Currently, there are over 2,200 clinical trials trying to find a vaccine or a therapy for Covid-19. The National Institute of Health recently halted its hydroxychloroquine clinical trial, concluding that there was no real benefit for Covid-19 patients. On the other hand, dexamethasone has recently shown positive preliminary results from the RECOVERY (Randomised Evaluation of COVid-19 thERapY) clinical trial.
The UK RECOVERY trial is a Phase II/III randomised, controlled trial that began in March 2020 and is testing numerous potential treatments for Covid-19, including lopinavir-ritonavir, azithromycin, tocilizumab, convalescent plasma, and low-dose dexamethasone. The trial also had a hydroxychloroquine arm, but the UK Medicines and Healthcare Products Regulatory Agency (MHRA) suspended this due to no significant difference in mortality rate and hospital stay duration. More than 11,000 patients were enrolled in 175 NHS hospitals in the UK. A total of 2,104 patients were randomised to receive 6mg per day of dexamethasone for 10 days and then compared to 4,321 patients that received usual care alone (patients on ventilation, patients who required oxygen only, and those who did not need any respiratory assistance). Dexamethasone was found to reduce deaths in patients on ventilators by one-third and by one-fifth in patients who required oxygen only. No benefits were found in those who did not need respiratory assistance. With these results, the UK government approved the use of dexamethasone for Covid-19 patients needing oxygen and those on ventilators.
Although these early preliminary results are very promising, only the complete results will provide a full picture and robust assessment. With 14 additional clinical trials investigating dexamethasone against Covid-19 and with eight trials expected to complete in 2020, this could provide additional evidence for the efficacy of dexamethasone for the treatment of Covid-19.
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