Good News - Dexamethasone

[Guy Etchells]

There is now a treatment that can cut deaths of those on mechanical mentilators by one third and those on oxygen by one fifth.
The standard use drug Dexamethasone has been shown to be effective is such cases.

Cheers
Guy

[Viktoria]

Just seen that in the news Guy, good news indeed.
Plus the School meals voucher scheme is extended.
And. A Mayor for Lancashire, not sure yet what benefits that will bring.
How different from A Lord Lieutenant?
Oh, just on the news now,all 15 areas will have a voice - unity is strength!
 Viktoria.

[sugarfizzle]

I have just seen this (though BBC figures don't tally throughout their article).

So two treatments now which can help -
Dexamethasone, been around for years, can help those who need only oxygen and those who need ventilating.
Remdesivir a new drug, reduces duration of illness.

Both of some limited use, but we are finding out more every day. Fantastic news.

Regards Margaret

[sugarfizzle]

Next double blind trial - a combination of dexamethasone and remdesivir?

Unethical maybe to give some patients a placebo, but could have three groups - one on dexamethasone, one on remdesivir, a third on both.
I'll ring them up to suggest it 

Margaret

[Guy Etchells]

Hospitals already use remdesivir, to treat Covid-19 it is said to shorten the duration of infection.
I assume they will now use Dexamethasone if the patient needs oxygen therapy or to go on a ventilator.
Cheers
Guy

[sugarfizzle]

Patients who are just on oxygen are not currently in this country on remdesivir. I don't know that this will change.

Those ventilated patients on remdesivir are currently not on dexamethasone, unless they were part of the trial.
A new trial would have to start to evaluate the combined effects of remdesivir and dexamethasone - enhanced side effects, possibly dose change, potential interactions etc.

I can't see everyone on a ventilator getting both drugs at the same time without evaluation.

I was on Orion-4 drug trial to see if a new injection, proven to lower cholesterol levels in those whose levels remained elevated in spite of maximum drug therapy, also reduced mortality, stroke, heart attack etc.

I.e. It is known that inclisiran reduces cholesterol and it is known that reducing cholesterol reduces incidence of heart attacks and strokes. What is not known is if inclisiran reduces heart attacks and strokes.

Hence the trial, currently suspended. I only got one injection, no idea whether it was inclisiran or placebo.

Regards Margaret

[sugarfizzle]

I have just googled 'dexamethasone antiviral interaction'.

Google changed it to antiretroviral, but there are potentially serious interactions.

When I searched for "antiviral" it was more about enhanced or reduced antiviral effect, i.e. dosage might have to be adjusted.

Regards Margaret

[josey]

I have just seen this (though BBC figures don't tally throughout their article).

Why oh why do they not get a numerate person [needn't be a statistician or scientist] to read the draft article? I have noticed a lot of mathematical errors creeping in to BBC website articles recently.

[Guy Etchells]

Patients who are just on oxygen are not currently in this country on remdesivir. I don't know that this will change.

Those ventilated patients on remdesivir are currently not on dexamethasone, unless they were part of the trial.
A new trial would have to start to evaluate the combined effects of remdesivir and dexamethasone - enhanced side effects, possibly dose change, potential interactions etc.

I can't see everyone on a ventilator getting both drugs at the same time without evaluation.

I was on Orion-4 drug trial to see if a new injection, proven to lower cholesterol levels in those whose levels remained elevated in spite of maximum drug therapy, also reduced mortality, stroke, heart attack etc.

I.e. It is known that inclisiran reduces cholesterol and it is known that reducing cholesterol reduces incidence of heart attacks and strokes. What is not known is if inclisiran reduces heart attacks and strokes.

Hence the trial, currently suspended. I only got one injection, no idea whether it was inclisiran or placebo.

Regards Margaret

I was not meaning at the same time, the way I understood the recommendations was assessed patients would be given a short course of remdesivir, in one of the first stages by the time they need a ventilator it is too late to try remdesivir. The treatment with dexamethasone is for patients who require forced oxygen therapy or treatment on a ventilator machine.
Cheers
Guy