Baroness Heather Hallett, Chair of the COVID-19 Inquiry, has described the RECOVERY trial’s identification of the drug dexamethasone to treat COVID-19 patients as ‘one of the two success stories of the pandemic’, along with the UK’s COVID vaccination programme.
She noted that by March 2021, the drug – an inexpensive and readily available steroid – had saved an estimated 22,000 lives in the UK, and 1 million across the globe.
Hallett was presenting the main findings of a 274-page report, the fourth of 10 to be published by the inquiry, which was established to independently examine the UK’s response to the pandemic and to learn lessons for the future.
The report quotes the late Professor Sir Nicholas White, expert witness to the inquiry, who stated that the dexamethasone finding was ‘the single most important therapeutics research result of the pandemic’ and a ‘remarkable achievement’.
The RECOVERY trial was set up in just nine days after being designated an urgent public health research study and 10,000 patients were recruited in two months. It focused on testing treatments that were already being used for other conditions.
Within 100 days the trial had its first results, showing that two drugs being used to treat hospitalised COVID-19 patients – hydroxychloroquine and lopinavir-ritonavir – did not improve survival, while dexamethasone was found to be life-saving. Within hours of the results confirming its effectiveness, hospitals began dispensing dexamethasone to COVID-19 patients.
RECOVERY went on to become the largest clinical trial into treatments for COVID-19 in the world, recruiting over 48,000 patients across 177 NHS trusts as well as international sites. It evaluated a total of 16 drugs, identifying four effective treatments.
Sir Martin Landray, Professor of Medicine and Epidemiology at Oxford Population Health, and Joint Chief Investigator for the RECOVERY trial, said:
A collaborative approach was critical to our success – working with research networks across the UK, integrating the trial into routine care, and working at pace with regulators, enabled us to deliver results in the most exceptional circumstances.
We couldn’t have done it without the hard work and dedication of those in the Oxford Coordinating Centre, the hospital staff in the UK and internationally, our funders, and collaborators. Most importantly, we are indebted to the 48,000 participants.
To be prepared for future pandemics, Baroness Hallett called for continued investment in biomedical research and development, and stated that ‘Vaccines alone are not enough. Therapeutics are an essential tool in the response armoury.’
Sir Peter Horby, Moh Family Foundation Professor of Emerging Infectious Diseases at the Pandemic Sciences Institute, University of Oxford, and Joint Chief Investigator for the RECOVERY trial, said:
The report highlights the need for investment to support research and development capabilities, to maintain the close links between government, academia and industry, and to be able to pivot easily to combat new pathogens.
RECOVERY demonstrated the power of a flexible, streamlined approach to produce reliable results quickly and save lives. Continued investment in research is vital; we must learn from the last pandemic, and the findings of this report, to be ready for the next.
The report states that ‘The UK research response was able to draw upon pre-existing trial infrastructure established in previous health emergencies. For example, the RECOVERY trial was informed by one of eight ‘hibernated’ studies commissioned by the National Institute of Health and Care Research following a review of the 2009 pandemic influenza outbreak.’
RECOVERY is now testing treatments for flu and pneumonia, funded by Flu Lab, an organisation founded to advance innovative approaches for the prevention and treatment of influenza. To date over 3,500 patients have been recruited to this new work.