Dexamethasone and COVID-19 management

25 Jun 2020

The World Health Organization has welcomed news that the University of Oxford’s RECOVERY trial has reported positive preliminary results for the use of dexamethasone on patients who are critically ill from COVID-19.

Dexamethasone is a prescription-only corticosteroid that is used as an anti-inflammatory and immunosuppressant. The results of the trial have produced significant interest as dexamethasone is readily available and affordable in many countries.

Doctors are reminded that this news may result in an increase of patients asking for the medication, as was seen with media reports of premature promising results for the use of hydroxychloroquine on COVID-19 patients. The TGA have provided the following points that doctors should consider if faced with requests for dexamethasone:

  • “The RECOVERY trial has not yet been published; the results reported are preliminary findings only.
  • The RECOVERY trial reportedly showed benefit only for ventilated or oxygenated COVID-19 patients in hospital, not for mild cases or prophylactic use. There is no evidence to support use of this medicine for COVID-19 in the outpatient setting.
  • There is currently no national shortage of dexamethasone injection or tablets reported to the TGA. Based on information provided to the TGA by sponsors, there is currently sufficient stock of dexamethasone tablets and injection to meet normal demand.
  • Sponsors and wholesalers are closely monitoring the demand for their dexamethasone products and will implement appropriate measures if necessary, to mitigate the risk of shortages.
  • Unnecessary stockpiling of dexamethasone tablets and injections is strongly discouraged as it could create supply issues and prevent patients who require treatment with dexamethasone from accessing this medicine.”

An article from NPS MedicineWise explores the available evidence for dexamethasone and COVID-19 management, available here.