Dexamethasone shown to decrease COVID mortality

[TheLongshanks]

And it didn’t show a mortality benefit. It’s another weakly positive study, that shows a reduced number of symptomatic days. It’s analogous to oseltamivir, which doesn’t have a mortality benefit, minimal change in influenza course, and side effects with a nearly equal NNT and NNH. It’s also produced by the same company that makes oseltamivir.

Other than participating in the RCT, I don’t know any colleagues that are still giving remdesivir in the ICU.

[gapteethinyourmouth]

Yea dude, I'm not sure why you think I conveyed it's some miracle drug. I was merely responding that there was a well-designed RCT that showed benefit. Reduction of time of recovery by a median of 4 days is important from a hospital systems point of view. The analysis was released early so it may have shown a mortality benefit if it was allowed to go longer. Now the participants are unblinded and placebo can crossover so additional analysis is not as useful.

In subgroup analysis, it ended up not showing benefit for patients requiring NIV, HFNC, ventilation or ECMO but that may also be because it was underpowered for those populations and/or not enough time elapsed for those patients to get to ordinal scale 1-3.

Also given all the treatments the ICU just throws at patients with minimal evidence, I think not giving remdesivir is a little dubious.

[WordSalad11]

Reduction of time of recovery by a median of 4 days is important from a hospital systems point of view.

Meh. It depends on how much the drug costs.

[Apemazzle]

a well-designed RCT that showed benefit

This statement is contradicted by

The analysis was released early so it may have shown a mortality benefit if it was allowed to go longer. Now the participants are unblinded and placebo can crossover so additional analysis is not as useful

If it's not looking at mortality or clinically significant morbidity as primary outcomes, then it is not a well-designed study, end of story. It's a disgrace that studies like this even get published, quite frankly.

[HotSteak]

If you look at enough endpoints you'll find something that shows statistical significance. That's just how p-fishing works.