the source data, emphasizes Professor Werechild.