Marseilles infectiologist Didier Raoult says that hydroxychloroquine, combined with an antibiotic, was effective against Covid-19, based on a new trial conducted on 80 patients. But some doctors always call for caution, like Professor François Bricaire, former head of the Parisian infectious diseases department of La Pitié-Salpétrière.
What do you learn from Professor Raoult's work on chloroquine?
FRANCOIS BRICAIRE. I have not yet been able to analyze in detail the result of its last trials carried out on 80 patients. But one thing first: we must not sue Didier Raoult. We can think what we want from this gentleman, who can probably offend some, but he is a quality doctor in terms of research at an international level. Chloroquine, I myself have used it for years as an anti-infective treatment and it has been prescribed for all expatriates potentially exposed to malaria without any major inconvenience being reported overall. Provided that this medication is taken in accordance with the rules and under strict medical supervision.
But is it effective against the Covid-19?
I understand that we tried to use it as the Chinese did first. Because it is an old molecule which has an activity in vitro against a certain number of viruses. It was therefore rational to test it even if so far it has never given positive results in vivo on humans.
Didier Raoult has been widely criticized for the methodology of his study.
He has done scientific work but whose methodology can be criticized because it includes several biases, in particular the validity of the control group ( Editor's note: the group who did not receive the treatment ) and his tests do not meet the perfect criteria that requires science. According to these trials, chloroquine would lower the viral load of patients, but that does not demonstrate the definite effectiveness of this drug or that covid-19 is cured if it is taken.
If you were still the head of an infectious diseases department, would you prescribe it?
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I would be very annoyed but I believe not, I would not prescribe it except in very specific cases. Personally, I rather have the feeling that chloroquine will prove to be ineffective in clinical terms. I believe that I would await the results on a larger scale from the study launched at European level which is under way. Only this study will allow to know if this drug has an action or not on covid-19. The problem is that there is so much noise around this drug that it is gaining momentum in public opinion today. And it would seem that certain patients only agree to lend themselves to studies in a hospital environment on this molecule only on the condition of receiving it. If you want to do a serious study, you have to compare people who receive it and others who do not.
Do you understand that some doctors already prescribe it?
Since there is currently no other effective treatment, I understand that some people offer it in hospitals saying to themselves: in war as in war, either it is effective and so much the better for my patients, or it does not is not and we will at least have tried to improve the lot of those who are badly affected. But let's be clear: I say no to the widespread use of chloroquine among the population. Because this would lead, as we can already see, to misuse of the drug, outside of strict hospital control. And it could quickly get out of hand.
If chloroquine is ultimately effective, at what stage of the disease should it be administered?
It would be illogical to use it at too advanced a stage of the disease because the action of the drug would then be uncertain. Logic suggests that it should be used much earlier.
VIDEO. Chloroquine debate: "Patients must benefit from this approach"