COVID-19: steroid lowered mortality and potential drug-drug interaction

Low-dose dexamethasone is associated with reduced mortality risk among patients with severe COVID-19, making it the first drug to show such an effect, according to a statement by trial investigators at the University of Oxford. Over 6,000 hospitalised patients were randomised to receive either dexamethasone (6 mg daily) or usual care for 10 days.

Dexamethasone was associated with significantly lower risk for death among ventilated patients (rate ratio, 0.65) and other patients receiving oxygen (RR, 0.80), compared with those given usual care. Patients who did not require respiratory support did not see a benefit. The authors estimate that eight ventilated patients or 25 patients requiring only oxygen would need to be treated with dexamethasone to prevent one death. The results have not been published in a journal yet.

The U.S. Food and Drug Administration (FDA) is warning that remdesivir should not be used alongside hydroxychloroquine or chloroquine as it may result in lower antiviral activity for remdesivir. The announcement was based on lab studies, but the interaction has not been observed in the clinical setting. The FDA recently pulled the emergency use authorisation for hydroxychloroquine and chloroquine for COVID-19.