A relatively cheap, inhaled asthma drug helps older people struggling at home with Covid to recover three days faster, according to a landmark study.
A trial in people over 65, and over 50 with underlying health conditions, found that inhaling budesonide twice a day for two weeks shortened their recovery time and helped them stay well and feel better than those who were not given the drug in subsequent weeks.
The interim results from the Principle trial, which is looking for treatments that can be used in the community rather than hospital, could change clinical practice around the world, say the researchers. In many countries, fewer hospital beds are available for Covid patients, making it important to treat as many people at home as possible.
Fewer people in the trial were admitted to hospital among those given the inhaled corticosteroid drug – 8.5% compared with 10.3% who had usual therapies – but that was at a time of falling hospital admissions so the effect is not clear, the scientists say. Their paper is published as a pre-print, which means it has not yet been through peer review.
The study “has found evidence that a relatively cheap, widely available drug with very few side-effects helps people at higher risk of worse outcomes from Covid-19 recover quicker, stay better once they feel recovered, and improves their wellbeing,” said its joint chief investigator Chris Butler, a south Wales GP and professor of primary care at Oxford University.
“We therefore anticipate that medical practitioners around the world caring for people with Covid-19 in the community may wish to consider this evidence when making treatment decisions, as it should help people with Covid-19 recover quicker.”
Patients treated with inhaled budesonide were asked to inhale 800 micrograms twice a day for 14 days and were followed up for 28 days. The interim analysis found the median recovery time was three days faster for those on the drug, and that 32% of those taking it recovered within 14 days, remained well at 28 days and reported greater wellbeing. This compares with 22% in the usual care group.
Butler’s counterpart, Prof Richard Hobbs, who heads the university’s Nuffield department of primary care health sciences, said: ‘For the first time we have high-quality evidence of an effective treatment that can be rolled out across the community for people who are at most risk of developing more severe illness from Covid-19.
“Unlike other proven treatments, budesonide is effective as a treatment at home and during the early stages of the illness. This is a significant milestone for this pandemic and a major achievement for community-based research.”