Cheap steroid dexamethasone is the first drug that reduces deaths from covid-19


Cheap steroid dexamethasone is the first drug that reduces deaths from covid-19
According to the results of a British clinical trial, a press release announced on Tuesday that a severe steroid has reduced deaths from coronovirus infections, helping some sick patients with severe lung damage.

The 60-year-old drug, dexamethasone, is the first drug to increase the likelihood of people surviving covid-19, a disease caused by the new coronovirus. This reduced the risk of death of patients with respirators by one-third and the risk of death of patients with oxygen by one-fifth, leading to news that generated a lot of interest and hope.

British regulators quickly approved the drug to require oxygen to hospitalized patients, and Prime Minister Boris Johnson announced the results, declaring that "there was a real reason to celebrate a remarkable British scientific achievement and this Not only will the country benefit, but the whole country. "World."

Dexamethasone is a workhorse steroid commonly used to treat inflammation, including outbreaks of rheumatoid arthritis, and was administered as a tablet, liquid, or intravenous preparation in the trial. Some other steroids are also being tested against covid-19.

Outside doctors tempered their optimism about the news with urgent calls to release details of the researchers' findings so that doctors could analyze the data carefully and understand the benefits and limitations of the drug.

"If it's reproducible and works, it's a huge win, but it's a very" yes ", said infectious pathologist Isac Bogoche of Toronto General Hospital. This is as cheap as borscht, as my grandparents would say. "It is widely available. Every doctor on the planet who practices hospital medicine feels comfortable with this medicine."

But without complete test data, doctors like Bogoche are in a difficult position. Bogoch said if a patient is hospitalized today with covid-19, he is unsure whether he will use the drug without further information. The World Health Organization and the National Institutes of Health treatment guidelines, starting on Tuesday afternoon, recommended not using steroids due to a lack of evidence that the potential benefit from the benefits of the drugs was suspected.

Anthony S., director of the National Institute of Allergy and Infectious Diseases. Fauci said in an interview on Tuesday that a group of experts who have developed the covid-19 treatment guidelines are already planning to assess the data and assess whether the recommendations should change.

"This is the whole purpose of the guidelines panel, which can be assembled in a blink of an eye," Fauci said.

The results come from a large British clinical trial, designed to test six potential treatments, including dexamethasone, against specific care. The British researchers who led the trial said they chose the unconventional route of declaring the results before providing additional data because of the importance of public health.

The researchers estimated that dexamethasone could prevent one death in about eight ventilated patients or one death in about 25 cases in which patients require supplemental oxygen.

Oxford University professor Peter Horby, who led the trial, joined Johnson at a news conference at 10 Downing Street. He said that in the world's largest covid-19 clinical trial that studied six drugs in the past three months, dexamethasone was "the one I'm most excited about."

Doctors can walk up to the pharmacy cabinets in five minutes and prescribe it. They know how it works and they know it will help. And so it can be done tonight, it is fantastic, ”said Horby.

England medical director Chris Whitty said on Twitter that it was "the result of the most important test ever for covid-19."

But for physicians, this is yet another example of the difficulty of practicing medicine during the covid-19 era, in which scientific findings are regularly shared through press releases, media reports, or preliminary studies Are not even subject. Reviewing deficiencies that help identify deficiencies. Or defect.

"I think physicians are generally not going to change the practice in a press release, although it may seem like that," said Naheed Bhadelia, medical director of the Special Pathogen Unit at Boston Medical Center.

A press release on interim data from the first vaccine safety test developed by biotech company Modern skyrocketed the stock market, but scientists are still waiting to see full results. On Monday, a dispute over hydroxychloroquine, an antimalarial drug promoted by President Trump and others for preliminary evidence, was resolved when the Food and Drug Administration withdrew an emergency use authority, in part from the Briton himself Due to data. Testing showed that the drug did not help patients.

British researchers took the test patients into groups who received dexamethasone or routine care. More than 2,000 patients received low-dose dexamethasone daily for 10 days, while 4,000 patients received specific care.

Outside doctors said it is important for people to understand that this was not a medication or treatment of covid-19 for people with mild symptoms. The effect was seen in patients with severe lung damage requiring supplemental oxygen or ventilators.

Instead of targeting the virus, the steroid targets the body's immune response, which can go haywire as people struggle with an infection, which can lead to inflammation and lung damage. The rationale behind testing for steroids in people is that drugs can soothe inflammation in the lungs or other components of the immune response.

Steroid use against coronavirus has been a source of medical debate, and some fear that drugs may be a risk factor for infection. Steroids, including dexamethasone, have been tried with mixed results against acute respiratory distress, a form of lung failure that somewhat resembles severe covid-19 infection.

"We are always a concern when we give steroids to patients in general, because steroids reflect the immune system," Bhadalia said. "They are at risk of worsening of existing infections and increase the likelihood that another infection will ensue."

Steroids can be added to a small but growing arsenal of evidence-supported drugs used against covid-19. Remedsvir, an antiviral drug, gained emergency use rights in the United States following a trial that showed it reduced the length of hospital stay. Various human trials of monoclonal antibody drugs have been initiated, which many experts hope may provide a powerful weapon against the disease.

Doctors hope that if a second wave of coronovirus infection begins in the fall, they will have more treatment and knowledge to save people's lives.

Nick Cammac, the leader of the covid-19 therapeutic accelerator at Wellcome, a philanthropic organization that helps pay for British research, called the results a "success" in a statement, calling for dexamethasone worldwide for critically ill patients Must be worldwide, but added that this was only the beginning.

This is very promising news and an important step, but we still have a long way to go. "To end this epidemic, we still need better diagnostics to detect, treat, and vaccinate drugs to prevent covid-19."

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