Updated April 23, 2020
The most commonly prescribed treatment for lupus, hydroxychloroquine (best known as Plaquenil) is not effective for treating COVID-19 according to a new study of 368 hospitalized patients in United States Veteran Administration medical centers.
Led by Mr. Joseph Magagnoli, Dr. Siddharth Narendran and Dr. Felipe Pereira at University of South Carolina, the team of researchers analyzed data from this group of patients who were given standard of care alone, or in combination with hydroxychloroquine alone or in addition to the antibiotic azithromycin. Whether or not patients needed a ventilator or had died were the two measurements of efficacy.
The worst outcomes occurred among patients given hydroxychloroquine alone plus standard of care (13.3 percent needed mechanical ventilation and 27.8 percent died). Of patients who did not receive any hydroxychloroquine, 14.1 percent needed ventilation and 11.4 percent died. Of those given hydroxychloroquine plus azithromycin, 6.9 percent needed a ventilator and 22.1 percent died.
Researchers found no evidence from their study that hydroxychloroquine either with or without azithromycin lowered the risk for needing a ventilator and saw an increase in the number of deaths. They concluded, “These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.”
Based on the anecodotal and limited observational research to date, the National Institutes of Health notes in guidelines issued April 21 that there is not enough clinical data to recommend either for or against using hydroxychloroquine to treat COVID-19. However, the guidelines recommends against using hydroxychloroquine plus azithromycin outside of a clinical trial because of potential toxic side effects. The U.S. Food and Drug Administration also cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of a hospital setting or clinical trial due to the risk of heart rhythm side effects.
Click here for more background on the initial work looking at the possibility of using hydroxychloroquine for COVID-19.