New York - US hospitals said they have
pulled way back on the use of hydroxychloroquine, the malaria
drug touted by President Donald Trump as a Covid-19 treatment,
after several studies suggested it is not effective and may pose
significant risks.
Early hopes for the decades-old drug were based in part on
laboratory experiments and its anti-inflammatory and antiviral
properties. But its efficacy has so far failed to pan out in
human trials, and at least two studies suggest it may increase
the risk of death.
Several hospitals that two months ago told Reuters they
were using hydroxychloroquine frequently for patients with
Covid-19 have cut back.
Orders for the drug have dropped to a tenth of the
late-March peak, to about 125,000 pills last week, said Vizient
Inc, a drug buyer for about half of US hospitals.
The significant decrease in use is a sign that US physicians no longer believe the drug's potential benefit
outweighs the risks. Some European governments this week banned
hydroxychloroquine use for Covid-19 patients.
Dr. Thomas McGinn, deputy physician in chief at Northwell
Health, New York's largest healthcare system, told Reuters it
decided to stop prescribing hydroxychloroquine at its 23
hospitals in mid-April, after clinical data began to emerge.
"People were in our hospitals, they were dying, and we
wanted to do something," he recalled. "But the minute the data
came out ... showing no benefit and potential harm, I think we
all needed to step back," he said.
This electron microscope image made available and colour-enhanced by the National Institute of Allergy and Infectious Diseases Integrated Research Facility in Fort Detrick, Marylandd., shows Novel Coronavirus SARS-CoV-2 virus particles, orange, isolated from a patient. Picture: NIAID/National Institutes of Health via AP
The US Department of Veterans Affairs, which has medical
centers throughout the country, also has "ratcheted down" use of
the dug as other treatments have become available, VA Secretary
Robert Wilkie told a congressional hearing on Thursday.
The VA was among the first to flag the potential increased
death risk of using hydroxychloroquine in Covid-19 patients in
April.
British medical journal The Lancet last week published an
analysis of 96,000 COVID-19 patients showing those treated with
hydroxychloroquine or the related chloroquine had higher risk of
death and heart rhythm problems.
The observational study does not have the rigor of a
randomized, placebo-controlled trial, but its size made it
influential, and added to what was observed in the far smaller
VA analysis.
Seattle's University of Washington hospital system has also
stopped recommending hydroxychloroquine as a coronavirus
standard of care, noting in its latest treatment guidelines that
"recent clinical studies have not demonstrated virologic or
clinical benefits."
Trump has been a particularly strong supporter of
hydroxychloroquine, calling it a "game changer" early on. He
later said he was taking the drug to prevent infection despite
no scientific evidence it could do so, after people who worked
at the White House tested positive for COVID-19. He has also
urged others to try the medicine.
Proponents of the drug as a Covid-19 treatment argue it may
need to be administered at an earlier stage in the disease to be
effective. Doctors are waiting for studies that might prove
that.
Results could be released as early as this week for two of
the University of Minnesota's three hydroxychloroquine trials,
according to Dr. Radha Rajasingham, lead researcher for one of
the studies.
"Everyone's idea of the safety of this drug kind of changed
overnight," Rajasingham said, referring to an April 24 U.S. Food
and Drug Administration warning of increased risk of heart
rhythm problems. "We have really had trouble enrolling" patients
in the trials, she added.
Other studies comparing the drug to a placebo are expected
later.
"We are still waiting for randomized, controlled data, but
there is much less enthusiasm now for hydroxychloroquine,
azithromycin and some of the other treatments that people have
been touting," said Dr. Timothy Brewer, an infectious disease
specialist at the University of California, Los Angeles, which
now recommends the drug's use only in clinical trials.
"There is enough observational data to suggest that they
have no benefit, or a small benefit, and there are some risks."