Hydroxychloroquine, the “game changer” as per the president of the US has been in the news for quite some time. Rulers from all around the world have thanked PM Modi for supplying them with hydroxychloroquine to curb this virus. Zydus, IPCA, and numerous other Indian manufacturers supply 70% of the global requirement of HCQ worth $300-400 million. Following this, manufacturers like Zydus and IPCA had enhanced their manufacturing capacities by many times.
In my previous article (https://www.inventiva.co.in/trends/nandini/india-making-a-name-abroad-the-hydroxychloroquine-way-indias-generosity-during-these-times-is-winning-hearts/ ), I have shared a snippet of the same. Now comes the actual game changing part. Since the drug has been imported by various countries and has been used widely, the real time results are quite shocking.
A study was conducted in Virginia and was funded by the National Institutes of Health and the University of Virginia. In the study of 368 patients, 97 patients who took hydroxychloroquine had a 27.8% death rate. The 158 patients who did not take the drug had an 11.4% death rate. There was an increased mortality rate in patients who are being treated with Hydroxychloroquine. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.
Another method was proposed where people used a combination of hydroxychloroquine and the antibiotic azithromycin for stopping the spread of the virus. This was studied and no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19.
Researchers in France examined medical records for 181 Covid-19 patients who had pneumonia and required supplemental oxygen. About half had taken hydroxychloroquine within 48 hours of being admitted to the hospital, and the other half had not. There was no statistically significant difference in the death rates of the two groups, or their chances of being admitted to the intensive care unit. However, it found eight patients who took the drug developed abnormal heart rhythms and had to stop taking it.
The use of this drug was warned beforehand but still it is being used.
Another study suggests that at least 1% of patients will be at increased risk for a hydroxychloroquine or chloroquine QT reaction capable of triggering drug-induced sudden cardiac death (especially if used in combination with azithromycin). Even though the probability of these reactions is less, it will cause damage. Thousands of lives could be at risk from medications that were supposed to help them to recover from the virus. Ackerman believes such dire consequences can be avoided easily if physicians carefully evaluate vulnerable patients and treat them with utmost care.
European Medicines Agency:
The European Medicines Agency, one of the biggest agencies in the world has reported that there have been serious and fatal problems with people who have consumed the drug in any form. There have been heart rhythm problems with chloroquine or hydroxychloroquine, particularly when taken in high doses or in combination with the antibiotic azithromycin.
“In the context of COVID-19, these medicines should only be used as part of clinical trials or in line with nationally agreed protocols. They must not be used without a prescription and without supervision by a doctor,” said the EMA.
Indian Council for Medical Research (ICMR)
The Indian Council for Medical Research (ICMR) has cleared the use of HCQ for treating patients with covid-19. HCQ could in theory modulate the immune system’s response to the virus and protect them. However, these dosages are also linked to instances of cardiac arrhythmia and liver damage.
The question is, why are we using a drug which is causing us harm?
“I think it was resorted to more out of a sense of desperation”, said Joseph Masci, an infectious disease specialist and director of global health at Elmhurst Hospital in Queens, a borough of New York City, which is at the centre of the epidemic in the USA. “It is just an indication of how sudden and massive this outbreak has been.”
There have been no “adequate, approved and available” alternative drug for the virus and that is why the US Food and Drug Administration (FDA) is allowing the use of the antimalarial drugs hydroxychloroquine and chloroquine to treat coronavirus disease 2019 (COVID-19).
WHO agrees by stating “insufficient data to assess the efficacy of either of these medicines in treating patients with COVID-19, or in preventing them from contracting the coronavirus”.
Till the time satisfactory results haven’t been taken up in the research labs for the use of this drug, it can be safely said that this drug, HCQ, isn’t the actual solution but just a course of “desperate times require desperate measures”