By Frank Long, MS, Editorial Director, Rehab Management
Results from a large-scale study based in the United Kingdom speak clearly about hydroxychloroquine’s effectiveness in treating COVID-19. After analyzing data from 1,500 randomized subjects to determine whether the drug reduces mortality for hospital patients undergoing treatment for COVID-19 the researchers determined that the drug offers no significant benefit.
Good solution, wrong illness
While hydroxychloroquine has a long history as a successful antimalarial drug its efficacy as treatment for COVID-19 has fizzled outside of uncontrolled studies and anecdotal reports. One example of the sketchy evidence used to support hydroxychloroquine is the laughably unscientific research offered by Dr. Vladmir Zelenko on a program hosted by Rudy Giuliani that gathered more than 574,000 views on YouTube.
The evidence Zelenko presents fails a number of litmus tests, including the absence of a control group and no formal testing method—other than Zelenko’s claim to have successfully treated 699 COVID-19 patients with hydroxychloroquine..
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“No significant difference”
The spread of anecdotal findings such as those made by Zelenko hastens the need to distribute the results of data gathered through controlled research such as the new findings of a study led by Peter Horby, MD, PhD, and Martin Landray, MB, ChB, PhD. Both are professors at University of Oxford and chief investigators whose work is part of the RECOVERY (Randomised Evaluation of COVID-19 Therapy) Trials, a large-scale group of clinical trials testing several potential coronavirus treatments.
Horby and Landray’s study enrolled more than 11,000 patients and compared a control group with a group treated with hydroxychloroquine. As a result of their testing the two investigators determined that hydroxychloroquine provides no substantial benefit in treating COVID-19 patients.
“We have concluded that there is no beneficial effect of hydroxychloroquine in patients hospitalised with COVID-19.”Peter Horby, MD, PhD, Martin Landray, MB, ChB, PhD, Oxford University, June 5, 2020.
A summary of the trial from the Nuffield Department of Population Health reports that a total of 1,542 patients were randomized to hydroxychloroquine and compared with 3,132 patients randomized to usual care. There was no significant difference between the groups in the primary endpoint of 28-day mortality.
The summary furthermore notes that no evidence was found to indicate any beneficial effects of hydroxychloroquine on duration of hospital stay.
Other drugs still being tested as part of the RECOVERY Trials include Lopinavir-Ritonavir, used to treat HIV, and Dexamethason, a steroid used to reduce inflammation.
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Fauci Backs Away
The findings appear to close the door on early hopes that hydroxychloroquine could offer a mitigating effect on the course of the disease or as a prophylactic. In mid-March during a CNN televised town hall meeting Anthony Fauci, MD, Director, National Institute of Allergy and Infectious Diseases, noted that there was non-proven, anecdotal data that hydroxychloroquine worked in treating COVID-19 patients. He stressed, however, that a lack of high-quality research should attenuate any rush to declare the off-label use of hydroxychloroquine for COVID-19 as definitively successful.
By May 27 Fauci was more resolved in dismissing hydroxychloroquine as a COVID-19 treatment during an interview with Jim Sciutto on CNN. The interview came shortly after France announced a ban on the use of hydroxychloroquine for the treatment of COVID-19.
“The scientific data is really quite evident now about the lack of efficacy for [hydroxychloroquine],” Fauci told Sciutto. He added that adverse cardiovascular events such as arrhythmias could result from the use of the drug among certain patients.
“I’m not so sure you’d want to ban it but the data are clear right now,” Fauci adds.
In this two-minute video Horby summarizes the ongoing RECOVERY trial that is testing several other pharmacological therapies for COVID-19.
More about this topic: It’s No Hoax. Brains, Lungs, COVID-19