A malaria drug widely touted by President Donald Trump for treating the new coronavirus showed no benefit in a large analysis of its use in U.S. veterans hospitals. There were more deaths among those given hydroxychloroquine versus standard care, researchers reported.
The nationwide study was not a rigorous experiment. But with 368 patients, it’s the largest look so far of hydroxychloroquine with or without the antibiotic azithromycin for COVID-19, which has killed more than 171,000 people as of Tuesday.
The study was posted on an online site for researchers and has not been reviewed by other scientists. Grants from the National Institutes of Health and the University of Virginia paid for the work.
Researchers analyzed medical records of 368 male veterans hospitalized with confirmed coronavirus infection at Veterans Health Administration medical centers who died or were discharged by April 11.
About 28% who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. About 22% of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival.
Hydroxychloroquine made no difference in the need for a breathing machine, either.
Researchers did not track side effects, but noted a hint that hydroxychloroquine might have damaged other organs. The drug has long been known to have potentially serious side effects, including altering the heartbeat in a way that could lead to sudden death.
Earlier this month, scientists in Brazil stopped part of a study testing chloroquine, an older drug similar to hydroxychloroquine, after heart rhythm problems developed in one-quarter of people given the higher of two doses being tested.
Many doctors have been leery of the drug.
At the University of Wisconsin, Madison, “I think we’re all rather underwhelmed” at what’s been seen among the few patients there who’ve tried it, said Dr. Nasia Safdar, medical director of infection control and prevention.
Patients asked about it soon after Trump started promoting its use, “but now I think that people have realized we don’t know if it works or not” and needs more study, said Safdar, who had no role in the VA analysis.
The NIH and others have more rigorous tests underway.
(AP)
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5 Responses
This therapy should be used as early on as possible, not in the late stages when the patient is in the hospital already, people cant seem to understand the difference
Not only that is true but the fact that the study is sponsored by the University of Virginia, the same university that promotes student groups that say there are too many white people and white people should be segregated takes away any credibility in this study.
This isn’t “trump’s drug”. He happened to mention that there may be some hope with it. That at a press conference he tried to show people there were things that could be on the horizon. It would be slander to imply it’s “Trump’s Drug” or that he benefits from it, or that he lied about it being 100% effective. It’s called HOPE, and there were many in the scientific community who thought the same thing… that’s why he said it.
You quote a study released on Tuesday, April 21, 2020 showing that hydroxychloroquine showed no benefit in a study performed in US veterans hospitals. This news tends to let people believe that Hydroxychloroquine (Plaquenil), really, does not work and that those who claim that we should not use it are correct. Because of this viral pandemic that already killed 171 000 individuals and may continue killing people I would greatly appreciate the right of response.
The leading doctor to study and promote hydroxychloroquine is Didier Raoult, professor in infectious diseases in Marseille, France. French native myself and physician, I have the privilege to listen to him directly and not through the incomplete or distorted translation of media or criticizing doctors. Professor Raoult kept saying that Plaquenil must be given at the time the virus is replicating, meaning at the beginning of the disease. COVID-19 evolves in two phases. A viral phase made of a viral syndrome; bodyache, cough, fever, stuffy nose etc… According to Pr. Raoult Plaquenil must be used at this time. The second phase that does not always happen is due to the exaggerated immune response due to the release of inflammatory mediators called cytokines. We use the term cytokine storm to underline the severity and amplitude of this phenomenon. As a result, the iron that is the hook that connects the oxygen to the hemoglobin of the red blood cells is released from the hemoglobin. The hemoglobin is then no longer able to connect with oxygen. The saturation of oxygen drops and sometimes to death. Professor Raoult has been clear from the beginning. At the time of respiratory distress, the virus is no longer detectable. At the time it is necessary to go to the emergency room, it is no longer a viral problem but an immunological problem. it is too late to use Hydroxychloroquine.
What to think of a study showing that Tamiflu (anti-flu medication) given at day 5 does not work? What to think of a study showing that Valtrex (anti-herpes medication) at day 5 of herpes does not work? Those who know well that Tamiflu and Valtrex must be given within the first 48 hours would laugh or worse, would be sorry for the waste of money and misleading outcome. Pr. Raoult states that like any antiviral Plaquenil must be given at the beginning of the disease. Studying Plaquenil at the hospital level shows that we want to verify what Pr. Raoult is claiming but we really ignore what he says. Plaquenil must be given at home! All studies done on Plaquenil in hospital or in ICU are foolish and misleading. Dr. Zelenko, physician of the Jewish community of Monroe, NY treated 697 COVID-19 patients at the initial phase of the disease. Zero death, none hospitalization. Dr, Peronne, Professor in infectious diseases in France and supporter of Pr. Raoult mentioned Dr. Zelenko on French TV. There was a reportage on French TV about Dr. Zelenko. Why was Dr. Zelenko ignored by the American medical authorities? Marseille where Pr. Raoult works has the lowest mortality of 0.5%.
