His tweet threw trouble. Thursday evening, Professor Didier Raoult, Marseilles media infectiologist who campaigns to treat people affected by Covid-19 with chloroquine, welcomes a decree from the Ministry of Health which appeared in the Official Journal during the day. "As part of the health emergency, hydroxychloroquine may be prescribed to treat COVID-19. Thanks to Olivier Véran for listening ”, can be read in his message. A statement that caused some excitement on social networks. Explanations.
As part of the health emergency, hydroxychloroquine may be prescribed to treat COVID-19. Thanks to @olivierveran for listening.https: //t.co/NX2H6iwI07
- Didier Raoult (@raoult_didier) March 26, 2020What is hydroxychloroquine?
This is the product marketed by Sanofi laboratories under the name of Plaquénil. It is originally designed to treat diseases like lupus or rheumatoid arthritis. This treatment, like Kaletra for HIV carriers, benefits from a marketing authorization for the diseases mentioned above.
At the IHU in Marseille, Professor Raoult is currently testing Plaquénil on patients with Covid-19. While the debate swelled over the need to generalize its use, a hypothesis defended by other doctors and even by politicians, the authorities feared that many practitioners would end up administering Plaquenil off MA, by engaging their responsibility In case of problem.
Why this controversy?
Monday evening, during a press conference, Olivier Véran unveiled the conclusions of the High Council of Public Health concerning the prescription of treatment with chloroquine to treat patients with Covid-19.
The use of this antimalarial has been debated for several days. He is defended in particular by Professor Raoult, who supports the need to generalize his prescription to fight against the spread of the coronavirus. His advice was not followed.
"The High Council of Public Health recommends not using chloroquine in the absence of a recommendation, with the exception of severe, hospital forms and on the collegial decision of doctors and under strict medical supervision", details Olivier Véran. An opinion that the Minister of Health had decided to follow by promising the forthcoming publication of a decree to regulate the delivery of this treatment. The famous decree published Thursday.
To read the Marseille specialist, one might therefore believe that the government has finally gone further than what it had promised. On closer inspection, this is not the case. With this decree, the government is doing its best to regulate the use of chloroquine-based treatments in two ways.
What has changed the decree?
The text acknowledges the fact that hydroxychloroquine can only be administered to Covid-19 patients "in the establishments which take care of them". It therefore finds itself reserved for the most serious cases, since hospitals currently only receive patients with severe symptoms.
Another guarantee: this prescription can only intervene after a collegial decision by the doctors. In all other cases, off-label prescriptions will be strictly prohibited.
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The decree specifies that the National Agency for the Safety of Medicines and Health Products (ANSM) is "responsible, for these drugs, to draw up a protocol for therapeutic use for health professionals and to establish the terms of information adapted to the attention of patients ”. According to our information, this protocol will be available in the "next few days."
Who can prescribe it?
The authorities' other fear was that patients with lupus or rheumatoid arthritis would be denied treatment. In order to guarantee them the best possible access, the decree provides that the first prescriptions of Plaquénil can only come from "specialists in rheumatology, internal medicine, dermatology, nephrology, neurology or pediatrics". That is, for the management of the diseases for which the treatment was designed, and not for Covid-19. City doctors can only prescribe it for the renewal of patient treatment.
"This decree recognizes the possibility of administering hydroxychloroquine to the most seriously affected patients while acknowledging the fact that there is not yet a scientific consensus concerning it", summarizes a health source. "There is no widening of the cases which are taken into account, confirmed Thursday the ministry of Health to the Huffington Post. This decree does not change anything that had been decided before and does not depart from the last speech of Olivier Véran on the subject. "