Malaria drug tied to risk of death

No con­firmed ben­e­fit to pa­tients found

Montreal Gazette - - WORLD - MICHAEL ERMAN AND ANKUR BAN­ER­JEE

The malaria drug hy­drox­y­chloro­quine, which U.S. Pres­i­dent Don­ald Trump says he has been tak­ing and has urged oth­ers to use, was tied to in­creased risk of death in hos­pi­tal­ized COVID-19 pa­tients, ac­cord­ing to a large study pub­lished in the med­i­cal jour­nal Lancet.

In the study that looked at over 96,000 peo­ple hos­pi­tal­ized with COVID-19, those treated with hy­drox­y­chloro­quine or the re­lated chloro­quine had higher risk of death than pa­tients who were not given the medicines.

The au­thors said they could not con­firm whether tak­ing the drug re­sulted in any ben­e­fit in coron­avirus pa­tients.

“Ur­gent con­fir­ma­tion from ran­dom­ized clin­i­cal tri­als is needed,” they wrote. This study was not a placebo-con­trolled trial.

Hos­pi­tal­ized pa­tients tend to have a more se­vere ver­sion of COVID-19. Some pro­po­nents of the drugs as treat­ments for the dis­ease ar­gue that they may need to be ad­min­is­tered at an ear­lier stage in order to be ef­fec­tive.

There are on­go­ing ran­dom­ized, con­trolled clin­i­cal tri­als to study the drug’s ef­fec­tive­ness in pre­vent­ing in­fec­tion by the new coron­avirus as well as treat­ing mild to mod­er­ate COVID-19. Some of those tri­als may yield re­sults within weeks.

De­mand for hy­drox­y­chloro­quine has surged as Trump re­peat­edly pushed for its use against the coron­avirus. “What have you got to lose,” he said.

This week, Trump said he has been tak­ing hy­drox­y­chloro­quine as a pre­ven­ta­tive medicine, de­spite a lack of sci­en­tific ev­i­dence.

The Lancet study au­thors sug­gested the medicines should not be used to treat COVID-19 out­side of clin­i­cal tri­als un­til those stud­ies con­firm their safety and ef­fi­cacy for COVID-19 pa­tients.

The U.S. Food and Drug Ad­min­is­tra­tion has said hy­drox­y­chloro­quine should only be used for hos­pi­tal­ized COVID-19 pa­tients or those in clin­i­cal tri­als. The drug has been tied to dan­ger­ous heart rhythm prob­lems.

The Lancet study looked at data from 671 hos­pi­tals, where 14,888 pa­tients were given ei­ther hy­drox­y­chloro­quine or chloro­quine, with or with­out an an­tibi­otic, and 81,144 pa­tients who were not treated with those drugs.

Both hy­drox­y­chloro­quine and chloro­quine have shown ev­i­dence of be­ing ef­fec­tive against the coron­avirus in a lab set­ting, but stud­ies of the drugs in pa­tients have proven in­con­clu­sive at best.

Sev­eral small stud­ies in Europe and China spurred in­ter­est in us­ing hy­drox­y­chloro­quine against COVID-19, but were crit­i­cized for lack­ing sci­en­tific rigour.

Sev­eral more re­cent stud­ies have not shown the drug to be an ef­fec­tive treat­ment for the dis­ease.

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