Rheumatoid arthritis

Coronavirus: What is dexamethasone and how does it work?

What’s reaction been worldwide?

The World Health Organization has welcomed the trial results, saying more therapies are now needed for milder symptoms.

The findings are particularly good news for developing countries too.

In many African nations, for example, the drug costs less than two dollars.

In South Africa, where the drug is manufactured, the government has already been advised to use it to treat patients on oxygen or ventilation support.

Data from the WHO shows that more than 5,000 people have died from Covid-19 in Africa, the majority of whom had underlying health conditions.

What other conditions is it used for?

The drug can help treat various illnesses involving inflammation or swelling in the body, or conditions where the immune system goes into overdrive – for example, severe asthma which can cause inflammation in the airways and lungs, severe allergic reactions or painful, inflamed joints.

Dexamethasone is also useful in autoimmune conditions such as rheumatoid arthritis or lupus, which are caused by the immune system mistakenly attacking the body.

Are there any side-effects?

Common side effects of dexamethasone used for non-COVID conditions include anxiety, difficulty sleeping, weight gain and fluid retention.

Rarer side effects include eye disorders, blurred vision and haemorrhage.

However, coronavirus patients only need a relatively low dose which should limit side effects.

The Chief Medical Officer for England said there were “no excess harms identified in using this dose of dexamethasone in this patient population”.

Do other steroids work?

Prof Peter Horby, who led the UK research on dexamethasone, said the use of steroids to treat viral respiratory infections, such as Covid-19, has been controversial.

Trials of the drugs during other disease outbreaks, including Sars – another coronavirus- were mixed with some showing a benefit, but others not.

“It’s been a huge ongoing debate,” says Prof Horby.

Scientists are trialling other steroids, such as methylprednisolone, in coronavirus patients with some promising early results.


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