Last week, a study in the UK found that dexamethasone, a common steroid, increased the survival of critically ill COVID-19 patients who needed help with breathing.
A few days after the publication of this report, weekly demand for dexamethasone increased by over 600% in the United States, according to data from the healthcare performance improvement company Vizient. This figure corresponds to what is happening in the world, as the Director General of the World Health Organization, Tedros Adhanom Ghebreyesus, said that demand for the drug had “increased” following trials in the United Kingdom . –>
Dexamethasone now represents the second pharmaceutical treatment whose efficacy has been demonstrated for COVID-19. An antiviral medication, remdesivir, has been shown to help hospital patients leave the hospital earlier.
Following positive data on dexamethasone, the steroid was quickly approved by the United Kingdom government for use in COVID-19 patients.
In the United States, Secretary of Health and Human Services, Alex Azar, said Friday that the drug had been added to treatment guidelines, and the Infectious Disease Society of America announced Thursday that doctors should consider use the steroid in hospital patients with COVID-19.
Even given the recent surge in demand, experts say there is no immediate threat of a drug shortage. –>
Although promising, dexamethasone has only been shown to help patients with severe COVID-19 who need help with breathing, ventilation or oxygen support. Steroid treatment does not help people with milder COVID-19 disease, which accounts for most cases. Dexamethasone has also not been shown to prevent COVID-19 infections.
A close up of a box of dexamethasone tablets in a pharmacy June 16, 2020 in Cardiff, United Kingdom. Results of a trial announced today have shown that dexamethasone, a cheap and widely used steroid that is used to reduce inflammation, has reduced the death rate by about a third in COVID-19 patients. most seriously ill admitted to hospital.
A close up of a box of dexamethasone tablets in a pharmacy June 16, 2020 in Cardiff, United Kingdom. Results from a trial announced today have shown that dexamethasone, a cheap and widely used steroid that is used to reduce inflammation, has reduced death rates by about a third in COVID-19 patients. most seriously ill admitted to hospital. /.
In fact, it may not be safe to use it in patients with mild illness. In the UK study, dexamethasone “does not significantly increase mortality if used in lighter patients with COVID-19,” said Dr. Todd Ellerin, director of infectious diseases at South Shore Health . He warned that for patients with milder COVID-19 disease, “the risks of the drug probably outweigh the benefits”.
Even in new seriously ill coronavirus patients, there is still some caution regarding the use of dexamethasone.
“We have very many articles showing both the pros and cons of steroids for critically ill patients, many doctors may want to wait for additional data,” said Erin Fox, drug shortage expert at University of Utah.
According to Fox, there has been a shortage of certain forms of injectable dexamethasone since 2011, where “in some cases, you couldn’t get the exact size or strength you wanted.”
The good news is that intravenous and oral dexamethasone was used in the UK study and either can be used to help seriously ill COVID-19 patients.
“Dexamethasone is widely used in all hospitals,” added Fox. “Even small rural hospitals would keep some in stock.”
Steven Lucio, vice president of pharmacy solutions at Vizient, said, “I hope we will be able to manage the supply situation,” as there are several providers of injectable and oral dexamethasone.
That said, the drug should always be administered wisely, Ellerin noted, adding, “We have to be careful not to amass dexamethasone, or it will almost guarantee that we will have a shortage.” ”
This contrasts with the concern over the increasing demand for oxygen concentrators, an essential resource for the treatment of severe COVID-19 cases that exceeds supply. Tedros has found that 80% of the market is controlled by just a few companies.
Smoothing out the curve, requiring fewer supplies for treatment, is perhaps the surest way to prevent shortages of critical supplies, noted Dr. Rajesh T. Gandhi, member of the Infectious Disease Society of America.
With frequent hand washing, wearing a mask, and social distancing, Gandhi added, “We know how to prevent these cases. ”
Hassal Lee, a doctorate in neuroscience and a medical student at the University of Cambridge, is a contributor to the ABC News medical unit. Sony Salzman is the coordinating producer of the unit.
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