COVID-19: Brazilian trial for Trump touted drug halted after 11 high-dose patients killed

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Possible treatment for COVID-19, highly touted by US President Donald Trump in recent weeks, was withdrawn from high-dose use in a Brazilian trial because it feared it would have harmful effects on the heart patients.

Chloroquine, normally a drug used to treat malaria, has raised hopes in some medical circles amid reports that it can help offset symptoms of the deadly virus. But the New York Times reports that a recent clinical trial has seen patients develop irregular heartbeats, a number of whom developed heart arrhythmias and died later.

Chloroquine (closely related to the more widely used hydroxychloroquine) has been presented by Trump as a possible partial solution to the pandemic in the United States. The Times reports that the United States Food and Drug Administration has granted emergency authorization for the use of the two drugs in American hospitals. and American companies have started to produce more of them. Trump has been boisterous about the drug’s potential benefits, but among those who contradict his views is his own expert, Anthony Fauci, who has provided Americans with regular updates on the crisis. In a recent daily briefing on coronaviruses at the White House, Trump intervened and prevented Fauci from answering a question about hydroxychloroquine.

Experts say that in reality there is little to support the theories that chloroquine and hydroxychloroquine are effective against COVID-19. Cholroquine was first presented as a treatment during the 2012 MERS epidemic, reports Science Alert, but it was not continued because it has not been shown to be effective.

The study in Brazil was conducted with 81 patients in a hospital in Manaus, in the state of Amazonas. In addition to chloroquine, patients also received azithromycin, an antibiotic also used in the United States, often associated with chloroquine. However, the use of higher doses of chloroquine (600 milligrams versus 450 milligrams) was stopped after just six days, after the deaths of 11 of the patients who received the highest dose.

The news is likely to fuel new doubts about the effectiveness of the drugs; In recent days, statements advocating caution around their use have not been difficult to find.

Robert A. Harrington of the American Heart Association said in a recent statement on azithromycin and hydroxychloroquine:

“The urgency of COVID-19 should not diminish the scientific rigor with which we approach treatment with COVID-19. Although these drugs may work against COVID-19 individually or in combination, we recommend caution with these drugs for patients with existing cardiovascular disease. “

Dr. David Juurlink, head of the clinical pharmacology division at the University of Toronto, told The New York Times about the study in Brazil:

“For me, this study provides useful information, that chloroquine causes a dose-dependent increase in an ECG (electrocardiogram) abnormality that could predispose people to sudden cardiac death. “

At least one province in China, Guangdong, has recommended equally high doses of chloroquine to treat patients, reports the Times, and Dr. Marcus Lacerda, who worked on the study in Brazil, told The Times that the new studies have shown that “the high dose the Chinese used is very toxic and kills more patients.” “

“This is why this part of the study was discontinued early,” he said.

A New York area hospital has told The Times that it has no plans to discontinue the use of hydroxychloroquine-azithromycin at lower doses in patients who are not seriously ill.

On April 7, the United States Centers for Disease Control and Prevention removed very unusual advice from their websites informing doctors about how to prescribe hydroxychloroquine and chloroquine.

The move came three days after Reuters reported that the CDC had released key dosage information for the two antimalarial drugs based on unassigned anecdotes rather than peer-reviewed science.

– with Reuters files

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