Dexamethasone is an existing steroid drug that prevents the body from releasing substances that cause inflammation. Available as a tablet or injection, it is already used to treat conditions including ulcerative colitis, arthritis, lupus, psoriasis and breathing problems.
On Tuesday, researchers at the University of Oxford in the U.K. announced dexamethasone was found to reduce deaths by one-third in hospitalized COVID-19 patients hooked up to ventilators, and a fifth in those requiring oxygen. They found it had no benefit to those who did not need respiratory support. The study involving 2,104 patients was part of the university’s RECOVERY trial into potential COVID-19 treatments.
The findings have not yet been published in a peer-reviewed journal, meaning other experts have not been able to assess the team’s data.
Following the announcement, Google searches in the U.S related to dexamethasone spiked, including terms such as “buy,” “buy online,” and “prevent COVID.” While some searches appeared to be related to buying stocks in companies that sell the drug, related queries included “where can I buy dexamethasone,” and “dexamethasone over the counter,” suggesting an interest in taking it.
In the U.S., the drug is only available with a doctor’s prescription. Experts told Newsweek the general public should not try to buy dexamethasone from illicit websites.
Duncan Young, a professor of intensive care medicine at the University of Oxford who is not working on the dexamethasone trial, told Newsweek via email: “Individuals may be able to obtain stocks from the internet (likely tablets rather than injection form) but as with all illegally-procured drugs the quality will be unknown.”
Young said: “Dexamethasone has not been shown to prevent COVID-19 infection, and it is very unlikely it would.”
Taking the drug in an attempt to prevent COVID-19 “would be dangerous,” he said, as it has a range of serious side effects including psychosis, increased risk of infections and ulcers.
In the RECOVERY trial, the drug was administered in injections over a short period of time and the potential benefits balanced against the potential side effects, said Young. “If individuals take dexamethasone as prophylaxis they will be exposed to the drug side effects but will get no benefit.”
Ayfer Ali, assistant professor in the Strategy and International Group specializing in drug repurposing at the U.K.’s Warwick Business School, told Newsweek: “It is really important to stress that dexamethasone has not been shown to lower deaths in mild disease and we have no data on whether it modifies disease duration in any of the patients.
“Dexamethasone is an immunosuppressant that can theoretically make early disease worse and make one more susceptible to get ill with COVID-19 if used for those who don’t have the disease. We just don’t know.”
Echoing their concerns, Ian Hall, professor of molecular medicine at the University of Nottingham told Newsweek: “Currently there is no evidence it works in patients with milder disease, and people should not take dexamethasone, which is a powerful steroid with significant side effects if used inappropriately, outside of the guidelines.”
Nick Cammack, COVID-19 Therapeutics Accelerator Lead at the U.K.-based research-charity the Wellcome Trust, told Newsweek: “Anything can be bought on the internet, but we stress the importance of paying attention to the advice given about the use of dexamethasone and thinking of the critically ill patients who stand to benefit from it.”
If enough people abuse dexamethasone, this may result in an increase of non-COVID-19 hospitalizations, Dr. Faheem Younus, chief of infectious diseases at the University of Maryland Upper Chesapeake Health, told Newsweek. He also highlighted it may increase a person’s risk of catching infections.
Asked whether there are concerns that the public might try to take dexamethasone, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, told Newsweek via email: “We have seen that the public can do some crazy things in this pandemic, sometimes influenced by ignorant people so, yes, it’s possible, but we hope people may be more sensible.”
He said: “Steroids have many side-effects and using them when there is no benefit is very foolish. It is for use by doctors in hospitals for very sick patients, not for those in the community and definitely not for prevention.”
Commenting more widely on the results of the trial, Evans said: “There is a process by which the virus moves to infect someone, cause disease and cause death. Dexamethasone is relevant right at the end of that process in being the first drug to convincingly show a reduction (not total prevention by any means) in death from COVID-19.”
He went on: “It is good news, but it is not a complete answer. We will need a variety of drugs to act at different stages of the disease process and to deal with different aspects of the disease, such as coagulation problems, as well as hopefully several different effective vaccines, so the battle is not won, but it is a good step towards it.”
This article has been updated with comment from Ayfer Ali, Ian Hall, Faheem Younus, and Nick Cammack.
