Hydroxychloroquine for COVID-19 needs more data to inform clinical guidance

Larger and more robust randomized clinical trials are needed

Photo by Amanda Jones on Unsplash

As COVID-19 spreads, the search for treatment is ramping up. The antimalarial and immunosuppressant hydroxychloroquine has received some attention, including that of President Trump. There are currently around 60 planned or in-progress clinical trials to test its efficacy as a treatment for COVID-19. However, the results of recently completed clinical trials indicate there are not enough data to support hydroxychloroquine use for COVID-19 treatment at the level of expectations set by President Trump, says GlobalData.

Angad Lotay, infectious diseases analyst at GlobalData, commented, “As the initial results for the hydroxychloroquine clinical trials do not provide sufficient data, larger and more robust randomized clinical trials are needed to inform clinical guidance on the use, dosing, or duration of hydroxychloroquine for prophylaxis or the treatment of SARS-CoV-2 infection.”

Hydroxychloroquine, which is sold by Concordia Pharmaceuticals under the brand name Plaquenil, and chloroquine are oral prescription drugs that have been used for many years to prevent and treat malaria and certain inflammatory conditions. Although these agents are well-established, they possess the potential to cause numerous side effects and should be used with caution in those who have diabetes, those with neurological disorders, and those with vision disorders. Recent data highlights how hydroxychloroquine retinopathy is more common than previously reported. Other side effects include cardiomyopathy and bone marrow suppression, but these are not commonly reported.

“Other studies have suggested that a combination of hydroxychloroquine with azithromycin may be beneficial to prevent severe respiratory tract disease in those diagnosed with COVID-19. However, further data is required, as these studies were small (n <36) and there is not enough evidence to convincingly implement guidance on this. Furthermore, azithromycin is associated with prolonged cardiac repolarization and QT interval, imparting a risk of developing cardiac arrhythmias. Therefore, extra caution is required when considering this combination.”


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