EMA endorses use of dexamethasone in COVID-19 patients on oxygen or mechanical ventilation

Treatment with dexamethasone resulted in relative reduction in death of about 35 per cent in patients on invasive mechanical ventilation and about 20 per cent in patients receiving oxygen without mechanical ventilation

EMA’s human medicines committee (CHMP) has completed its review of results from the RECOVERY study arm that involved the use of the corticosteroid medicine dexamethasone in the treatment of patients with COVID-19 admitted to hospital, and has concluded that dexamethasone can be considered a treatment option for patients who require oxygen therapy (from supplemental oxygen to mechanical ventilation).

Based on the review of available data, EMA is endorsing the use of dexamethasone in adults and adolescents (from 12 years of age and weighing at least 40 kg) who require supplemental oxygen therapy. Dexamethasone can be taken by mouth or given as an injection or infusion (drip) into a vein. In all cases, the recommended dose in adults and adolescents is 6 milligrams once a day for up to 10 days.

Published data from the RECOVERY study show that, in patients on invasive mechanical ventilation, 29 per cent of those treated with dexamethasone died within 28 days of starting dexamethasone treatment compared with 41 per cent of patients receiving usual care, with a relative reduction of about 35 per cent.

In patients receiving oxygen without mechanical ventilation, the figures were 23 per cent with dexamethasone and 26 per cent with usual care, with a relative reduction of about 20 per cent.

No reduction in the risk of death occurred in patients who were not receiving oxygen therapy or mechanical ventilation. These results were supported by additional published data, including a meta-analysis conducted by the World Health Organization (WHO) which looked at data from seven clinical studies investigating the use of corticosteroids for the treatment of patients with COVID-19.

Companies that market dexamethasone medicines can request this new use to be added to their product’s license by submitting an application to national medicines agencies or to EMA.