No evidence of benefit in hydroxychloroquine treatment of COVID-19 patients, study suggests

Researchers who examined data from nearly 15,000 patients with COVID-19 found no evidence that taking hydroxychloroquine or chloroquine provides treatment benefits and may be associated with an increased risk of serious cardiac complications, a study published in The Lancet says.

Chloroquine – normally used to treat malaria – and the related hydroxychloroquine drug, which is often used to treat autoimmune diseases like lupus or arthritis, have been the subject of furious debate in the race to find a treatment for powered COVID-19. partly because of repeated recommendations by U.S. President Donald Trump to drugs, which were not based on scientific evidence and raised alarm among medical experts.

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"This is the first large-scale study to find statistically robust evidence that treatment with chloroquine or hydroxychloroquine does not benefit patients with COVID-19," Dr. Mandeep Mehra, lead author of the study and medical director for Brigham and Women & # 39; s Heart and Vascular Center Hospital in Boston, said in a press release on Friday.

"Instead, our findings suggest that it may be associated with an increased risk of serious heart problems and an increased risk of death."

Mehra and his team analyzed data from more than 96,000 hospitalized patients with laboratory-confirmed SARS-CoV-2 – the coronavirus that causes COVID-19 disease – between December 2019 and April 2020 in several countries, but more than half of cases occurred in North America.

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They compared the results of nearly 15,000 patients treated with chloroquine or hydroxychloroquine – alone or in combination with antibiotics – with more than 81,000 patients who were not treated with any of these drugs.

The researchers found that those who took chloroquine or hydroxychloroquine were more likely to develop severe cardiac arrhythmias or irregular heartbeats.

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They also determined that about one in 11 patients who had not been treated with chloroquine or hydroxychloroquine died in the hospital, compared with death rates of about one in six for those who took the drugs.

Researchers recommend further studies

However, the researchers cautioned that, because it is an observational study and not a randomized control study, which is the gold standard of medical research, they could not rule out the possibility that other unmeasured factors were responsible for the increase in deaths. .

Because the drugs have demonstrated antiviral effects in laboratory studies, chloroquine and hydroxychloroquine still deserve to be studied, the researchers noted, and said the need for randomized clinical trials is urgent.

"Randomized controlled trials will be needed before a conclusion can be reached on the benefit or harm of these agents in patients with COVID-19," the article said.

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But until the results of these studies appear, chloroquine and hydroxychloroquine should not be used to treat patients with COVID-19, the researchers said.

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The Lancet's press release also emphasized that chloroquine and hydroxychloroquine have a "good safety profile" when taken as prescribed for malaria and autoimmune diseases – and that the study results "do not imply that patients should stop taking take these drugs if they are prescribed for approved conditions ".

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