KT Explainer: All you need to know about dexamethasone

Since the start of the pandemic, the race has been on to find a viable cure.

Earlier this year, US President Donald Trump threw his might behind the malaria drug Hydroxychloroquine, touting it as the "cure" for coronavirus and stockpiling doses for the treatment of Covid-19 patients in the US.

However, last week, the FDA revoked its emergency use authorisation of the drug, as they concluded the drug may not be effective in treating the virus.

News of a major breakthrough, therefore, by scientists in the UK, who found that administering low doses of the generic steroid drug dexamethasone reduced mortality rates in severely affected Covid-19 patients by 35 per cent has been hailed as a much welcome development.

Dexamethasone is not a new drug; it has, in fact, been in medical use since 1961 and is on the World Health Organization's List of Essential Medicines.

Khaleej Times spoke to Dr. Muhammed Shafeeq K, specialist pulmonologist at Aster Hospital, Mankhool and Qusais, to understand what the heartening results of this latest trial mean in the fight against Covid-19.

Here's all you need to know.

What is dexamethasone?

Dexamethasone is a steroid, an anti-inflammatory drug. It reduces the body's inflammatory reaction by mimicking the usual steroid hormones produced by our body. Its main action is anti-inflammatory activity.

What is it usually used to treat?

It's a common and cheap drug, having wide-range use. It is used to treat any disease that causes severe inflammatory reaction in our body. Its commonest use is in patients who get admitted with asthma exacerbation (attack). It is also used in various other conditions, such as patients who develop acute allergic reactions, anaphylactic reactions, autoimmune reactions such as rheumatoid arthritis, and other painful inflammatory conditions.

How can it help in the fight against Covid-19?

Studies are showing dexamethasone is effective in severe and critical Covid-19 cases - such as those who require oxygen supplementation or mechanical ventilator support.

Since this is a new infection to the body, in some individuals, their own body produces an exaggerated inflammatory response against this virus. This hyper-stimulation of the body's own immune system is what damages the body's cells and causes death.

Since dexamethasone is a potent anti-inflammatory drug, it helps to suppress the immune system and recover those patients from that critical stage.

In what form is dexamethasone administered?

It is administered via injection. The recent trial by scientists in the UK (called Recovery) found that giving a low dose of 6mg for 10 days reduced mortality in patients requiring ventilators by one-third, and in those requiring oxygen support by one-fifth. We have administered the same drug to some of our patients and gotten positive results too.

Why is it only effective in serious or critical cases of Covid-19?

Dexamethasone mainly acts by reducing the exaggerated inflammatory response. Patients who are only mildly affected by Covid-19 won't have that much stimulation of the immune system. If such patients are given this drug, it will suppress the body's normal immune system and there is a chance that the infection might actually progress.

Can it be used for children?

The trial has been performed mainly in adults. Since it's a steroid and mimics the normal hormones in our body, it can potentially be used. But the trials have only been done on adults so far.

Are there any side effects of taking dexamethasone?

As with any medicine, if there are effects, there will also be side-effects. Also, different individuals can have different reactions to the same medicine.

For dexamethasone, some common effects for short-term usage are anxiety, sleep disturbances, and weight gain.

Can one take it as a preventative medication? Should people stock it just in case?

Not at all. Only if a patient falls into the severe category of Covid-19 cases should dexamethasone be considered.

How much does it cost here in the UAE?

The per day cost is between Dh2-3. We have 8gm vials in stock, the cost of which is Dh2.6. It's quite a cheap drug.

karen@khaleejtimes.com