The ‘Recovery Trials’, or the ‘Randomised Evaluation of Covid-19 therapy’ conducted by Oxford University has shown immensely promising results. An important observation that has been noted as a part of the said trials is that a generic anti-inflammatory steroid, called dexamethasone, has proven to work wonders on patients who require critical care due to a COVID-19 infection. Such patients include those on mechanical ventilation or on a normal oxygen supply as well.
The good news is, India produces the dexamethasone drug in abundance, and if need be, can export the drug to other countries just like hydroxychloroquine.
If the observations of the study are studied carefully, it is seen that out of 100 patients infected with the virus, 12 patients on ventilator will now survive due to the administration of dexamethasone. Earlier, these 12 patients would not survive the infection. As such, out of 100 patients in the UK, while 60 recover without any symptoms or after being mildly symptomatic, 40 patients on ventilation or oxygen support were bound to succumb to the infection. With the help of dexamethasone, however, this number has been reduced to 28.
Dexamethasone may reduce deaths by up to one third in hospitalised patients with severe respiratory complications of COVID-19, the trials showed. In intermediate patients, who required oxygen support only, the deaths were reduced by a fifth. However, there was no impact of the corticosteroid on patients with mild or no symptoms.
Peter Horby, one of the Chief Investigators for the trial, said, “Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result. The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients.”
Dexamethasone inhibits over-activity of the body’s immune system in critical patients, as a consequence of which it prevents inflammation in the lungs, which is usually a sign of an exacerbated immune system response indicating that the body’s own cells are being attacked instead of the infected/pathogenic cells. In cases where the virus strain does not cause much harm to the patients, it is understood that the immune system is working just fine against the pathogens, and as such, inhibiting the working of the immune system would not be wise.
Dexamethasone’s market in India is estimated at anywhere between 100-120 crore rupees. While the discovery of dexamethasone as a life saviour for CoVID-19 patients may have come a bit late for countries like the UK or those in Europe, the trials by Oxford can greatly aid India’s fight against the pandemic, since we are yet to peak in terms of infection spread and number of cases. The drug could further reduce India’s already low fatality rate, and could help us learn to live with the virus in a more confident manner.
Meanwhile, top pharmaceutical producers in India have assuredly said that they have the capacity of meeting potential future needs of the drug in India. Zydus Cadila is the leading producer of dexamethasone in the country. Sources within Zydus Cadila told Moneycontrol that the company has enough capacity to meet domestic need. Zydus Cadila reportedly occupies 83 percent market share for the drug in India.
Interestingly, according to estimates, India exported Dexamethasone worth $15.34 million in the year 2019-2020.
India is well-equipped to fulfill any future domestic demand of the generic drug, while also exporting the same to other countries. The COVID-19 pandemic, for all its faults, has established India as a leading pharmaceutical power in the world.
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