<![CDATA[Hydroxychloroquine hopes dashed as large study finds no great advantage to antimalaria drug in Covid-19 fight]>
A large-scale study in New York looking at the antimalarial drug hydroxychloroquine has cast further doubt on its effectiveness in the treatment of Covid-19 patients.
Researchers at Columbia University observed nearly 1,400 patients at a large medical centre in New York City in March and April. They found hydroxychloroquine use led to neither a higher nor lower chance of patients ending up with intubation or death.
"Our results cannot completely exclude the possibility of either modest benefit or harm of hydroxychloroquine treatment, but the findings do not support its use outside of randomised clinical trials," said Professor Neil Schluger, the corresponding author of the study published in The New England Journal of Medicine on Thursday.
In the observational study, about 60 per cent of the patients received hydroxychloroquine while the remainder did not. Researchers then examined the relationship between the use of the drug and the development of respiratory failure that led to intubation or death.
Of the 346 patients who developed respiratory failure, 262 were given hydroxychloroquine " 32 per cent of the 811 who received the drug. Meanwhile, nearly 15 per cent of the 565 patients not given hydroxychloroquine were intubated or died.
After taking into account both groups' differences in age, sex, initial vital signs and other factors, researchers found that patients who received the drug had the same risk of being intubated or dying as patients who did not receive it.
The researchers acknowledged that the study patients were all drawn from the same single hospital, suggesting the results might not apply to the general population. Still, the Columbia study is by far the largest published one of hydroxychloroquine in Covid-19 patients. Many previous studies had involved fewer than 100 patients.
Schluger said a larger scale randomised controlled trial would be needed to determine if hydroxychloroquine had any benefit for Covid-19 patients.
Zhong Nanshan, a top respiratory specialist, says chloroquine has a place in China's treatment of some Covid-19 patients. Photo: Xinhua alt=Zhong Nanshan, a top respiratory specialist, says chloroquine has a place in China's treatment of some Covid-19 patients. Photo: Xinhua
China's health authority has included chloroquine phosphate, another drug in the chloroquine family, in its official Covid-19 treatment plan.
Leading Chinese respiratory disease expert Zhong Nanshan has told local media on several occasions that chloroquine had helped improve patients' symptoms. But he added that so far there is no proven drug that could cure the disease.
Zhong said he was unsure about the combined use of hydroxychloroquine and azithromycin, a treatment endorsed by US President Donald Trump in March as a "game-changer" in the fight against Covid-19.
Trump stopped promoting hydroxychloroquine as a potential coronavirus treatment after more trials and studies suggested it either had no benefit or potentially created serious side effects.
In the current official treatment guidelines, China's National Health Commission has explicitly banned the use of chloroquine to treat Covid-19 patients with heart disease.
The US Food and Drug Administration cautioned in late April against the use of hydroxychloroquine or chloroquine for Covid-19 patients not being treated in hospital because there was a risk of heart rhythm problems.
This month, a team of pharmacists and clinicians at Harvard Medical School and Beth Israel Deaconess Medical Centre found evidence suggesting hydroxychloroquine carried a greater risk of electrical changes to the heart and cardiac arrhythmias.
Those taking hydroxychloroquine and azithromycin had greater QT prolongation " or electrical changes " than those taking hydroxychloroquine alone, they said.
Their cohort study of 90 Covid-19 patients in hospital in Boston was published in JAMA Cardiology on May 1.
This article originally appeared on the South China Morning Post (SCMP).
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