Early results from an NHS study has revealed the dexamethasone, a steroid, could be the first drug to reduce mortality among COVID patients who need respiratory support. How does it work? We spoke with Dr Sumit Ray, a critical care specialist.
Make some misses one is a very old drug very inexpensive it’s not a magic truck it’s not a wonder drug understand that everybody doesn’t need to take it so if you just talk to us a little bit about what this truck is and is this a new discovery or is that something that you have in your practice or d being using right so dexamethasone is a very old drug very
Inexpensive drug okay so that’s the good part of it i always love drugs which work which are cheap always worried about expensive drugs which work for a few people but having said that so dexamethasone is a steroid and said it is steroids have been used in a rds okay whenever there is acute respiratory distress syndrome and there’s a large damage to the lung the
Evidence has been kind of equivocal some studies have shown significant benefit to the road some haven’t shown that amount of benefit in terms of survival and in this case the recovery trial which was done in the in england by the nhs used the takes a methodology and it has shown to reduce as you said sir improves survival by 33 percent in ventilated patient and
About 25 percent in non ventilated patients on oxygen and even before this trials this trial was done with steroids because there was evidence that means probably in the setting of ovid steroids may benefit a subset of patients so already most of us were using steroids different doses somewhat higher doses than this and so this is very good news that a basic drug
Which is very cheap it’s very inexpensive is showing some degree of benefit it’s not a magic truck it’s not a wonder drug under and that everybody doesn’t need to take it if they’re those who have kove it because like all steroids has a side effects makes you prone to secondary infections so it has to be done under medical supervision right so the role in covent is
Is the inflammatory response basically when you have the cytokine increase so many patients with ghovat infections have an increase in the cytokine release of cytokines which are these chemicals which are released by the body in reaction to the infection so to a certain extent if you completely some press them there is a problem because you need the immune response
To fight the infection but it’s that immune response should not go out of control okay it will not over overboard so that’s what so the steroids kind of at a lower dose modulate this immune response how much exactly balance is elisa fine back so in this in this study they used a very small dose of six milligrams other studies have used higher doses not for kovin
But for a rds and other settings we expect me to a certain extent that this benefit steroid of it because of the initial kind of information that we got from our colleagues from abroad seem to show that there would be benefit and that’s why in india almost all of us are using steroids in the icu setting in critically ill kovach patients steroids have been used for
Multiple reasons for a long period of time so one is that you have amino logical disorders where your immune your immune system is at attacking some organs of your own body there are these are like autoimmune diseases where steroids have been used steroids are used in when you have severe allergic reactions right so steroids have a very positive role also steroids
Have been used in severe asthma when you have a severe spasm of the you know the airways of the lungs etc steroids low dose steroids have been used in in septic patients in septic shock where you know so when the blood pressure drops a low dose steroids i think the results have been so positive see the two reasons why it’s very exciting is large number of patients
Second done by the nhs which whose credibility is very very high across the world with all their problems third it doesn’t you know benefit anybody else but the patient it doesn’t increase you know the expert price is so low that you know the sales of the company or the share he is not going to go up just because dexamethasone and it’s produced by multiple companies
This out of patent so that’s the good part so the conflict of interest that we see in many drugs many medications which are which are used in a crisis like this expensive medications that data that is not there at all and that’s why the probability that let’s this study is a really true good study is very very high
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Explained: What is Dexamethasone? How Could It Work in COVID Patients? | The Quint By The Quint
