Drug Trump is taking only works on serious Covid-19 cases, says professor who led Oxford trial
A British professor who led the trial of the new drug that Donald Trump is taking has said it only works best on serious cases of Covid-19, adding to fears over the seriousness of the President's illness.
Mr Trump will remain on dexamethasone "for the time being" after first taking the steroid on Saturday, his medical team said on Sunday night.
The drug, which has been described as "groundbreaking", is widely used to reduce inflammation and has been found to reduce a patient's risk of death from Covid-19 by around a third.
Martin Landray, professor of medicine and epidemiology at the University of Oxford who oversaw the Recovery trial which took place in the UK and successfully concluded in June, said that dexamethasone is "available in pretty much every hospital in the world".
"The Recovery trial reported that dexamethasone reduces mortality or improves survival particularly for patients with severe Covid," he said.
"It’s a drug which we know well, it’s quite clear where the benefits are and it’s now recommended in the UK, it’s recommended by the World Health Organisation, it’s recommended by the NIH in the United States.
"It’s a very good drug in the right patients. But it’s not effective in patients who do not require oxygen, ventilatory support and so on."
Professor Landray said that for coronavirus patients on a ventilator, dexamethasone reduces the risk of dying by one-third, while for patients who are not on ventilators it reduces the risk of death by about one-fifth, but there is no benefit to dexamethasone in mild patients.
Mr Trump's oxygen levels dropped to 93 per cent at one point, his doctors confirmed on Sunday, at which point it is understood that a patient in the UK would be given oxygen and a dose of dexamethasone.
Jonathan Sterne, professor of epidemiology at the University of Bristol, contributed to a separate study on dexamethasone in critically ill patients which appeared in the Journal of the American Medical Association (JAMA) .
“The study I was involved with - the metaanalysis in the Journal of the American Medical Association - they were all patients admitted to intensive care and on substantial amounts of oxygen," he said. "The benefit of dexamethasone appears to be greatest in the sickest patients.
“The Recovery trial randomised patients and in the least sick patients - the ones who weren’t on oxygen when they started treatment - mortality was somewhat higher in the patients who had dexamethasone compared to normal care. So the WHO recommends against treating with steroids unless you are sufficiently sick.
“We were only focusing on the critically ill patients and it was clear that a course of steroids reduced mortality. From the Recovery trial, among the patients who were not on oxygen when they started treatment, you can say there was no benefit.”
The UK government approved dexamethasone to be available on the NHS in June, following clinical trials proving its efficacy at reducing the risk of death for Covid-19 patients.
It was described by Boris Johnson, the Prime Minister, as the first "chink of light" in the ongoing global effort against the pandemic.
The drug can either be taken orally or as an injection, and scientists said that up to 5,000 lives could have been saved in the UK if they had known about the effectiveness of the drug at the start of the pandemic.
