![Drugs Working: Professor Josh Davis said dexamethasone has "delivered the largest benefit to our patients". Drugs Working: Professor Josh Davis said dexamethasone has "delivered the largest benefit to our patients".](/images/transform/v1/crop/frm/3AijacentBN9GedHCvcASxG/9e669351-bec8-4380-81a1-d3ae2fe6d87f.jpg/r0_0_4000_2248_w1200_h678_fmax.jpg)
The potent anti-inflammatory drug dexamethasone has provided the most benefit to COVID-19 patients in the Hunter-New England region, among the approved medications.
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The Hunter-New England region has had about 3713 cases and 13 deaths of COVID-19 since the outbreak on August 5. That's a death rate of 0.35 per cent.
John Hunter Hospital infectious diseases specialist Professor Josh Davis said dexamethasone - a corticosteroid - was "cost-effective and readily available".
Dexamethasone is usually used to treat conditions including arthritis, skin and eye disorders, severe allergies and asthma.
"In line with evidence from clinical trials, dexamethasone has delivered the largest benefit to our patients," Professor Davis said.
Dexamethasone made headlines in June last year as the "world's first coronavirus treatment proven to reduce the risk of death".
Professor Davis said budesonide, sotrovimab, remdesivir, tocilizumab and baricitnib had been used to treat COVID patients in the Hunter, as well as dexamethasone.
These were among eight drugs proven to reduce COVID-19-related disease severity and mortality in large randomised controlled trials.
"The most appropriate COVID-19 treatment is a clinical decision determined by the patient's history and co-morbidities, clinical factors and the stage of infection," he said.
Since the start of the pandemic, about a quarter of hospital admissions for COVID-19 in Hunter-New England were for "people with either no symptoms or very mild symptoms".
These people were mainly admitted for infection-control reasons.
"These patients have not needed any drug treatment," Professor Davis said.
He said the Hunter New England health district was not experiencing any supply issues for COVID-19 drugs.
Professor Davis said vaccination was "the best way to reduce a person's risk of serious illness and death caused by COVID-19".
"COVID-19 vaccines are effective, safe and free from NSW Health vaccination clinics, GPs and pharmacies across the district."
Professor Davis told the Herald in September that at least 50 more COVID drugs were currently being trialled.
"I would say five of these will be successful and be added to our toolbox," he said at the time.
Since then, the antiviral pill Molnupiravir was found in a clinical trial to cut the risk of hospitalisation or death from COVID by about half.
COVID CASES TODAY, NOVEMBER 11: 60 new cases of COVID-19 in the Hunter New England health district
On Friday, British regulators approved the tablet - which is given twice a day to patients recently diagnosed with the disease.
Pharmaceutical company Merck has signed eight deals to sell more than 2 million courses of the experimental drug to governments.
It was originally developed to treat influenza. It is designed to introduce errors into the genetic code of the virus, preventing it from spreading in the body.
While most COVID vaccines target the spike protein on the outside of the virus, molnupiravir targets an enzyme that the virus uses to make copies of itself.
Other pharmaceutical companies are also in this race. Pfizer is trialling two antiviral tablets, while Roche is working on a similar medication.
Pfizer announced on Saturday that a clinical trial found its antiviral pill Paxlovid reduced the risk of hospitalisation and death by 89 per cent among high-risk patients, but the data hadn't been peer-reviewed.
While vaccines are key to stopping the spread of COVID-19, drug treatments are also needed to deal with breakthrough infections and those unable or unwilling to be vaccinated.
Drugs are also being developed to treat long COVID, the symptoms of which include fatigue, shortness of breath and cognitive dysfunction.
Symptoms may follow an initial recovery from an acute COVID-19 episode or persist from the initial illness.
"Symptoms may also fluctuate or relapse over time," the World Health Organisation said.
A drug trial in the UK is targeting the fatigue and muscle weakness caused by long COVID.
The drug, called AXA1125, targets mitochondria - which could be dysfunctional in long COVID patients with severe fatigue.
Similar trials may occur in patients with other forms of post-viral fatigue, including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
As for the much-discussed parasite treatment ivermectin, Professor Davis is sticking by his comments from September when he said: "The jury is still out on this drug".
The drug did seem promising at first, based on laboratory studies.
But several clinical studies, including randomised trials, have had conflicting results - "some showing benefit, some no benefit".
"At least four trials of ivermectin have now been retracted due to likely falsified data," he said.
"Several legitimate large clinical trials are currently testing ivermectin, and these will definitively answer the question."
He said ivermectin should not be recommended for routine use outside clinical trials.
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