Breakthrough steroid for coronavirus

Researchers at the University of Oxford have made a stunning breakthrough in treating coronavirus using a cheap steroid.

Dexamethasone, an easy to produce and relatively cheap steroid, has been shown to have achieved excellent results in treating critically ill patients, cutting the risk of death by a third in patients on ventilators and for those on oxygen by a fifth. It has shown great success in disrupting the so-called cykotine storm, the mass inflammatory reaction that is the coronavirus’s hallmark.

The treatment was trialled alongside several antiviral drugs and the antimalarial drug hydroxychloroquine in the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial, the largest randomised clinical trial for coronavirus treatments in the world.

Martin Landray, Professor of Medicine and Epidemiology at the Nuffield Department of Population Health,  spoke to Reaction a few weeks after the trials were announced in April. At that point, 6,000 patients had been enrolled across 160 or more hospitals. That figure now stands at 11,000 across 179 hospitals.

You can read the full interview here with Landray, who heads the trials. He had some fascinating observations on the need for randomised trials with control groups to ensure we learn as much as possible from the first wave of coronavirus.

Coronavirus is not at epidemic levels in Europe – it is however making swift progress in other parts of the world. Dexamethasone, which costs around five pounds per patient, is easy to produce at scale and readily available.

What really struck me about Landray’s comments in April was the UK’s unique institutional position of strength in the development of appropriate treatments – with a clear and well-defined goal married to good strategic decisions our centralised system is well-adapted to this kind of effort.

Much has been written about the soft power stakes of the coronavirus vaccine race. Vaccines will take some time, have a high error rate and take huge resources to produce across the world. No such obstacles present in the case of a readily available drug like dexamethasone. Discovered in Britain – available everywhere. Quite the advertisement!