We have rarely seen such emotion about a medication as we have about an old drug for malaria, rheumatoid arthritis (RA) and lupus. Hydroxychloroquine (HCQ) has been on the market under the brand name Plaquenil since 1955. That means it has been sold for 65 years. It is widely prescribed in countries where malaria is rampant. People with lupus and RA depend upon it. Now, many physicians are prescribing it for COVID-19. But others are convinced it is ineffective and dangerous. Why are health professionals so polarized about hydroxychloroquine?
Controlled Clinical Studies are Lacking:
There are no large-scale controlled trials that demonstrate the effectiveness of hydroxychloroquine against the coronavirus. A French researcher has generated a firestorm of controversy with his case studies. You can read about his first small report at this link and watch a video of this renowned researcher.
A follow-up observational trial involving 80 patients also generated criticism. Those supporting the drug thought it was exciting. Those who were doubtful thought it was woefully inadequate. Everyone remained polarized about hydroxychloroquine for COVID-19! Here is a description of his findings.
The Latest Chapter in Dr. Didier Raoult’s Research:
Didier Raoult, MD, PhD, is a microbiologist and expert in infectious diseases. Some people think he is a genius. Others suggest he bends the rules far too much.
On April 9, 2020, the President of France, Emmanuel Macron, visited Dr. Raoult’s laboratory in Marseille. This visit generated tremendous controversy in France. The president of the Federation of Doctors of France called the meeting “showbiz politics.” So, even in France, health care professionals are polarized about hydroxychloroquine for COVID-19.
Now, this French scientist is reporting that his colleagues have treated 1,000 patients with hydroxychloroquine and azithromycin at the earliest signs of infection. He maintains that this approach has reduced the number of people admitted to ICUs.
The Telegraph (April 9, 2020) reports that Professor Raoult shared his latest findings with President Macron:
“Controversial French virologist Didier Raoult has unveiled a study he said showed that an antimalarial and antibiotic treatment of more than 1,000 coronavirus patients successfully removed the virus in 10 days in almost 92 per cent of cases.”
Releasing the general results of a study like this before publication is highly unusual. French health professionals are as polarized about hydroxychloroquine for COVID-19 as are American physicians.
According to an article in Science (April 9, 2020):
“The French Ministry of Health has been ‘incredibly rigid’ and has ‘diabolized’ hydroxychloroquine, Perronne [head of infectious diseases at the renowned Raymond Poincaré University Hospital] tells Science Insider. He says there is considerable—though ‘imperfect and often unpublished’—evidence that the drug has benefits, and he believes its side effects are rare and easy to avoid. Perronne says he has refused to enroll patients in a randomized trial of hydroxychloroquine because a placebo group would be ‘unethical’ for a fatal disease. Instead, he recently decided to give the drug to all patients except the mildest cases.”
“But many scientists in France are outraged that a potentially harmful drug can be widely used with so little evidence for its efficacy.”
The American Perspective:
If you think physicians in France are polarized about hydroxychloroquine, just read what American health professionals have to say.
The Financial Times (April 3, 2020) quotes Andre Kalil, an NIH scientist who is leading a remdesivir trial to treat COVID-19:
“People are taking unsafe and unproven drugs, and the risk of dying from these drugs may be higher than dying from Covid-19.”
An opposing view was expressed in the opinion section of the Wall Street Journal (March 22, 2020). Jeff Colyer, MD, was governor of Kansas from 2018 to 2019.
He and his colleague, Daniel Hinthor, MD, Director of Infectious Disease at the University of Kansas shared this:
“Our experience suggests that hydroxychloroquine, with or without a Z-Pak, should be a first-line treatment.”
The Turkish Health Minister has stated that:
“We believe beginning early treatment played a big role in reducing the rate of lung infection among patients.”
Public health authorities in the U.S. have begun some studies, but they would like to have data from controlled trials before they make any widespread recommendations. It will likely be several weeks before we get the results of such studies. In the meantime, we wish health professionals weren’t so polarized about hydroxychloroquine. We will let the science speak for itself. In the meantime, though, it is important to be aware that some people should NOT take this drug. Here is a new article you may find interesting. https://www.peoplespharmacy.com/articles/are-you-at-risk-of-sudden-death-from-hydroxychloroquine
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