Major EU breakthroughs in Covid treatment

These last few months have produced promising advances in treatments for Covid-19 — especially out of the EU.

The large randomized, controlled RECOVERY trial (Randomised Evaluation of COVID-19 therapy) in the United Kingdom was launched in March to test a variety of potential treatments. On June 16th, those researchers announced that a common steroid, dexamethasone, had reduced deaths by one-third for patients on ventilators. 

The dexamethasone results were widely praised as a breakthrough, being the only drug thus far to have successfully reduced mortality rates. However, while the treatment has already been integrated into standard of care in the UK, researchers elsewhere were critical of the RECOVERY researchers not having released more detail about their findings.

Now, a large, intensive study by specialists from Zuyderland in the Netherlands, involving the use of other corticosteroids, has led to another breakthrough in the treatment of seriously ill corona patients. The results were immediate: dozens of lives have been saved in Zuyderland. The news was announced on Tuesday, 21 July, at a press conference in Zuyderland Medical Centre Sittard-Geleen.

The importance and uniqueness of these findings lies in the fact that it is the world’s first scientifically published study showing clear positive results of drug treatment for COVID-19, for both clinical improvement and mortality. The study was published in the Annals of the Rheumatic Diseases (ARD), a section of the British Medical Journal.

About a quarter of all coronary patients suffer from a so-called cytokine storm, an exaggerated reaction of their own immune system. The prognosis for this group of patients is generally poor: about half of those patients die. The Zuyderland study of 172 corona patients experiencing a cytokine storm showed that treatment with immunosuppressive drugs — first by means of high doses of prednisone, followed if necessary by the immunosuppressant tocilizumab — offers enormously beneficial results. 

So, how do corticosteroids work, and why do they result in effective treatment against Covid-19? 

Corticosteroids, such as prednisone (a synthetic corticosteroid), have an anti inflammatory effect on the molecules responsible for the inflammation, which then stems the spread of the infection in our body. Without this effect, the inflammation leads to a disseminated intravascular coagulation that can result in vascular clots that damage different organs, lungs included.

At this moment, the Zuyderland research treating 86 patients (part of the research group of 172) with the corticosteroid treatment has evidenced that

  • The chance of death is 65% lower, while the possibility of being ventilated in intensive care is even lower (71%).
  • The success achieved with patients who received treatment using steroid immunosuppressive medication was comparable to a similar group of patients who received treatment with standard medications, despite the much cheaper cost of the corticosteroids usage.

We note that, despite the Dutch news being already five days old, it has not been widely reported in the U.S. media. Nor were the RECOVERY findings. This leads us to wonder whether despite these being groundbreaking achievements in the search of covid treatments, they may not serve the economic interests of those who were most excited about the studies involving other more expensive treatments. 

For example, the widely hyped Gilead drug remdesivir, while shortening hospital stays, did nothing to improve mortality outcomes. Nonetheless, the expected price of the drug exceeded $5,000 for a course of treatment. (You may remember that the world was outraged when US President Donald Trump bought, in advance, 3 months of the entire global supply of the drug.)

On the other hand, the positive results shown by the UK and Dutch steroid studies far exceed those of the remdesivir treatment, significantly reducing mortality outcomes. Notable is that both of those corticosteroids, prednisone and dexamethasone, are widely available and very cheap — just a few bucks.

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