Local physicians said a U.K. study of the use of the steroid dexamethasone in treating severe COVID-19 patients showed promising results, but they're reserving judgment until more data from the study is published. Initial results were announced Tuesday in a press release.
The randomized trial, supported by the University of Oxford, tested dexamethasone in about 2,100 patients with an additional 4,300 receiving only usual care.
The study found that the drug reduced the number of deaths by one-third in patients using mechanical ventilators and one-fifth in patients receiving only oxygen. There was no benefit among patients who didn't require respiratory support.
"At this moment I would interpret this study with enormous caution. We haven't had a chance to read the paper, and it hasn't undergone peer review," said Dr. William Southern, chief of hospital medicine at the Albert Einstein College of Medicine and Montefiore Medical Center. "The reason so many people are excited is if it turns out to be valid and withstands scrutiny, it would very fundamentally change the way we treat patients with COVID-19."
Southern and Dr. Shitij Arora, an associate professor of medicine at Einstein, are working to publish a paper of their own on the use of several steroids, including dexamethasone, to treat patients severely ill with COVID-19. They said their findings are consistent with the U.K. researchers' data. Their article is still undergoing peer review.
"I understand people want to release findings because of the significant public health impact," Arora said. "Look at the number of retractions [recently] in NEJM and the Lancet. This trend is not the way to go."
The physicians said peer-reviewed research is particularly important because of the adverse effects steroids can have on some COVID-19 patients. They said patients who were less sick tended to fare poorly with steroids. For that reason, dexamethasone is unlikely to work as a treatment beyond hospitalized patients.
Dr. Angela Rasmussen, a virologist at Columbia University's Center for Infection and Immunity, said the earlier experience with hydroxycloroquine, in which people were taking it for nonapproved uses or hoarding it, shows why it's important for researchers to release clinical trial data. If the study pans out, she said, it's very encouraging.
"The fact that these findings apply to only a subset of patients with very severe disease means that it's essential to release the trial data so that it can be prescribed appropriately," she said.
This article was originally published in Crain's New York Business.
