If a british study has shown the effectiveness of the treatment for patients with severe, it might nevertheless prove dangerous for patients that are less critical.
This treatment is very promising. Dexamethasone is a drug that has proven effective for the seriously ill patients with the virus Covid-19 and reduces mortality, according to british researchers. The WHO has called earlier this week to increase production of dexamethasone.
“The next challenge is to increase the production and to distribute quickly and fairly, and dexamethasone in the world, focusing on the places where it is needed the most,” said the director general of the world Organization of health, Tedros Adhanom Ghebreyesus, during a virtual press conference.
what is dexamethasone ?
dexamethasone is a treatment is already known. It is a medication in the family of steroid used in numerous indications for its anti-inflammatory effect powerful. It is also prescribed for patients with cancer, in chemotherapy.
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According to the Vidal reference guide for health professionals, corticosteroids, synthetic – including the dexamethasone – decreased (high-dose) immune response. Their metabolic effect and sodium retention is less than that of hydrocortisone (…) In ophthalmology, it has been demonstrated that dexamethasone, a corticosteroid powerful, could suppress inflammation by inhibiting edema, fibrin deposition, leaking capillaries and the migration, phagocytic inflammatory response.”
on the other hand, it is a medicine that is “inexpensive and there are many manufacturers of dexamethasone in the world,” says Tedros Adhanom Ghebreyesus.
For whom is it effective ?
inexpensive and easily available, this steroid is at this point the only drug that appears to improve survival in patients with the Covid-19.
This does, however, concern that patients most severely affected : those who are placed on artificial ventilation and, to a lesser extent, those in which oxygen is administered without intubation. In the first, dexamethasone reduces the mortality of a third party, according to initial results of a large clinical trial british Recovery.
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The director-general of WHO has pointed out that “the dexamethasone should only be used for the sick of Covid-19 in serious condition or critical, under close clinical monitoring”. “There is no evidence that this drug works for patients with a benign condition or as a preventive measure, and it could cause damage”, he insisted.
Announced on Monday, these results have not yet been published in a scientific journal. But in the aftermath, the british government has announced that this treatment would be immediately used to treat the patients concerned.
dexamethasone is already used in many indications for its potent anti-inflammatory effects and immunosuppressive.
Why is it not miraculous ?
Precisely, the health authorities had warned throughout the crisis that the inflammatory drugs are contra-indicated for the treatment of symptoms suspicious of Covid-19. Of these medications, such as ibuprofen, “could be a factor of aggravation of the infection” in people sick with coronavirus, had alerted the minister of Health Olivier Véran.
The researchers of the british study on the dexamethasone put a damper on the treatment, reports the New York Times. It could actually be dangerous for people who are suffering from Covid-19, but in a way that is less virulent.
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“It’s a bit as if the disease was divided into two phases. A phase in which the virus dominates, and the phase immunological, where the damages are mainly caused by the immune system”, explains dr Martin J. Landray, lead author of the study and a professor of medicine and epidemiology at the University of Oxford, quoted by the New York Times.
“This drug may harm some patients, and we are not exactly sure what the patients are concerned”, the doctor Samuel Brown to the u.s. daily, an assistant professor of medicine pulmonary and critical care at the School of medicine of the University of Utah in Salt Lake City, who was not involved in the study.
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dexamethasone would therefore have very different effects depending on the stage of the disease where it is administered to the patient. “At the beginning of the disease, the immune system is your friend”, explains the professor Landray. “It fights the virus and mitigate it is not ae good idea.”
