Jun 17, 2020 - Health

Dexamethasone is creating cautious optimism

A hand holding a box of dexamethasone tablets.
Dexamethasone is on the World Health Organization's "essential medicines" list. Photo: Justin Tallis/AFP via Getty Images

The new best hope for treating seriously ill coronavirus patients may come from a synthetic steroid that has been around for roughly 60 years.

Why it matters: Because it's an old, inexpensive drug, dexamethasone may have a leg up on remdesivir and other new, potentially costly treatments — especially if they don't work as well.

Driving the news: British researchers said yesterday that dexamethasone helped save seriously ill coronavirus patients' lives in a randomized, controlled trial.

  • The steroid significantly reduced the risk of death among patients who were on a ventilator, and showed more limited benefit for patients who were on supplemental oxygen, according to the researchers' press release. It showed no benefit for mild cases.

Between the lines: Some physicians and researchers, including Peter Bach of Memorial Sloan Kettering, say dexamethasone now seems more promising than remdesivir — the only other drug that has been shown to help treat coronavirus.

  • Dexamethasone appears to save lives, and is most effective with severe cases. Remdesivir only shortens hospitalizations and is most effective for less severe cases.
  • Dexamethasone also is available as an oral tablet, whereas remdesivir is an IV medication.
  • And dexamethasone only costs about 50 cents per tablet, according to drug pricing research firm 46brooklyn, while Wall Street analysts believe Gilead may put a $5,000 price tag on each course of remdesivir.

Yes, but: Yesterday's encouraging news was another example of what Politico described as "science by press release" — a persistent problem during this pandemic.

  • Many researchers said it's difficult to call dexamethasone a winner yet, given the amount of misinformation and retractions that have come out with other coronavirus treatments.
  • The British researchers said they are "working to publish the full details as soon as possible."
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