A low-cost drug is first to reduce Covid deaths

In a major breakthrough, Oxford University scientists have identified a steroid drug widely used to treat asthma, allergies and rheumatoid arthritis, as significantly reducing risk of death from Covid-19 among patients with severe respiratory complications.
The low-cost and widely available steroid, dexamethasone, reduces death by up to one-third among those hospitalised with severe respiratory complications of Covid-19, chief investigators for Oxford University’s randomised controlled trial — the Recovery trial — announced on Tuesday.
UK health secretary Matt Hancock said the NHS treatment for Covid-19 will include dexamethasone henceforth.
In India, the drug is used to treat sepsis and is widely available in injectables and tablets.
More than 11,500 patients in NHS hospitals are enrolled in the trial, which began in March with 2,104 patients receiving 6 mg of dexamethasone once a day (by mouth or intravenous injection) for 10 days. They were compared with 4,321 patients in usual care. Dexamethasone reduced deaths by one-third in ventilated patients and by one fifth in patients receiving oxygen only. There was no evidence of benefit for patients who didn’t require oxygen. “Dexamethasone is the first drug to be shown to improve survival in Covid-19,” said Peter Horby, one of the chief investigators.
In India, the drug which is used to fight life-threatening sepsis and severe infections has annual sales of Rs 100 crore. Ahmedabad-based Zydus Cadila is its largest manufacturer. “There are enough supplies in India. It’s been used for over four decades in several indications, and is very affordable,” Zydus group chairman Pankaj Patel told TOI. Its price is regulated under the Drug Price Control Order, and is around Rs 5-6 per injection. It is also produced by small scale manufacturers
Doctors in India said the UK findings look promising but the data needs to be studied further. Delhi-based endocrinologist Anoop Misra said, “Please be careful not to over-interpret this study and start using it in every patient. It works only in those who require oxygen/ventilator.” Short-term use may increase blood sugar and blood pressure transiently, but the side effects can be managed, he added. Mumbai doctors said other steroids are part of treatment protocol in the country. Endocrinologist Dr Shashank Joshi, a member of Maharashtra’s task force, said intravenous use of steroid methyl prednisolone has been part of guidelines since April. “That’s probably one of the reasons we have seen lesser deaths than other nations. However, it’s only for hospitalised patients or those in ICUs.” (Inputs from Sumitra Deb Roy)

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