Dexamethasone: final results from RECOVERY study
Simon Collins, HIV i-Base
The final results from the dexamethazone arm of the UK RECOVERY study were published on 25 February in the NEJM.
In June 2020, an interim analysis led to immediate recommendation for use in adults hospitalised with severe COVID-19.
Overall, 2104 participants received dexamethasone and 4321 received standard care. The primary outcome of mortality within 28 days was reported in 22.9% (n=482) vs 25.7% (n=1110) of the active vs placebo group respectively. The age-adjusted rate ratio was 0.83 (95% CI: 0.75 to 0.93); p<0.001).
Results varied significantly depending on baseline level of oxygen support. Benefits were only reported for those with most severe COVID-19: 29.3% vs. 41.4% (rate ratio 0.64; 95% CI: 0.51 to 0.81) for those on mechanical ventilation and 23.3% vs. 26.2% (rate ratio, 0.82; 95% CI, 0.72 to 0.94) and 17.8% vs. 14.0% (rate ratio: 1.19; 95% CI, 0.92 to 1.55) receiving oxygen but not intubated.
These were very similar to the earlier interim results.
RECOVERY study group. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med 2021; 384:693-704 DOI: 10.1056/NEJMoa2021436. (25 February 2021).