Pakistan to use dexamethasone to treat critically ill COVID-19 patients

Pakistan will use dexamethasone to treat critical novel coronavirus patients after researchers in the United Kingdom announced that the inexpensive and widely available steroid cuts the risk of death.

The World Health Organization (WHO) has hailed the finding about the drug as a “lifesaving breakthrough.”

The number of COVID-19 patients has been climbing up dangerously 157738 infections and 3033 deaths, and Prime Minister Imran Khan Government has reverted to lockdowns.

Pakistan’s top health official, who serves as special assistant to the Prime Minister, Dr. Zafar Mirza says the country has ample supply of the drug and may include it in the standard treatment for COVID-19 patients on ventilators or in need of oxygen.

In a series of tweets, he said the WHO had responded positively to the new research, and an expert committee in Pakistan will now consider making it part of the treatment plan.

“It is an old a cheap anti-inflammatory medicine (steroid) & we have multiple producers in Pakistan,” he said.

Mirza clarified that the medicine is only to be used for critically ill COVID-19 patients who are on ventilators or need oxygen.

“The medicine MUST NOT be used by mild to moderate patients; self-medication is strictly prohibited and can be dangerous as the medicine has many side-effects,” he warned.

On Tuesday, the WHO said dexamethasone had reduced mortality by about one third for patients on ventilators, and by about one fifth for patients requiring only oxygen, referring to preliminary findings of research conducted at Oxford University.

“This is the first treatment to be shown to reduce mortality in patients with COVID-19 requiring oxygen or ventilator support,” WHO chief Tedros Adhanom Ghebreyesus said.

“This is great news and I congratulate the Government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this lifesaving scientific breakthrough.”

Dexamethasone is a steroid that has been used since the 1960s to reduce inflammation in a range of conditions, including inflammatory disorders and certain cancers.

It has been listed on the WHO Model List of Essential Medicines since 1977 in multiple formulations, and is currently off-patent and affordably available in most countries, according to the global health body.

According to the research, a total of 2104 patients were randomized to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomized to usual care alone. “Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).”

“Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; p=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; p=0.0021). There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75; p=0.14).”

Meanwhile, the demand for dexamethasone has skyrocketed in Pakistan soon after its successful trial against COVID-19 in the United Kingdom.

“Its original price in Pakistan is 85 paisa. But now it is not available anywhere,” Muhammad Riaz, a Lahorite said.