Chloroquine is a medication primarily used to prevent and treat malaria in areas where malaria remains sensitive to its effects. Certain types of malaria, resistant strains, and complicated cases typically require different or additional medication. Chloroquine is also occasionally used for amebiasis that is occurring outside the intestines, rheumatoid arthritis, and lupus erythematosus. While it has not been formally studied in pregnancy, it appears safe. It is also being studied to treat COVID-19 as of 2020. It is taken by mouth.
Hydroxychloroquine (HCQ), sold under the brand name Plaquenil among others, is a medication used to prevent and treat malaria in areas where malaria remains sensitive to chloroquine. Other uses include treatment of rheumatoid arthritis, lupus, and porphyria cutanea tarda. It is taken by mouth. It is also being studied as an experimental treatment for coronavirus disease 2019 (COVID-19).
By John Lauerman
May 29, 2020, 5:47 PM GMT+8
WHO halted an arm of global drug trial based on concerns.
Letter calls for more transparency in data and analysis.
Scientists are raising questions about a study that linked antimalarial drugs to increased heart risks and death among Covid-19 patients.
The study, published last week in The Lancet medical journal, found high rates of dangerous side effects in patients treated with hydroxychloroquine and chloroquine. A group of some 120 researchers signed a letter pointing out inconsistencies, calling on the authors and The Lancet to reveal more details about their analysis.
Not long after The Lancet study was published, the World Health Organization suspended a portion of a global study of potential Covid-19 treatments that included the antimalaria drugs because of safety concerns. Regulators in the U.K. and France called for a halt to trials.
The Lancet study, led by Mandeep Mehra of Brigham and Women’s Hospital in Boston, looked at the medical records of 96,000 coronavirus patients around the world, about 15,000 of whom were treated with antimalarials. Some of the patients also received antibiotics that are thought to enhance the benefit of the antimalarial drugs.
The letter pointed out 14 major shortcomings in the paper, including that computer code used to analyze the data wasn’t made public, and that no information was included on the medical centers that contributed data. It also said that rates of deaths reported from Africa seemed “unlikely,” that the daily doses purportedly received by some U.S. patients appeared higher than recommended, and that the level of chloroquine use in some continents was “implausible.”
The letter called on the U.S. company holding the data for the study, Chicago-based Surgisphere, to provide greater detail, and for an independent evaluation of the analysis. When scientists asked to see more of the data, according to the letter, Mehra replied that the authors weren’t able to share it under agreements with countries, governments and hospitals.
‘Chloroquine’ used to treat Covid-19 patients since first wave, says Health D-G
Sunday, 29 Mar 2020 09:14 PM MYT
PUTRAJAYA, March 29 — Chloroquine, a drug used for malaria, has been used to treat Covid-19 patients since the first wave of the outbreak in Malaysia and shown its efficacy, says Health director-general Datuk Dr Noor Hisham Abdullah.
He said the anti-inflammatory properties of the drug were effective in treating Covid-19 which caused inflammation in the lower respiratory tract.
“When the Covid-19 virus attaches to the lower respiratory tract it causes inflammation and replication of the virus and this drug helps treat the inflammation,” he told a press conference here today.
Besides ‘Chloroquine’, Dr Noor Hisham said the combination of ‘Lopinavir and Ritonavir’ and Hydroxychloroquine have also been used by Ministry of Health (MoH) since the first wave of the outbreak.
He said the drugs used in the first wave of the infection showed promising results in treating Covid-19, however, further research was still required.
He explained that the number of deaths due to the virus had increased as the patients were either elderly, had comorbidities such as high blood pressure and kidney disease, or those who sought treatment at a later stage or after they began having breathing difficulties.
“We have tried the drug and it is also part of a joint study with the World Health Organization called ‘Solidarity Trial’ involving many other countries,” he said.
He said besides those medicines, studies would also focus on the latest drug, ‘Remdesivir’ as announced yesterday.
