Indian doctors express cautious endorsement for dexamethasone for COVID-19

There was no benefit among those patients who did not require respiratory support.

A picture taken on June 16, 2020 in Paris shows tablets of Dectancyl, a drug manufactured by Sanofi containing dexamethasone. .The steroid dexamethasone has been found to save the lives of one third of the most serious COVID-19 cases, according to trial results.

Indian doctors have said the reported success of dexamethasone — an inexpensive steroid that retails for less than ₹10 for 10 ml and is made by several Indian manufacturers — at curing COVID-19 patients on ventilators is good news for India.

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Scientists administering the WHO-administered RECOVERY trial — the largest global clinical trial — that is checking the ability of several re-purposed drugs to treat COVID-19, reported on Tuesday that dexamethasone reduced deaths by one-third in ventilated patients and by one-fifth in other patients receiving oxygen only.

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For serious conditions

There was no benefit among those patients who did not require respiratory support.

Based on these results, one death would be prevented by treatment of around eight ventilated patients or around 25 patients requiring oxygen alone, scientists said.

The same trial had earlier reported no benefit from hydroxychloroquine in treating sick COVID-19 patients.

A scientific study with details on how the study was conducted and evaluations made isn't yet available and the preliminary results were communicated via a press statement.

“Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result. The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide,” Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial, said in a statement.

“If the claims bear out in the published study, then this is great news,” Dr. Able Lawrence, Professor of Clinical Immunology and Rheumatology at the Sanjay Gandhi Postgraduate Institute of Medical Sciences, told The Hindu. “It is a cheaper option than tocilizumab.”

The latter is also being tested as part of the RECOVERY trial and is an injectible. Dexamethasone and tocilizumab are not anti-virals but work to modulate the immune response of the body when confronted by a viral infection such as COVID-19.

Last week, the Indian Council for Medical Research revised the protocol for clinical management of COVID-19 and allowed the use of remdesivir, tocilizumab and convalescent plasma therapy (CPT) on certain groups of patients.

Remdesivir, a patented drug by U.S.-based Gilead Life Sciences , reduced hospital stays for very sick COVID patients but has not been shown to improve recovery itself.

Physician and epidemiologist, Dr. Giridhar Babu, told The Hindu that dexamethasone's ostensible benefit is “positive news” for those with severe disease. “This is cheap and widely available; however being a steroid, its abuse can lead to several adverse reactions.”