The readily available drug, administered via a cheap inhaler twice a day for up to 14 days, can be prescribed through GPs, raising hope that doctors will be able to start treating Covid-19 patients at home early in their illness.
An inhaled drug commonly used for asthma has been shown to shorten the recovery time of Covid-19 sufferers who do not need hospital treatment – a development that has been described as a “significant milestone” in the fight against coronavirus.
British scientists from Oxford University have found that budesonide, an anti-inflammatory medicine, can help accelerate recovery in the over-50s by an average of three days.
The NHS has issued new guidance saying the medicine should be considered for patients on a “case-by-case basis”.
Experts have hailed the interim findings from the UK’s Principle trial as a major breakthrough in treating Covid-19 outside of hospital.
Oxford’s Professor Gail Hayward, a co-principal investigator in the trial, told a media briefing: “I think this does have significant implications for the world as this is the first time a treatment has been shown to be beneficial for patients in their community.
“The majority of patients who get Covid are in the community. Something that can help them feel better three days sooner is significant.”
For the Principle study, 751 people with symptomatic Covid-19 were treated with budesonide at home over a 14-day period. Their progress was compared with 1,028 patients who were assigned the usual standard of NHS care alone.
The patients were drawn from two groups vulnerable to severe Covid: those aged over 65, and those aged between 50 and 64 with comorbidities, including a weakened immune system, heart disease and lung disease.
Of those who received the asthma drug, the results showed the estimated median time to self-reported recovery was 3.01 days shorter than the control group.
Professor Chris Butler, joint chief investigator of the trial and a primary care professor, said the drug “helps people at higher risk of worse outcomes from Covid-19 recover quicker, stay better once they feel recovered, and improves their wellbeing.”
Professor Richard Hobbs, joint chief investigator, said: “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.”
Some 32 per cent of those taking budesonide in the trial, compared to 22 per cent of the usual care group, recovered within the first 14 days of their treatment. They were followed up for a total of 28 days.
Scientists involved in the study have said they intend to continue assessing patients to determine whether budesonide also prevents the development of long Covid in those who have been infected with coronavirus.
“We are only presenting data for 28 days of follow-up,” said Prof Butler. “We will in due course be following these people for longer and will be able to talk about long Covid more comprehensively in due course.”
There are also some early indications that the drug can prevent hospitalisation with Covid-19.
Among patients who had completed all 28 days of study follow-up, 8.5 per cent of those treated with the drug had been hospitalised as a result of their symptoms. This compares to 10.3 per cent of patients in the standard care group.
However, researchers say that since fewer people than expected were admitted to hospital in the trial, and with cases and admissions to hospital continuing to drop in the UK, the interim analysis – published as a pre-print – cannot prove whether budesonide reduces hospital admissions.
The trial was stopped on 31 March after researchers became confident that the drug was capable of improving recovery time. Their findings are drawn from data up to 25 March, meaning the results are not fully complete.