“This is only for research, and drugs that we have used off-label such as Lopinavir and Ritonavir, those we have been using since the first wave,” he added. — Bernama
A Wisconsin woman who has had lupus for most of her life said she takes hydroxychloroquine and still caught COVID-19.
Kim, who only wants her first name used, said she has taken the anti-malarial drug for 19 years to help treat the pain caused by her lupus.
Kim said when the pandemic began, she only left her home to go to the grocery store. She said by mid-April though, she started feeling coronavirus symptoms.
“Weak all over. Coughing, fever. The fever was very high,” Kim said. “It just went downhill from there. I couldn’t breathe no more.”
Kim said her primary care doctor prescribed antibiotics, but her condition worsened. She said when she went to an urgent care center days later, nurses said her oxygen saturation levels were at 78%, when they need to be at 95% or higher.
Kim said after arriving at a hospital, she tested positive for COVID-19.
“When they gave the diagnosis, I felt like it was a death sentence. I was like, ‘I’m going to die,'” Kim said. “I’m like, ‘How can I be sick? How? I’m on the hydroxychloroquine.’ They were like, ‘Well, nobody ever said that was the cure or that was going to keep you safe’ and it definitely did not.”
However, a study just published in a French medical journal provides new evidence that hydroxychloroquine does not appear to help the immune system clear the coronavirus from the body. The study comes on the heels of two others—one in France and one in China – that reported some benefits in the combination of hydroxychloroquine and azithromycin for COVID-19 patients who didn’t have severe symptoms of the virus.
I am a medicinal chemist who has specialized in discovery and development of antiviral drugs for the past 30 years, and I have been actively working on coronaviruses for the past seven. I am among a number of researchers who are concerned that this drug has been given too much of a high priority before there is enough evidence to show it is indeed effective.
There are already other clinical studies that showed it is not effective against COVID-19 as well as several other viruses. And, more importantly, it can have dangerous side effects, as well as giving people false hope. The latter has led to widespread shortages of hydroxychloroquine for patients who need it to treat malaria, lupus and rheumatoid arthritis, the indications for which it was originally approved.
The idea that the combination of hydroxychloroquine with an antibiotic drug, azithromycin, was effective against COVID-19 gained more attention after a study published on March 17. This study described a trial of 80 patients carried out by Philippe Gautret in Marseille, France. Although some of their results appeared to be encouraging, it should also be noted that most of their patients only had mild symptoms. Furthermore, 85% of the patients didn’t even have a fever—one of the major telltale symptoms of the virus, thus suggesting that these patients likely would have naturally cleared the virus without any intervention.
Pressed by Trump, US pushed unproven coronavirus treatment guidance
Reuters -April 5, 2020 10:52 AM
WASHINGTON: In mid-March, President Donald Trump personally pressed federal health officials to make malaria drugs available to treat the novel coronavirus, though they had been untested for Covid-19, two sources told Reuters.
Shortly afterwards, the federal government published highly unusual guidance informing doctors they had the option to prescribe the drugs, with key dosing information based on unattributed anecdotes rather than peer-reviewed science.
While Trump, in a series of tweets and press comments, had made his opinions on the drugs, chloroquine and hydroxychloroquine, well known, the nature of his behind-the-scenes intervention has not been previously reported.
The guidance, published by the Centers for Disease Control and Prevention, has received scant notice outside medical circles.
The episode reveals how the president’s efforts could change the nature of drug oversight, a field long governed by strict rules of science and testing.
Rarely, if ever, has a US president lobbied regulators and health officials to focus their efforts on specific unproven drugs.
“The president is short-circuiting the process with his gut feelings,” said Jeffrey Flier, a former dean of Harvard Medical School.
“We are in an emergency and we need to rely on our government to ensure that all these potential therapies are tested in the most effective and objective way.”
In a statement to Reuters, the White House said the president had not launched a “pressure campaign” but was taking appropriate action.
“The President’s top priority is the health and safety of the American people which is why he has brought together the federal government and private sector, including doctors, scientists, and medical researchers, for an unprecedented collaboration to expedite vaccine development,” said the statement, which did not address Reuters questions about the CDC guidance.
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