Chloroquine again at the heart of scientific disagreement. One week after its publication in the scientific journal The Lancet, the study questioning the effectiveness of hydroxychloroquine in the treatment against Covid-19, now poses serious questions within the scientific community.
Barely published, the work had however been deemed sufficiently disturbing for the World Health Organization (WHO) to decide to immediately suspend its clinical trials on the molecule. As you might expect, Professor Raoult was among the first to react, deeming the study "messed up". But critics are now raining from all sides, pro-chloroquine or not.
Nearly 100 doctors and scientists from around the world (including two from France) published an open letter Thursday asking to know more about the data used by the large study. Because, remember, this is based on information from some 96,000 patients hospitalized between December and April in 671 hospitals. Colossal data that the authors of the publication refuse to communicate.
"A vulgar stew"
“It is not known how this data could have been transmitted from the hospitals. This could be illegal, pure hacking, "says Professor Philippe Froguel, endocrinologist and geneticist, professor at the Lille University Hospital. “In normal times, there are procedures to follow, authorizations to claim. Hospital data cannot be accessed without the agreement of the establishments. In the case of 600 hospitals, this should have taken months, ”added the scientist. And to insist, preferring to avoid any misunderstanding: "Let's get on well, I am absolutely not pro-Raoult, but this study looks like a vulgar stew!" "
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As a reminder, these studies compare the condition of patients who have received hydroxychloroquine treatment with that of other patients who have not received it. This is an observational study of people already hospitalized, not a randomized clinical trial where patients are selected in advance to participate. “For this type of study, you need to collect data on the fly. The difficulty is then to recover everything, without producing approximations or potential biases, ”explains Jean-Daniel Lelièvre on the phone, head of the infectiology service at Henri-Mondor hospital in Créteil.
Data error, lack of ethics…
However, an error has already been noted by the Guardian: deaths in a hospital in Asia had been accidentally counted ... in Australia. "The error has been corrected, which does not fundamentally change the results," justified Dr. Sapan Desai, founder of Surgisphere, the company from which the hospital data originated. A company that itself raises some reservations: "It is a box of five people, unknown to the battalion", points to the finger Philippe Froguel.
Besides the lack of transparency and the curious speed with which the study went up, many underline the “obvious lack of ethics” of the work. "Usually, when you want to do a study on humans, you have to present a project to an ethics committee which validates it or not. It was not the case. It would also have been necessary to call on an international scientific committee responsible for verifying and analyzing the mountain of data to avoid any error ”, notes the scientist.
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Reading the medical data left more than one skeptical researcher. The main surprise: "The figures are of incomprehensible homogeneity," says the professor.
If we look for example at the rate of patients with hypertension, it remains roughly the same from one continent to another: it concerns 27.1% of North Americans, 26.4% of Europeans, 25.9% of Africans or 26.6% of Asians. The same goes for the rate of diabetics: 13.7% of North Americans suffer from it, against 14.6% in South America, 14.2% in Europe, 12.9% in Africa and 14.1% in Asia.
"There is no reason why these data should be so homogeneous from one continent to another, especially since the body mass index (BMI on the table, Editor's note) is never the same", notes Philippe Froguel.
A "final opinion" expected mid-June
"One could almost believe that this study was carried out with the aim of showing that chloroquine is dangerous", quips the researcher. Worse, the publication could, in his opinion, in the longer term, discredit hospital medicine as well as health authorities in France and around the world. "When we see the haste with which the authorities have stopped the tests on the molecule after the publication of such work, that ridicules us," he said.
"This study is clearly not perfect", abounds with his colleague, Jean-Daniel Lelièvre. "If this publication was the only one proving that chloroquine was not effective in the treatment against the virus, we would have reason to be embarrassed ... But these results go in the same direction as other studies already published on the subject", reminds the scientist.
In their collective letter, the hundred experts call for the establishment by WHO of a group responsible for conducting an independent analysis of the study's conclusions. Asked on Friday about this issue, the organization noted that the suspension of the trials involving the molecule was "temporary" and that its experts would give their "final opinion" after examining other elements (notably the analyzes of the Solidarity trial ), probably by mid-June. Chloroquine, not yet buried?
VIDEO. Chloroquine: "The latest publications are not in favor of this treatment"
