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       Inhaled steroid keeps

       COVID-19 patients with mild

       to moderate disease out of

       the hospital

             national study led by           or hospitalization due to COVID-19   Since the study was conducted prior
             emergency medicine              compared to 5.4 % of the patients   to the emergence of new SARS-CoV2
       A ysicians at the University at       who received placebo.              variants, it doesn’t address how the
       Buffalo has found that patients with                                     treatment might affect those infected
       mild to moderate COVID-19 who         This effect on emergency           by new variants, such as delta, but
       are treated with an inhaled steroid   department care and                Clemency noted that it would be
       are significantly less likely to require   hospitalizations was an important   reasonable to assume ciclesonide
       emergency department care or          secondary endpoint of the study.   would benefit them as well.
       hospitalization due to COVID-19 than
       those treated with placebo.           “Our study did not show that       “The study didn’t address the delta
                                             ciclesonide relieved symptoms      variant, but there’s no reason to
       The results of the double-blinded,    faster,” said Brian M. Clemency,   think that infections caused by delta
       randomized, controlled study were     DO, first author on the paper and   would fundamentally differ in this
       published in JAMA Internal Medicine.   professor of emergency medicine   respect,” he said.
       Participants were enrolled from June   in the Jacobs School of Medicine
       through November 2020.                and Biomedical Sciences at UB,     While the study didn’t address
                                             “but the treated group was less    which patients, in particular, would
       A total of 400 patients participated   likely than those treated with    benefit from ciclesonide, Clemency
       from 10 centers throughout the        placebo to go to the emergency     noted that the findings suggest
       U.S., with about half receiving       department or be hospitalized, and   that for some patients with mild to
       treatment and half receiving          that’s significant.                moderate COVID-19, this drug may
       placebo. Forty-seven patients were                                       provide a benefit.
       from the Buffalo area.                “Any COVID-19 treatment that can
                                             reduce emergency room visits or    “For patients who are at high risk
       Participants treated with ciclesonide   hospital admissions provides a   for developing severe COVID-19,
       did not see faster mitigation of their   benefit not just to the patient but   ciclesonide may be a low-cost, low-
       symptoms —the primary endpoint        also to the health care system and   risk treatment that can be taken at
       of the study — than those who         the community at large,” he said.  home,” he said.
       received placebo, with both groups
       seeing resolution of all symptoms on   Clemency is a physician with UBMD   Inhaled corticosteroids have been
       average within 19 days. For this study,   Emergency Medicine, based at Erie   seen as potentially beneficial in
       COVID-19 symptoms were defined as     County Medical Center.             treating COVID-19 because they
       cough, dyspnea (shortness of breath),                                    reduce inflation and target key
       chills, feeling feverish, repeated    Treatment for mild to moderate     proteins involved in virus replication.
       shaking with chills, muscle pain,     disease is needed
       headache, sore throat, and new loss                                      Ciclesonide is approved for the
       of taste or smell.                    While much COVID-19 research       long-term treatment of asthma as
                                             has appropriately focused on       maintenance therapy in patients 12
       Fewer emergency department visits     patients with severe disease,      years of age and older in the U.S.
                                             Clemency and his colleagues        and over 6 years of age in Canada. In
       However, patients treated with        were interested in studying mild   vitro studies have shown ciclesonide
       ciclesonide were less likely to require   to moderate cases. He explained   to block COVID-19 viral replication
       emergency department care or          that mild to moderate cases of     and to have antiviral properties
       hospitalization for reasons attributable   COVID-19 constitute the majority   against COVID-19.
       to COVID-19. In this study, only 1%   of cases and may be responsible
       of patients who received ciclesonide   for a significant amount of       Source: State University of New York
       required emergency department care    community spread.                  at Buffalo

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