Is hydroxychloroquine a safe treatment for patients with COVID-19?

What is hydroxychloroquine?

Centuries ago, the Incas in Peru dried and ground cinchona tree bark, then mixed the resulting fine powder with a liquid. In doing so, they produced a medicine used to lower fever later called quinine.

Hydroxychloroquine is a prescription medicine that was approved decades ago to treat malaria. It is also used to treat autoimmune diseases like rheumatoid arthritis and lupus. It is sometimes referred to by its brand name, Plaquenil, and is closely related to chloroquine, which is also used to treat malaria.


Is hydroxychloroquine a safe treatment for patients with COVID-19?

At Vanderbilt Medical Center in Nashville, Dr. Wesley Self said he has lost count of how many patients he has treated for COVID-19. To find better ways to take care of those patients, the Self is serving as lead investigator for the nationwide clinical trial on hydroxychloroquine as a treatment for COVID-19. On Thursday, the National Institutes of Health formally announced the trial.

Researchers started enrolling trial participants on April 2, self said. There is reason to think hydroxychloroquine could reduce swelling in the lungs of a person with the virus, self said.

But people with COVID-19 are taking many medications, and those medications may interact with each other in unexpected ways. On top of that, self said people infected with the virus “may be more susceptible to side effects from medications.”

“There’s a promise for this drug, but we simply don’t have enough data in patients with COVID,” he said.

To understand whether or not the drug might help COVID-19 patients, the Self and his research team are conducting a randomized trial. That means some patients infected with the coronavirus will receive hydroxychloroquine, and some won’t.

Those who do get hydroxychloroquine will receive the medication for five days. The research team will then compare which group of patients get better faster and which ones may have reactions and side effects from the drug, Self said. And investigators, medical teams and patients won’t know which patients get the medication, ensuring that — all else being equal — every patient gets the same level of care. The trial is expected to last several months, or until researchers see definitive evidence that the drug is or isn’t helping.

“We know this is an emergency, so we were already working very quickly,” Self said. “We’re trying to run this study as fast as we can while making sure it is still safe.”

Until researchers complete these trials, anyone touting the benefits of using these drugs is only speaking anecdotally. These trials “are the way we learn,” said Dr. Richard Schilsky, chief medical officer for the American Society of Clinical Oncology and an expert on clinical trials. If the study is well-designed and conducted, the findings won’t be based on hearsay or intuition but a scientific observation.

Until then, it remains unclear if these antimalarial medications offer effective treatment and relief during the COVID-19 pandemic. And no one should take these medications without consulting with their health care provider.

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