Currently, there are more than 2,200 clinical trials trying to find a vaccine or therapy for Covid-19. The National Institute of Health recently stopped its hydroxychloroquine clinical trial and concluded that there was no real benefit for Covid-19 patients. On the other hand, dexamethasone has recently shown positive preliminary results from the RECOVERY (Randomized Evaluation of COVid-19 thERapY) trial.
The UK RECOVERY trial is a Phase II / III randomized controlled trial that started 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 Health Products Regulatory Agency (MHRA) discontinued this because there was no significant difference in mortality rate and length of hospital stay. More than 11,000 patients were enrolled in 175 NHS hospitals in the UK. A total of 2,104 patients were randomized to receive 6 mg per day of dexamethasone for 10 days and then compared to 4,321 patients who received routine care alone (ventilated patients, patients who only needed oxygen, and those who did not require respiratory support). . Dexamethasone was found to reduce deaths in ventilator patients by one third and by one fifth in patients who only needed oxygen. 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 who need oxygen and those with respirators.
Although these early preliminary results are very promising, only the full results will provide a complete picture and solid evaluation. With 14 additional clinical trials investigating dexamethasone against Covid-19 and with eight trials expected to be completed in 2020, this could provide additional evidence of the efficacy of dexamethasone for the treatment of Covid-19.
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