Asthma drug Budesonide can alleviate Covid-19 at home

Budesonide, a cheap generic drug, can make Covid-19 illness slightly less miserable, according to a report on a clinical trial in Britain.

It is a corticosteroid drug widely used by people with asthma and chronic obstructive pulmonary disease, who take it using a palm-sized inhaler, The Economist reports.

The drug has an anti-inflammatory effect like steroids in general, which suggests that it was worth trying in patients with covid-19.

Initially, people with chronic pulmonary diseases were under-represented among covid-19 patients, which appeared to be unusual to the doctors as they are particularly susceptible to other respiratory infections such as the flu.

Later, Laboratory studies found that in Petri dishes budesonide inhibits replication of SARS-CoV-2, the virus that causes covid-19.

The results came from a trial called PRINCIPLE, which is testing treatments for covid-19 that people can take at home. The trial is run at more than 2,600 general-practice surgeries in Britain and is one of the biggest in the world for covid-19 outpatient treatments. It enrolled patients with covid-19 symptoms who were at high risk of becoming severely ill—people over 50 with various underlying health problems and people over 65 regardless of their general health. About 750 people were randomly selected and prescribed an easy-to-use inhaler with budesonide that they could take at home. They were compared with just over 1,000 patients who received usual care (which involves not much else than advice to take paracetamol and to keep an eye on blood-oxygen levels). On average, people in the trial had been unwell for six days before they were enrolled.

Researchers followed up the patients for 28 days. In the usual-care group the median time to recovery was 14 days. The misery was three days shorter for those who were prescribed budesonide; when asked daily, they also reported feeling less ill. By day 28, 10.3% of those who did not receive the drug were admitted to hospital. After adjusting for various differences between the two groups, the researchers found that the rate of admission in the budesonide group was 2.1 percentage points lower, though this result was preliminary and not statistically significant. If confirmed in the final analysis expected in the coming weeks, this result would mean that the drug can prevent the hospitalisation of one in five people who would otherwise have ended up in a covid-19 ward.

Budesonide is a cheap generic drug widely available around the world. It is "virtually side-effect free", says Chris Butler of Oxford University, one of the lead researchers in the PRINCIPLE trial.

An inhaler with the drug costs Britain's National Health service only £14 ($19). All of this makes it an easy thing to prescribe to people who are nursing covid-19 at home. Primary-care doctors can finally offer them more than just sympathy.