A cheap and widely available asthma drug can speed recovery for people with coronavirus who have not been hospitalized.
Budesonide – an inhalation drug sold under the brand name Pulmicort – is used worldwide to treat asthma and COPD. However, a study from Oxford University found that it can also be used at home to cut recovery time from Covid-19 by an average of three days for those at increased risk of the disease.
The corticosteroid is safe and effective in the early stages of coronavirus infection, according to the study.
Researchers said the discovery was a “major milestone” in the pandemic.
Budesonide was included in the Oxford University’s randomized study to investigate randomized interventions against Covid-19 in the study of the elderly (principle) in November last year.
Experts suggest that doctors around the world want to consider the results of the study when making treatment decisions.
Joint Chief Investigator Professor Richard Hobbs, director of the Nuffield Department of Primary Care Health Sciences at Oxford University, said, “For the first time we have high quality evidence of effective treatment that can be introduced across the community to people who are in the community are at greatest risk for developing a more severe disease from Covid-19.
“Unlike other proven treatments, budesonide is effective as a home treatment and in the early stages of the disease.
“This is a significant milestone for this pandemic and an important achievement for community research.”
For the interim report, a total of 961 patients were randomly selected to receive inhaled budesonide at home.
They were compared to 1,819 patients who were randomly assigned to standard NHS care alone.
Of these, 751 people in the budesonide group and 1,028 in the usual care group had the virus and were included in the primary interim analysis.
Based on the interim analysis using the March 25 data, the study found that the estimated median time to self-reported recovery for inhaled budesonide was 3.011 days shorter compared to usual treatment.
Research, which has not yet been peer-reviewed, suggests that there is a high probability (0.999) that treatment is superior to usual standard of care.
The results found that 32% of those who took inhaled budesonide, compared with 22% in the usual care group, recovered within the first 14 days since being randomized to the study and remained healthy for up to 28 days thereafter.
Participants in the budesonide group also reported better well-being after two weeks, researchers found.
Among patients who completed all 28 days of follow-up, 8.5% (59/692) in the budesonid group were hospitalized with Covid-19 compared to 10.3% (100/968) in the usual Care group.
The researchers say the interim analysis published as a pre-printed form cannot indicate whether budesonide is reducing hospital admissions, as fewer people than expected were hospitalized in the study and cases and hospital admissions in the UK continue to decline.
Joint Chief Investigator Chris Butler, a South Wales general practitioner and professor of primary care in the Nuffield Department of Primary Care Health Sciences at Oxford University, said: “Principle, the world’s largest platform study of outpatient treatment for Covid-19, has found evidence that a relatively cheap, widely used drug with very few side effects helps people at higher risk for worse results from Covid-19 recover faster, stay better once they feel recovered, and improve their wellbeing.
“We therefore believe that doctors around the world caring for people with Covid-19 in the community will want to consider this evidence when making treatment decisions as it should help people with Covid-19 recover faster.”
Patients with coronavirus symptoms who started within 14 days and who are at higher risk of poor disease outcome were eligible for the study, and those who tested positive were included in the main analysis.
Those treated with inhaled budesonide were asked to inhale 800 micrograms twice daily for 14 days and followed up for 28 days.
All patients were over 50 years old with an underlying health condition that placed them at higher risk for severe Covid-19 disease or were over 65 years of age.
Once all remaining patients in the study have completed their follow-up and a full analysis is complete, detailed results will be released in time for recovery and hospital admissions.
For this preliminary report, 92.8% of subjects randomized to the budesonide arm had the opportunity to complete 28 days of follow-up.