Plaquenil has been used since 1940, for the past 80 years to prevent and treat malaria and for different diseases. More than one milliard of people took Plaquenil over the years. The same doctor who, today, refuses to give Plaquenil based on the fear created by medical authorities would have given you plaquenil without any hesitation two months ago if you had to travel to Asia or Africa for malaria prevention. Plaquenil used to be over the counter in France for years until two months ago. There is a cardiac risk, known as prolonged QT interval on electrocardiogram. A professor of Rheumatology Jean Roudier who has been using Plaquenil qualifies the cardiac risks of exceptional and preventable by having an electrocardiogram before treatment. I found one article reporting a cardiac side effect on only one case. Out of 1000 patients who took Plaquenil, Dr. Raoult does not report any cardiac side effects. The famous Z-pack (Zithromax given for sore throat), Diflucan (for yeast infections), cipro (for urinary tract infections) and many other medications have the exact same problem. Let’s not forget the terrible potential side effects you may have with all common medications and the liver toxicity potentially irreversible due to Tylenol. Side effects without the correlation with the frequency of occurrence is a non sense. None will be able to drive or fly on a plane if we only consider the risk in absolute value. More than one milliard of individuals took Plaquenil over the past 80 years.
The fact with this COVID-19 is that up to today there is no other option than Plaquenil. If the physician does not trust, does not want to give Plaquenil there is nothing else that is known to work. Why has the medical world been so reluctant to use Plaquenil? Because medications must follow a procedure of validation following the rules of evidence-based medicine to insure the efficacy and safety. What is evidence-based medicine in short? It is a medical methodology to establish the validity of a treatment based on the comparison with a group control that does not take the treatment or takes a placebo (fake medication). Patients do not know whether they take a placebo or not, physicians do not know whether they give a placebo or not. This appears to be the most objective, accurate, and reliable methodology to assess the validity of a treatment. Dr. Raoult did not follow this methodology and the academic medical world disagreed with his treatment and recommended prudence until the evidence of its efficacy was proven.
The first study from China showed 22 out 24 patients that got cured with Plaquenil. A second study with 80 patients showed similar results. Later results from Dr Raoult ‘s team confirmed the good results. In times where hundreds die everyday, and in absence of any other alternative, the risk benefit ratio favored the use of Plaquenil. It was not enough for the medical establishment who does not want to go astray from the regular medical methodology. What it is true to decide on the release of a new medication for chronic conditions, for long term care may not be true in time of life-threatening crisis. When a person is drowning, when a person is in a house on fire one would send anything to the one who is drowning to grasp on, and any bucket of water to extinguish the fire. Verifying first the solidity of the rope or the quality of the bucket would even not come up to mind. Yes, we need the best rope to save people, we need the best architects to have the most safe buildings but we do not send architects to extinguish a fire. There is a time for research and a time to save life. Today, in the name of evidence-based medicine, in total absence of any alternative treatment, the choice was made to do nothing other than monitoring the oxygen instead of giving the chance to an old, cheap and safe medication that showed to be promising.
I had a patient that I knew for the past 14 years. I saw him with a cough and fever. I warned him that the law prohibits giving Plaquenil without a positive COVID-19 test. The test came back positive 24 hours after his death. I told the wife that he died from COVID-19 but I am not convinced of it. I knew that he could die without Plaquenil. There was no other treatment known to work. I was forced to let him go to his destiny.
Professor C. Perronne did state on French TV that death could have been avoided with early intervention with Plaquenil and Zithromax. Today, French leaders (Professor Douze-Blazy, Perronne and Raoult) all Professor in infectious diseases warn the world that death can be avoided and could have been avoided by using Plaquenil and zithromax.
Evidence-based medicine was supposed to be a tool created by doctors to guide doctors in their therapeutic decisions. It has been said that evidence-based medicine, as a tool, should always remain in the status of a servant. By letting evidence-based medicine override our clinical judgment, evidence-based medicine became our master and we, doctors, became its servant. We serve collectively the master that dictates our thoughts and decisions with discipline that defines what we call good doctors. Studies showing the inefficiency of Plaquenil in hospitals and ICUIs have excluded the early stage of disease and therefore distort the message of those who promote this medication leading to the discredit of a medication that has the potentiality to save life. When someone dies from drowning in front of people? Does he die because he fell in the water or because nobody who was present threw something to him to rescue him? Everytime I hear that someone died from COVID, I am wondering if COVID-19 was really the cause of death. I do not have the expertise or authority to voice my opinion. This is a question that the medical world will have to think about.
The problem is that hydroxychloroquine’s patent has expired so there is no money in it.
Vaccines would be a money maker. “Follow the money.”
Take vitamin C vitamin D and zinc and you’ll be fine.