This drug is already used in many indications for its powerful anti-inflammatory and immunosuppressive effects.
“This is a major step forward in the quest for new ways of treating COVID patients,” said the Pr Stephen Powis, medical director of the NHS, the British public health service.
Indeed, as those responsible for Recovery pointed out, “dexamethasone is the first drug which has been observed to improve survival in the event of COVID-19”.
A drug from another family, the antiviral remdesivir, has shown some effectiveness in speeding up the recovery of patients hospitalized from COVID-19. The announcement was officially made at the end of April by the American authorities.
But remdesivir, on the other hand, has not been able to prove that it prevented deaths.
At this stage, despite a multitude of leads, no other treatment has had convincing results.
In early June, the same Recovery trial concluded that hydroxychloroquine, in which some countries have high hopes, had no beneficial effect against COVID-19.
This finding led the American health authorities on Monday to withdraw the authorization to use hydroxychloroquine in an emergency against COVID-19, as well as a related drug, chloroquine, which had for a time been defended by President Donald Trump.
Finally, the Parisian hospital group AP-HP assured at the end of April that another drug, tocilizumab, “significantly” reduced the risk of dying or going to intensive care in patients with COVID-19 in serious condition. But these claims have not yet been backed up by numbers or the publication of a study.
Many experts believe that the key to treating COVID-19 will lie not with a single drug, but a combination of several of them.
One of the solutions could perhaps be to “combine low doses of dexamethasone with other drugs that act on inflammation, or with therapies that target the virus, such as remdesivir”, explained Dr. Stephen Griffin, University of Leeds.
In the Recovery trial, 2,104 patients received dexamethasone (oral or intravenous) for 10 days at a dose of 6 mg per day.
Comparing to 4,321 other patients who had not received it, the researchers determined that the treatment reduced mortality by a third in patients placed on mechanical ventilation.
In addition, mortality was reduced by a fifth in less severely ill patients, who were given oxygen through a mask, without intubating them.
In contrast, the treatment showed no benefit for patients who did not require respiratory support.
These results have not yet been published as a detailed study, but have only been the subject of a Recovery press release.
After its evaluation of hydroxychloroquine, this is the second time that this major clinical trial has made it possible to reach a major conclusion on COVID-19. In total, more than 11,500 patients from 175 UK hospitals are participating in the trial, which is evaluating multiple treatments.