The professor at the Santara clinics evaluated the drug published against COVID-19: when will it be used to treat patients in Lithuania?

Delfi spoke about this with the head of the Hematology, Oncology and Transfusion Center of the Santara Clinics prof. Laimonas Griškevičius.

The doctor says this situation is nothing special when it comes to new treatments for general illnesses, so it would be enough for doctors to know more about the medical details before prescribing COVID-19 to patients with infection, i. and. See published results of the entire study. So far, it has only been briefly featured in the British media.

“Physicians treating COVID-19 patients need to see the publication, dig deeper into the medical examination data, not just see the press release,” says the professor. L. Griškevičius.

– I don’t think we need additional permits for a new treatment. There are other diseases and conditions in which doctors choose to treat a patient in one way or another based on research data published in the medical literature. That’s a pretty common situation. “

According to Gytis Andrulionis, head of the State Medicines Control Agency (CBI), the World Health Organization (WHO) calls this British discovery an outbreak in the treatment of seriously ill patients with COVID-19.

“Although the information on the efficacy of dexamethasone is new, it is being carefully evaluated and analyzed. It will be decided immediately whether to include this drug in a nationally agreed treatment protocol for patients with COVID-19 and to start treatment in patients in the country. The best way to use this medicine in the treatment of people with coronavirus infection will be decided by medical experts and clinical pharmacologists, and there will also be consultations and collaboration with scientists from other countries, “said the head of the IWT.

So far cautious

Prof. L. Griškevičius says that a lot of published information so far on preparations that may help patients with COVID-19 infection has been denied, therefore, in this case, specialists are still cautious. However, according to the head of the Hematology Center of the Santara Clinics, this time the published information is considered correct.

“Until now we know little, because the study itself has not been published, in other words, its data has not been published in a medical journal. We know as much as it is published in the media, we do not know the medical details,” said the professor. . L. Griškevičius.

A hematologist says that dexamethasone is a medicine well known to many doctors. According to British researchers, the drug was effective in patients with severe COVID-19, that is. and. those patients who needed extra oxygen or those who even needed artificial pulmonary ventilation.

“Administration of this drug reduced patient mortality, i. And. The number of deaths from COVID-19 infection, says Prof. L. Griškevičius.

– This is the first study to show a life-saving benefit. Other large randomized studies to date have shown that the drug has been ineffective or, for example, treatment with remdesivir has been shown to reduce the duration of the disease, but has not been shown to be beneficial in reducing patient mortality. ” .

A study with dexamethasone showed that patients with severe COVID-19 had a reduction in mortality from infection.

Dexamethasone reduced mortality by one third in patients connected to pulmonary ventilators and by one fifth in patients requiring supplemental oxygen. news.sky.com.

Efficacy data for the steroid medication was taken from the Recovery clinical trial, which evaluated several possible treatments for COVID-19. It is estimated that this drug would have saved 4-5 thousand. Live if patients had received it sooner.

The tests, led by a team of scientists from Oxford University, involved about 2,000 people. patients were given dexamethasone. Almost 4 thousand more. patients were not prescribed in the study. In patients who needed lung ventilation, the drug reduced the risk of death by 40 to 28 percent. In patients who needed supplemental oxygen, the risk of death from the drug was reduced from 25 to 20 percent.

If these results are justified, prof. L. Griškevičius agrees with other experts that this will be important in the treatment of people with COVID-19 infection.

But in addition, the hematologist adds that it is positive and important that dexamethasone is a known drug, widely used and available (cheap) for many doctors.

“The drug dexamethasone is mainly used as an immunosuppressant, as an anti-inflammatory and anti-tumor medicine, for example in the treatment of blood diseases, blood cancer. It also has more uses. Doctors know this drug well: its positive and negative properties, says prof. L. Griškevičius.

“If, after evaluating the data provided in the medical publication, we are convinced of its effectiveness, I think we would treat Lithuanian patients with this drug.”

Anti-inflammatory drug

As emphasized by the doctor at the Santara clinics prof. L. Griškevičius, dexamethasone is not an antiviral medicine.

“It is a medication that suppresses the inflammatory response and cytokine storms,” ​​said the doctor.

– The need for supplemental oxygen and the patient’s connection to the ventilator often arises when there is a very severe inflammatory response syndrome and cytokine storms. Dexamethasone specifically inhibits these cytokine storms. We are currently using dexamethasone to suppress a cytokine storm from causes other than COVID-19, such as other viral infections, autoimmune or blood diseases. “

According to an IWT press release, dexamethasone is a synthetic glucocorticoid. It is included in several pharmaceutical forms: eye drops, solution for injection or tablets. It can contain alone or in combination with other active substances. The therapeutic effect of dexamethasone is due to its potent inhibition of inflammation and immunity (approximately 30 times greater than that of physiological glucocorticoid hydrocortisone).

It is used to treat certain diseases of the nervous system and the lungs and airways (acute asthma, acute obstructive laryngitis), as well as severe and widespread acute skin conditions such as erythroderma and herpes simplex, autoimmune diseases such as systemic vasculitis, rheumatoid arthritis, idiopathic arthritis juvenile systemic severe. Dexamethasone is used to treat adults with idiopathic thrombocytopenic purpura. The drug is used in combination with an anti-infective treatment for tuberculous meningitis and for the treatment of some oncological diseases.

Dexamethasone is a prescription medication and can cause side effects such as hypersensitivity, decreased reaction, depression, insomnia, weight gain, hypertension, or even rupture of the heart muscle after a recent myocardial infarction, congestive heart failure in predisposed patients, heart failure.

See more about this drug on Wednesday’s Delphi program: