Don’t use unproven COVID-19 treatments: researchers
Guidelines from McMaster say more science is needed before patients and doctors try out potential cures
The need for science to backup potential treatments of COVID-19 was made clear in guidelines created by McMaster University working with an international team.
There is no proven treatment for COVID-19 and the researchers found only low- or very lowquality evidence regarding potential cures — such as the malaria drug hydroxychloroquine touted by U.S. President Donald Trump.
“The enormity of the adverse health consequences of COVID-19 has understandably left clinicians and patients eager for interventions that can decrease progression, prevent mortality and speed recovery,” states the guidelines published April 29 in the Canadian Medical Association Journal (CMAJ).
“This eagerness has perhaps contributed to overly sanguine assessments from experts, regulatory authorities and prominent politicians regarding the potential benefits of treatments, with underappreciation of potential harms.”
Aimed at physicians and patients, the guidelines make recommendations regarding specific treatments for severe and mild cases using the most recent evidence as of April 25. It includes antiviral drugs like hydroxychloroquine, corticosteroids and a century-old treatment called convalescent plasma therapy.
The researchers caution that two very low-quality studies have raised the possibility that hydroxychloroquine could increase the risk of mechanical ventilation and death.
The team from Canada, China, South Korea, Mexico, Saudi Arabia and Singapore included internationally known Hamilton infectious disease researcher Dr. Mark Loeb and McMaster’s Dr. Gordon Guyatt, who is recognized as one of the founders of evidence-based medicine. The team worries that some of these treatments will be given — despite a lack of proof they work.
“The recommendations in this guideline should discourage use of interventions for which there is very low-quality evidence,” the researchers state. “However, misleading statements about and advocacy for use of medications for which we were unable to find robust evidence of benefit at this time present the major barriers to this guideline’s implementation.”
A trio of Hamilton studies are looking to fill the gaps quickly in the race to get better quality evidence.
St. Joseph’s Healthcare and McMaster hope to answer if hydroxychloroquine could prevent COVID-19 among healthcare workers and others exposed to the virus. It will also examine it as an early treatment for mild cases.
The Population Health Research Institute, affiliated with Hamilton Health Sciences and McMaster, has already started a trial in hospitals and the community to test a combination of two drugs — the antibiotic azithromycin taken with malaria medication chloroquine or also hydroxychloroquine.
Lastly, McMaster will look at convalescent plasma therapy in a national study that collected its first plasma donation Wednesday from a COVID-19 survivor in Vancouver.
This is the second guideline McMaster has created since the start of the pandemic. The first provided recommendations on treating COVID-19 patients in the intensive-care unit and was published in the journals Critical Care Medicine and Intensive Care Medicine at the end of March.
It normally takes at least a year to create these guidelines and mount large clinical trials, but researchers are working at a rapid pace to get answers on COVID-19.