AN ANTI-INFLAMMATORY drug lauded by US President Donald Trump as a potential treatment for Covid-19 does not help clear the virus and may make the outcome for patients worse, according to new research.
A randomised clinical trial from China showed that hospitalised patients with mild to moderate Covid-19 who received hydroxychloroquine did not recover from the virus quicker than those receiving standard care, and adverse effects were higher in those who received hydroxychloroquine.
The research has been published in the British Medical Journal, as has separate research from France that shows the drug does not significantly reduce admission to intensive care or death in patients hospitalised with pneumonia due to Covid-19.
Hydroxychloroquine can reduce inflammation, pain and swelling, and is widely used to treat rheumatic diseases. It is also an anti-malarial drug.
Laboratory tests previously showed some promising results, but accumulating trial and observational evidence has called into question whether the drug has any meaningful clinical benefits for patients with the virus.
Hydroxychloroquine has been promoted by Trump – despite the opposing view of Dr Anthony Fauci, the US government’s top infectious disease expert – and is included in Chinese guidelines on how best to manage the virus.
The US Food and Drug Administration (FDA) issued an emergency use authorisation to allow the drug be provided to certain patients in hospital. However, the organisation has since cautioned against the drug’s use outside of a hospital setting or a clinical trial due to the risk of heart rhythm problems.
TheJournal.ie previously debunked a widely shared social media post that claimed hydroxychloroquine and ‘zpac’, otherwise known as the antibiotic azithromycin, would help a patient to full recovery from the virus within 12 hours.
Adverse effects
In the Chinese study, researchers assessed the effectiveness and safety of hydroxychloroquine compared with standard care in 150 adults hospitalised with Covid-19.
Patients were randomly split into two groups – almost half of them received hydroxychloroquine in addition to standard care, and the others received standard care.
Four weeks into the trial, tests revealed similar rates of Covid-19 in the two groups but adverse effects were more common in those who received hydroxychloroquine.
There were no major differences between the two groups in terms of symptoms improving or the speed at which this happened.
Adverse effects were recorded in seven of the 80 patients (9%) who did not receive hydroxychloroquine and in 21 of the 70 patients (30%) who were given the drug.
In one study, adverse effects were more common in patients who received hydroxychloroquine. in the hydroxychloroquine recipients was diarrhoea, which was reported in seven of the 70 (10%) patients. Two hydroxychloroquine recipients reported serious adverse effects due to progression of the virus and respiratory infection.
A patient with upper respiratory infection was discharged from hospital after finishing the 14 days of treatment with hydroxychloroquine. They developed a dry throat and pain in their pharynx (the part of the throat behind the mouth and nasal cavity) and had to be readmitted to hospital.
The BMJ notes that while further work is needed to confirm these results, the authors say their findings do not support the use of hydroxychloroquine to treat patients with mild to moderate Covid-19.
In the French study, researchers assessed the effectiveness and safety of hydroxychloroquine compared with standard care in adults admitted to hospital with pneumonia due to Covid-19 who needed oxygen.
Of 181 patients, 84 received hydroxychloroquine within 48 hours of admission and 97 did not.
Researchers found no meaningful differences between the groups in relation to transfer to intensive care, death within seven days, or developing acute respiratory distress syndrome within 10 days.
The researchers have said that caution is needed in the interpretation of their results, but their findings do not support the use of hydroxychloroquine in patients hospitalised with pneumonia related to Covid-19.
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