Paula Lugones
05/22/2020 - 17:48
- Clarín.com
- World
A massive study of 96,000 cases of people hospitalized for coronaviruses on six continents warned that the use of hydroxychlorquine, the drug that US President Donald Trump said he is taking for prevention, significantly increased the risk of death for patients. The report, published this Friday in the prestigious magazine The Lancet , also concluded that people treated with that drug were more likely to develop life-threatening cardiac arrhythmias .
The study is the largest to date on the risks and benefits of treating patients with Covid19 with this drug that has been approved for use in rheumatologic conditions, lupus, or malaria, but not to treat coronaviurs. "It is not one thing to be without benefit, but this shows different harms," said Eric Topol, cardiologist and director of the Scripps Research Translational Institute. "If there was ever hope for this drug, this study killed them."
The drug became popularly known when, in mid-March, President Trump promoted its use - mixed with the antibiotic azithromycin - from his Twitter account as a drug that would be a milestone "in the history of medicine." And since his press conferences he encouraged its use, despite the fact that his scientific advisers tried to lower the tone saying that the drug was not approved for the coronavirus. There were several affected in the United States by people who bought the drug at the pharmacy and ingested it at any symptoms.
On September 24, the Food and Drug Administration then discouraged its massive use and recommended it only in hospital trials and as research evidence. Chinese doctors also noted that there was no clear evidence that chloroquine was effective in their patients. Another drug, remdisivir, was recently approved by the FDA for treatment of coronavirus in critically ill patients.
Despite recommendations to the contrary, Trump was again surprising and said last week that he was taking hydroxychloroquine preventively . The president is in the risk group since he is 73 years old and somewhat overweight. He said he had been doing it 10 days ago, just when some of the White House officials had tested positive. Presidential physician Sean Conley said, "With the president, we concluded that the potential benefits of a treatment outweighed the relative risks," he said.
The study published in The Lancet analyzed data from 96,000 patients with COVID-19 who received chloroquine or its analogue, hydroxychloroquine (ingested with or without the antibiotics azithromycin or clarithromycin), and data from 81,000 control patients. The patients are from more than 600 hospitals.
In light of the results, the researchers suggest that these treatment regimens should not be used to treat COVID-19 outside of ongoing clinical trials.
Mandeep R. Mehra, lead author of the study and researcher at Brigham Women's Hospital in Boston, United States, explains that “this is the first large-scale study to find statistically sound evidence that treatment with chloroquine or hydroxychloroquine does not benefit patients with COVID-19 ”. Rather, "it suggests that it may be associated with an increased risk of serious heart problems and an increased risk of mortality."
Consulted by Clarín, the Argentine cardiologist Oscar Cingolani, professor at the Johns Hopkins University School of Medicine and associate director of the coronary critical care unit of that Baltimore city hospital, explained that the work published in The Lancet was on people who they were in an advanced stage of the disease. "The study suggests that in this group of patients not only did it not show effectiveness but an increase in adverse effects," he said, "and revealed that those taking hydroxychloroquine, combined or not with the antibiotic, could have up to 30% more mortality ” .
He added that "it is likely that the picture of someone who is in intensive therapy, with various other medications on them, with little oxygen in the blood, lung and liver problems influences the effect that hydroxychloroquine can have." "This drug, combined with azithromycin or others, intervenes with ion channels within the heart, producing cardiac arrhythmias, which can lead to sudden death," he noted.
Cingolani also pointed out the differences with studies by the controversial French virologist Didier Raoult, who promoted the use of this drug, which is now authorized in France only for seriously ill patients. He noted that “in desperation to find a drug in the midst of the pandemic, a study was published by a French expert who said that a certain number of internees were given hydroxychloroquine and compared to another group that did not receive the drug, but that he was in another hospital, treated by other people. This essay was much more famous than serious . It was not a clinical trial with the same number of people, the control group was not the same. On the other hand, there were very few patients. "
This new study, highlights Cingolani, "having more than 90,000 patients, shows that this drug, at least for the coronavirus, is not a panacea, far from it: not only were there no beneficial effects but, on the contrary, an increase was seen of mortality ”.
The Argentine also pointed out that work is continuing on this drug and that there are three studies underway in the United States that analyze its efficacy in mild patients or as "prevention", something that could be very useful for healthcare personnel. But there are still no details about these works.
Washington. Correspondent