President Donald Trump can't seem to stop talking, shouting, and tweeting about hydroxychloroquine. The US President has taken to the airways over the last few weeks to spout the benefits of the anti-malaria drug as a treatment against COVID-19, despite the lack of medical evidence.
“What do you have to lose? Take it,” Trump said at a press conference on Saturday. "I really think they should take it ... try it, if you'd like."
(It goes without saying, don't try a new medication without suitable supervision and don't take medical advice from someone without medical training.)
However, despite the President’s obsession with this drug, it's not all that it seems. There’s little scientific evidence to confirm hydroxychloroquine is an effective treatment for COVID-19. There is, however, a huge amount of misinformation and controversy surrounding the drug’s role in the ongoing pandemic. Here’s what you need to know.
Hydroxychloroquine (also known by its brand name Plaquenil) is loosely chemically related to quinine, the bitter ingredient in tonic water, that's been widely used to treat malaria and shown some promise in the treatment of other viral infections. It's also used to treat lupus.
Much of the renewed hype around the drug has come from a small French study published in the International Journal of Antimicrobial Agents (IJAA) on March 20, 2020. This non-randomized trial, involving just 36 patients, found that taking hydroxychloroquine was “significantly associated” with a reduction in viral load in COVID-19 patients, noting this effect was “reinforced” by also taking the antibiotic azithromycin.
The study has since run into a fair amount of criticism. The International Society of Antimicrobial Chemotherapy (ISAC), which publishes the IJAA, responded to the flack by releasing a statement saying “the article does not meet the Society’s expected standard... Although ISAC recognizes it is important to help the scientific community by publishing new data fast, this cannot be at the cost of reducing scientific scrutiny and best practices.”
Subsequent studies have failed to reproduce the results of the French study. A second study, also with a small number of COVID-19 patients, found that hydroxychloroquine was no better than the current treatment of oxygen, fluids, antiviral drugs, and rest.
On top of this, there are also some concerns over the potential side-effects of the drug. The American College of Cardiology has published a new guidance warning that the combo of hydroxychloroquine and azithromycin might raise the risk of some patients experiencing potentially fatal irregular heartbeats. There are also early suspicious, based on preliminarily unpublished research, that hydroxychloroquine may be toxic when taken in combination with certain diabetes medications.
Disagreements over the drug have caused quite the fall out in the White House. Dr Anthony Fauci, the country’s top infectious disease doctor, head of the National Institute of Allergy and Infectious Diseases (NIAID), and part of Trump's own coronavirus taskforce, has cautioned against putting too much promise in hydroxychloroquine. When asked by journalists on March 24 whether the drug was considered a treatment for COVID-19, he replied: "The answer is no, and the evidence that you're talking about... is anecdotal evidence."
The NIAID chief was again asked about the efficacy of the drug during a press briefing Sunday, April 5. Before Dr Fauci could answer, Trump jumped in, dismissing the questions with: “I answered this 15 times. You don't have to answer that question,” before moving onto the next question.
In sum, while there is some interesting preliminary evidence, there is currently not enough evidence to herald hydroxychloroquine as a wonder drug and the ultimate solution to the COVID-19 pandemic.
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