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GPs to test inhaled corticosteroids in major Covid treatment study


Oxford vaccine


GPs are now able to test a new type of potential treatment for Covid-19, an inhaled corticosteroid, as part of an Oxford University trial.

Researchers have added budesonide to the PRINCIPLE trial, a nationwide study testing possible therapies within primary care and community settings.

GPs in participating practices will trial the medication, which is often prescribed for asthma and COPD, from today (27 November).

The University of Oxford, which has led the trial since April, is also urging GPs to ‘sign up their eligible patients’ – anyone aged over 65, or those aged over 50 with certain underlying conditions.

Those involved in the trial will be seeing whether the common inhaled corticosteroid can be taken by the over 50s at home when prescribed within 14 days of illness with Covid, to both speed up their recovery and prevent hospitalisation.

Anyone who is based in the UK, fits the eligibility criteria, and has Covid symptoms or a positive test result, can join the trial. This can be online, over the phone, or via their GP, and does not require face-to-face consultations.

Patients in the study will be randomly assigned to receive an inhaler in the post and the usual standard of care from their GP. They will be asked to inhale two puffs twice a day for 14 days, with each puff providing a 400 microgram dose of budesonide. This cohort will be followed up for 28 days and compared to participants who have been assigned to receive the usual standard of care only.

Budesonide is considered a safe, cheap inhaled corticosteroid and without any serious side-effects linked to short-term use. It has become the fourth medication to be tested in the PRINCIPLE trial, joining antibiotics doxycycline and azithromycin, after hydroxychloroquine was suspended in June.

Researchers believe that when inhaled, it can stop the Covid virus from entering the lung cells; restrict damaging inflammation; and inhibit viral replication.

This is because some patients with Covid mount a ‘significant’ immune response, which leads to high levels of inflammation that can damage cells in the airways and lungs. Inhaling budeonside into the airways is said to target anti-inflammatory treatment where it is most needed, and potentially minimise lung damage that might have been caused otherwise.

Trial lead Professor Chris Butler said: ‘Budesonide is relatively inexpensive, safe and easy-to-administer drug for respiratory conditions that may have a role to play in treating Covid-19. It is only through enrolling volunteers on a randomised controlled trial like PRINCIPLE that we can assess whether there are clear benefits or harms associated with potential treatments like budesonide.

‘We need many more volunteers to join the trial so we can get the answers we really need to keep people with Covid-19 out of hospital. Like vaccines and preventative measures, treatments have an important role to play in minimising the burden of this disease on society.’

Pulse recently interviewed Professor Butler about the trial, which more than 2,100 volunteers and 1,000 GP practices have signed up to so far.

READERS' COMMENTS [3]

Andrew Bamji 27 November, 2020 10:09 am

Given that the action of steroids in Covid-19 is to damp down the systemic immune response that results in a cytokine storm I doubt that inhaled steroids have anything to offer, Indeed, given in the early stage of disease, they may even make things worse. I would be extremely cautious about giving them to anyone.

Slobbering Spaniel 27 November, 2020 3:45 pm

I’ve tried them myself and they make no difference .

terry sullivan 27 November, 2020 5:10 pm

what covid is being referred to?

is there any test available to prove cv19? cold viruses are covid?