Today, a RECOVERY (Randomised Evaluation of COVid-19 thERapY) Collaborative Group paper has been announced as the 2021 winner of The British Medical Journal’s prestigious UK Research Paper of the Year Award. This award recognises original UK research that has the potential to contribute significantly to improving health and healthcare.
The paper, “Dexamethasone in Hospitalized Patients with Covid-19”, published in the New England Journal of Medicine, described the discovery in June 2020 of the world’s first effective, readily available treatment for COVID-19 – the inexpensive steroid, dexamethasone.
The winner was announced this evening at a virtual awards ceremony hosted by Dr Fiona Godlee, Editor in Chief at The BMJ and Dr Phil Hammond, and attended by RECOVERY Co-Chief Investigators Professor Sir Peter Horby and Professor Sir Martin Landray.
Now in their 13th year, The BMJ Awards are the UK’s leading medical awards, with the aim of promoting excellence in healthcare; showcasing knowledge and experience that will inspire others; and giving exposure to teams who demonstrate courage and passion for overcoming challenges. The nominated publications were judged by the BMJ’s editorial team according to the scale of the problem that they addressed, the impact they had, and whether the project took an innovative and original approach.
The dexamethasone study involved 6425 patients with severe COVID-19, who were recruited from 175 NHS hospitals across the UK. These were randomly allocated to receive either usual standard care, or 6mg dexamethasone daily. The results showed unambiguously that dexamethasone reduced deaths by one-third for patients on ventilators and by one fifth for patients receiving oxygen only. Based on these results, one death would be prevented by treatment of around eight ventilated patients or around 25 patients requiring oxygen alone.
Launched in just nine days as an emergency response, the RECOVERY Trial has received widespread praise for its efficient, streamlined design and clear results based on reliable, large-scale data. Consequently, the findings have been accepted and adopted by healthcare services around the world. This treatment may have saved an estimated one million lives globally, including 22,000 in the UK, between July 2020 and March 2021.
At the time of the discovery, the UK Government’s Chief Scientific Adviser, Sir Patrick Vallance, said: ‘This is a ground-breaking development in our fight against [COVID-19], and the speed at which researchers have progressed finding an effective treatment is truly remarkable. It shows the importance of doing high quality clinical trials and basing decisions on the results of those trials.’
Sir Martin Landray, Professor of Medicine and Epidemiology and one of the Chief Investigators for RECOVERY, said: ‘This award is not just a testament to RECOVERY’s research team, but the dedication of the countless doctors, nurses and hospital staff involved with the study, and of course the patients and their families who took part. All of these have played an essential role in delivering this incredible result.’
The BMJ's Head of Research, Dr Elizabeth Loder said: ‘The set up of the trial and the fact that these results were generated under extremely challenging circumstances and shared rapidly undoubtedly changed international practice and improved outcomes for patients.’
To date, the RECOVERY Trial has recruited over 43,000 participants worldwide, and continues to investigate the following treatments for COVID-19:
- baricitinib (an immunomodulatory drug used in rheumatoid arthritis);
- dimethyl fumarate (an immunomodulatory drug used in psoriasis and multiple sclerosis);
- high-dose vs standard corticosteroids;
- empagliflozin (a routine treatment for type 2 diabetes).
The RECOVERY trial is conducted by the registered clinical trials units with the Nuffield Department of Population Health in partnership with the Nuffield Department of Medicine. The trial is supported by a grant to the University of Oxford from UK Research and Innovation/ the National Institute for Health Research (NIHR), and by core funding provided by the Bill and Melinda Gates Foundation, the Foreign, Commonwealth & Development Office, Health Data Research UK, the Medical Research Council Population Health Research Unit, the NIHR Oxford Biomedical Research Centre, NIHR Clinical Trials Unit Support Funding, and Wellcome. Funding for RECOVERY outside the UK is provided by Wellcome through the COVID-19 Therapeutics Accelerator.
The RECOVERY trial currently involves many thousands of doctors, nurses, pharmacists, and research administrators at 177 hospitals across the whole of the UK. In the UK, the trial is supported by staff at the NIHR Clinical Research Network, NHS DigiTrials, Public Health England, Department of Health & Social Care, the Intensive Care National Audit & Research Centre, Public Health Scotland, the Secure Anonymised Information Linkage at the University of Swansea, and the NHS in England, Scotland, Wales and Northern Ireland.