Hydroxychloroquine and covid-19: what you need to know

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Hydroxychloroquine and covid-19 7:37

(CNN) - The possibility of using hydroxychloroquine to treat covid-19 amid the new coronavirus pandemic has sparked rancor and disagreement between politicians and scientists.

There have been indications that the drug is effective in treating or preventing covid-19, but the evidence has not supported due diligence from extensive clinical trials.

LOOK: A heated disagreement over the use of hydroxychloroquine to treat coronavirus breaks out in the White House

Still, many, including President Donald Trump, are asking doctors to prescribe hydroxychloroquine for patients with covid-19. This is what you should know:

Where are you from?

Hydroxychloroquine, also known by the brand name Plaquenil, and its analog, chloroquine, are derived from quinine, which French chemists isolated in 1820 from the bark of the cinchona tree, according to Medicines for Malaria Venture. In 1934, German scientists created synthetic chloroquine as part of a class of antimalarials, MMV said. Hydroxychloroquine is the least toxic version of chloroquine.

Can it be used to treat covid-19?

It is not clear. In laboratories, it has shown some efficacy against the severe acute respiratory syndrome coronavirus responsible for the present pandemic. But White House coronavirus response coordinator Dr. Deborah Birx has said that efficacy in test tubes does not mean it will work in humans.

Human studies have presented conflicting conclusions. For example, a small Chinese study said the prognosis was "good" but that the drug requires more research. Meanwhile, a French study combining the drug with a popular antibiotic, which Trump said could change the rules of the game, showed "no evidence of rapid antiviral elimination or clinical benefit."

Another French study showed promise in treating the virus, according to The Lancet medical journal, "but virologists and infectious disease experts warn that the result is premature."

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So is it an antimalarial?

Yes, but since 2006, its use in severe malaria has not been recommended due to resistance problems, particularly in the Oceania region, according to the World Health Organization.

It also has value as a "disease-modifying antirheumatic drug" that can decrease arthritis pain and swelling, according to the American College of Rheumatology. It is used to treat rheumatoid arthritis, childhood arthritis, some symptoms of lupus, and other autoimmune diseases.

"It is not clear why hydroxychloroquine is effective in treating autoimmune diseases. Hydroxychloroquine is believed to interfere with cell communication in the immune system, "says the university.

Are more human studies coming?

Yes, many of them. Drug manufacturers have provided millions of doses to the federal government, and the US Food and Drug Administration. The US, which has not officially approved hydroxychloroquine for the treatment of covid-19, has issued an emergency use authorization to treat patients with covid-19.

The drug should be used as a last resort for extremely ill patients after they can "talk to their healthcare provider about everything they could do to save their lives," US Surgeon General Jerome Adams told Fox News.

In Detroit, 3,000 patients at Henry Ford Hospital will be part of a trial whose results will be tracked in a formal study, said Vice President Mike Pence, who is leading the White House coronavirus response. The federal government is also working to obtain millions of doses in areas with high infection rates, another White House official said.

Why does Trump keep mentioning it?

He believes the drug can be a powerful weapon against covid-19, he says, "and there are signs that it works on this, some very strong signs." He also believes that taking the drug could be helpful as a preventive measure for health workers, he said.

Experts have not suggested the latter, but Trump is right that there are promising signs. While health experts say it's best to wait until clinical trials determine whether hydroxychloroquine is safe and effective in treating covid-19, Trump wants faster results. It may not work, he said, but he doesn't want to wait 18 months to find out.

The US Department of Health and Human Services. USA He has also cited encouraging anecdotal reports, but also insisted that more clinical trials are needed.

But it's sure?

Trump points to the fact that it has been in use for decades, "so we know that if things don't go as planned, it won't kill anyone." In fact, health experts feel better about its safety than "an entirely new drug," Adams told Fox.

Hydroxychloroquine is well tolerated in patients with covid-19, according to the US Centers for Disease Control and Prevention. While the American College of Rheumatologists says it is generally well tolerated.

Side effects are rare, according to the university, and most commonly include nausea and diarrhea. Less common side effects include skin rashes, hair changes, weakness, and, rarely, anemia or vision changes.

That said, Nigerian officials have reported cases of overdose, and an Arizona man who took a form of chloroquine used to clean fish tanks died.

Should people take it and see what happens?

Lupus patients routinely use the drug to treat their symptoms, for some there is no alternative, and it is the only known therapy for primary Sjögren's syndrome, another autoimmune disorder, The Lancet said.

Due to the shortage sparked by coronavirus-related interest, the Lupus Foundation of America has asked drug makers to increase their production of hydroxychloroquine, and Kaiser Permanente is no longer supplying routine prescriptions for chloroquine, The Lancet reported.

FDA Commissioner Stephen Hahn, who called for a "large and pragmatic clinical trial" of the drug, also urged caution, cautioning against "treating patients with a product that might not work when they might have sought other, more appropriate treatments." .

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