Hydroxychloroquine and COVID-19

March 26, 2020

People are talking about hydroxychloroquine and coronavirus. And others are looking to grab some for personal use. But what is it, and can it help the thousands of people currently fighting the virus?

What is Hydroxychloroquine?

The Centers for Disease Control and Prevention (CDC) describes chloroquine as a medicine that treats and prevents malaria. Additionally, the drug has been found to treat symptoms of lupus.Hydroxychloroquine is a diluted version of chloroquine. It is used to prevent and treat acute attacks of malaria. It is also used to treat discoid or systemic lupus and rheumatoid arthritis in patients whose symptoms have not improved with other treatments.

Hydroxychloroquine and COVID-19

There was one study that showed promise of hydroxychloroquine as an effective way to treat COVID-19, in France. The study was conducted on a small sample size, 36 patients who met the inclusion criteria (20 hydroxychloroquine-treated patients and 16 control patients). The trial showed that hydroxychloroquine treatment was associated with reduced viral load. They assumed that results could be better when used in combination with azithromycin.However, the study’s small size and other weaknesses mean it does not offer a lot of helpful information in determining hydroxychloroquine's possible effectiveness in treating COVID-19. The researchers estimate that a trial would require 784 patients with no drop-outs to determine whether hydroxychloroquine definitively results in better or worse outcomes.

Drugs and Off-Label Use

Physicians prescribe or suggest certain FDA-approved drugs for an unapproved use, what’s known as “off label” drug use.Although some off-label therapies can be beneficial and even lifesaving for some patients, in most cases, there is little or no scientific evidence to prove they work. Many patients ended up with severe, and potentially deadly side effects and consequences.The FDA explains the "Off Label" drugs use. While it can be beneficial, there are some things to be cognizant of when considering the option. This BioSpace article goes into more detail.

The White House and Hydroxychloroquine

Recently, President Trump held a press conference calling for healthcare providers to begin using ‘hydroxychloroquine and azithromycin’ together in order to treat patients, regardless that Anthony Fauci of the “National Institute of Allergy and Infectious Diseases” warned against doing so, stating that the study was anecdotal.

Just a day after Trump’s press conference, multiple poisonings were reported from people who attempted to treat themselves with chloroquine and overdosed on the drug.It‘s important to note that hydroxychloroquine/chloroquine poses well-known serious risks to patients including cardiac toxicity which may lead to sudden heart attacks, irreversible eye damage and severe depletion of blood sugar which may lead to coma.Doctors and pharmacists started warning the public of potentially dangerous effects of taking these drugs without medical supervision, especially in combination with azithromycin, as it can lead to serious complications and sudden death.Lately, autoimmune patients who use Hydroxychloroquine as the key element of their treatment to control chronic diseases like lupus, are finding it increasingly difficult to find in pharmacies suddenly flooded with people bearing prescriptions for a five-day supply to have just in case they experience symptoms of COVID-19.Yet, several manufacturers have promised to donate hydroxychloroquine in response to fighting COVID-19. And if healthcare providers choose to utilize it for treating people infected with the virus, being already in short supply, the drug’s typical users are the ones who will suffer.

Finding the Right Treatment

The early hope is on hydroxychloroquine and chloroquine being an existing, easy-to-produce medicine that proved some effectiveness at treating COVID-19 infection. Many hospitals, including the University of California, San Francisco, and the University of Washington, include them in their treatment guidelines but people will have to wait for evidence of whether they are benefitting patients and how much. One study in China concluded that it was no more effective than regular treatment.The CDC has called attention to other therapeutic options for patients with Covid-19, such as Remdesivir, an investigational intravenous drug with broad antiviral activity that inhibits viral replication. There’s some evidence that it benefits COVID-19 patients, clinical trials are running around the world and first data and results are expected to come in April.

Hydroxychloroquine in the News

Updated June 16, 2020FDA revokes the emergency use of hydroxychloroquine.Updated: April 17, 2020Several news outlets have come out with articles over the past few weeks, giving updates on the drug and its effects:New York TimesCNNNBC News

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