What is dexamethasone, the new drug being used to treat COVID-19?
Dexamethasone, a cheap, widely-available steroid, is the latest drug touted by experts in the UK as a possible treatment for COVID-19, with evidence suggesting that it can successfully reduce deaths from the virus by up to one third in severely-ill patients.
After researchers at the University of Oxford announced the headline results on Tuesday - with the full results to be released later this month - the British government immediately authorised its use in treating coronavirus patients.
It's not the first time during the coronavirus pandemic - which has killed 438,000 people worldwide - that a drug has been touted as a treatment for COVID-19, famously by the U.S. President Donald Trump, who controversially tweeted that he was taking the anti-malarial drug hydroxychloroquine.
Interestingly, it was the same researchers at Oxford that proved hydroxychloroquine did not work that suggested that dexamethasone could.
It may be early days, but experts are already saying that the drug could be a game-changer in saving the lives of the sickest coronavirus victims.
“This is the dream,” said Nick Cammack, a virus expert at the Wellcome Trust, a British charity that supports research, adding that the drug has been used for decades for other conditions. “It’s very straightforward to make so there’s no reason this can’t be rolled out for the entire world.”
So, what is dexamethasone?
It is a steroid, which is generally used to reduce inflammation, a key cause of death in coronavirus patients as the lungs swell to fight the infection.
While the World Health Organization warns against using steroids early on during treatment for the virus - as they can impede the fight against the infection - in the late-stages they can be effective.
“Early on, you’re fighting the virus and you want your immune system to be as intact as possible,” Dr Anthony Fauci, the U.S.'s top disease expert, said on Tuesday.
But in the advanced stage of COVID-19, the battle against the virus causes so much inflammation that it “is hurting you more than helping you,” he said. The results seen in the Oxford study make “perfect sense” with that notion, he said.
What are the upsides?
Firstly, of course, it has been proven to save lives: over four weeks, Oxford University found that it had reduced deaths in 35% of patients who needed treatment with breathing machines and by 20% in those needing supplemental oxygen.
Researchers estimated that the drug would prevent one death for every eight patients treated while on breathing machines and one for every 25 patients on extra oxygen alone.
“Those are big effects,” said one study leader, Dr Martin Landray at Oxford. “It’s not a cure, but it’s certainly a long way forward.”
Another key benefit of dexamethasone is that it is cheap: as little as 25 euros for a full course. As Cammack, at the Wellcome Trust, said, the drug is also widely available and would be easy to produce and roll out worldwide.
Are there any downsides?
Besides the fact that the drug is only useful in treating severely ill patients, there are side-effects in using steroids, including weight gain, high blood pressure, water retention, mood changes, sleep problems and rise in blood sugar for people with diabetes.
Some experts have also suggested that the mortality rates during the study was high: 41% of those on breathing machines and 25% on oxygen alone died.
“The mortality rate seems to be way higher than it is in the U.S.,” where one recent study found a death rate of 12%, although that was only after two weeks versus four in the UK study, said Dr Peter Bach, a health policy expert at Memorial Sloan-Kettering Cancer Centre in New York.