Small trial suggests antimalarial drugs are not effective in treating coronavirus

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On Saturday, the Food and Drug Administration approved the use of two antimalarials, hydroxychloroquine and a related drug, chloroquine, for emergency use to treat COVID-19. The drugs were touted by President Trump as a “game changer” for COVID-19.

However, a study that has just been published in a French medical journal provides new evidence that hydroxychloroquine does not seem to help the immune system clear the coronavirus from the body.

The study follows two others – one in France and one in China – who reported certain benefits in the combination of hydroxychloroquine and azithromycin for COVID-19 patients who did not have severe symptoms of the virus.

I have been a chemist specializing in the discovery and development of antiviral drugs for 30 years and I have been actively working on coronaviruses for seven years.

I am one of a number of researchers who fear that this drug may be given too high a priority before there is sufficient evidence to prove that it is effective.

There are already other clinical studies that have shown that 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 give people false hope.

The latter has resulted in a widespread shortage 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 the antibiotic azithromycin was effective against COVID-19 caught the eye after a study published on March 17. This study describes a trial of 80 patients conducted by Philippe Gautret in Marseille, France.

While some of their results seem encouraging, it should also be noted that most of their patients have only mild symptoms. In addition, 85% of patients did not even have a fever – one of the main telltale symptoms of the virus, suggesting that these patients would likely have naturally eliminated the virus without any intervention.

In another study, published on medRxiv, which has not yet been peer reviewed, Chinese scientists at Renmin Hospital at Wuhan University in Wuhan, China administered hydroxychloroquine to patients with only mild infections and free from medical problems, such as the Gautret study. The results showed that the 31 patients who received the drug showed a decrease in their symptoms 24 hours earlier than the patients in the control group.

In addition, symptoms of pneumonia improved in 25 of 31 patients compared to 17 out of 31 in the control group. As noted in several of the comments associated with the manuscript, there are problems with the translation of the article, thereby obscuring interpretations of some of the results. The document also appears to focus more on pneumonia than COVID-19. However, these issues can be resolved or resolved after the document has completed the peer review process.

But two other studies have contradictory results.

A second French group, led by Jean-Michel Molina, has now tested the combined hydroxychloroquine-azithromycin treatment in 11 patients at Saint-Louis Hospital in Paris, France, and their results were surprisingly different.

Like the Marseille study, the Molina trial was also a small pilot study. Molina and her colleagues used the same dosing schedule as Gautret. Unlike Gautret’s study, eight of 11 patients had underlying health conditions, and 10 of 11 had fever and were quite ill at the start of treatment.

These Parisian researchers found that after five to six days of treatment with hydroxychloroquine (600 mg daily for 10 days) and azithromycin (500 mg on day 1 and 250 mg on days 2-5), eight of the 10 patients were still positive for COVID19.

Of these 10 patients, one patient died, two were transferred to intensive care and another had to be withdrawn from treatment due to serious complications.

In addition, a similar study in China also showed no difference in viral clearance after seven days with or without hydroxychloroquine in the trial patients. This confirms Molina’s conclusions.

Despite the recent approval of this drug for COVID-19, questions remain as to the effectiveness of this treatment.

As Molina and her colleagues note, “The ongoing randomized clinical trials with hydroxychloroquine should provide a definitive answer regarding the suspected efficacy of this combination and will assess its safety. ” The conversation

Katherine Seley-Radtke, Professor of Chemistry and Biochemistry and President-Elect of the International Society for Antiviral Research, University of Maryland, Baltimore County.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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