New study shows limitations, risks of hydroxychloroquine for treating COVID-19
As scientists work on finding effective treatments against COVID-19, one new study confirms previous research that shows the drug hydroxychloroquine likely isn’t the answer.
In the study, published in the New England Journal of Medicine (NEJM) and funded in part by the pharmaceutical company EMS Pharma, researchers looked at the effectiveness of the antimalarial drug hydroxychloroquine and the antibiotic azithromycin in treating COVID-19 patients.
Hospitalized patients with suspected or confirmed COVID-19 were randomly assigned to receive standard care for the disease (such as the use of glucocorticoids, antibiotic agents and antiviral agents), standard care plus hydroxychloroquine (at a dose of 400 mg twice daily) or standard care plus hydroxychloroquine (at the same dosage) plus azithromycin at a dose of 500 mg once daily for seven days.
The researchers found that in patients with mild to moderate COVID-19, hydroxychloroquine used with or without azithromycin “did not improve clinical status at 15 days as compared with standard care.”
What’s more, elevated liver enzymes and heart rhythm problems were “more frequent” in patients who received either hydroxychloroquine with azithromycin or hydroxychloroquine alone, according to the study.
The latest study results don’t come as a surprise to experts in light of previous research that had already dashed hopes for hydroxychloroquine as a coronavirus treatment, along with the Food and Drug Administration’s cautionary warning about using the drug outside of hospital or clinical trial settings because of “reports of serious heart rhythm problems and other safety issues, including blood and lymph system disorders, kidney injuries and liver problems and failure.”
“While there was initial potential reported for hydroxychloroquine and azithromycin, which largely consisted of small case studies, the validity and reliability of these findings were always in question,” Dr. Iahn Gonsenhauser, chief quality and patient safety officer at the Ohio State University Wexner Medical Center, tells Yahoo Life. “Not many of my colleagues in the scientific community are very surprised by the most recent NEJM study.”
Dr. Steven Nissen, chief academic officer for the Cleveland Clinic Heart, Vascular and Thoracic Institute, calls the pursuit of hydroxychloroquine as a treatment strategy “sheer madness” and tells Yahoo Life that “there has never been any good solid scientific evidence that it does work.”
In addition, Dr. Dean Winslow, an infectious disease physician at Stanford Health Care, tells Yahoo Life that he was “very concerned” about the drug combination used in the study, which can cause heart rhythm changes.
“Both macrolide antibiotics [like azithromycin] and antimalarial drugs [like hydroxychloroquine] have the potential of prolonging the QT interval [the time between the heart muscle contracting and relaxing] in EKGs and can cause fatal arrhythmias and increased mortality,” he explains.
Adds Winslow: “This is further evidence that this is not a winning strategy. I think we’ve studied it enough.”
Nissen agrees, saying: “It’s time to stop pursuing this. It’s time to move on and study something that has a chance to help people.”
He also expressed his frustration with how treatments that haven’t been fully vetted are being prematurely announced. “Desperation is not a scientific strategy,” Nissen says. “We have people throwing spaghetti at the wall and seeing what sticks. We need a nationally coordinated strategy [by scientists] who understand clinical trials, and we just don’t have it.”
In the meantime, there are several treatments that have been beneficial to patients with the coronavirus, according to Gonsenhauser: “Convalescent plasma, a specific component of blood donated by COVID survivors that includes the immune cells their body generated to fight the virus; dexamethasone [a medical steroid], which has been used to combat extreme inflammation for a long time and has been shown to improve outcomes; and remdesivir, a drug that limits virus replication and has been shown to decrease the time it takes to recover from COVID, but may or may not improve the risk of dying.”
Another promising drug currently being studied is the oral medication favipiravir. “So far it seems to be very safe and well tolerated overall,” says Winslow.
He notes that even though we’re “making progress slowly” in terms of treatment strategies, Winslow explains that’s because the coronavirus is a challenging and “very virulent pathogen.”
“COVID is commanding an incredible amount of attention and work,” Gonsenhauser says. “Vaccine studies appear to be moving incredibly quickly, and we seem to learn more about the virus every day, ... It would be surprising if additional treatments are not identified, but at the same time, viruses are very tricky [and] the science is complicated, so it also wouldn’t be terribly surprising if the discoveries are limited.”
He adds: “In the meantime, masks for everyone, social distance and hand hygiene are the best efforts to all focus on.”
The study’s authors didn’t immediately respond to Yahoo Life’s request for comment.
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