BRUSSELS (Pakistan Point News / Sputnik - 05th May, 2020) Several antimalarial drugs gained global attention in the past months for their alleged ability to help coronavirus patients, but medical experts warn that there is no definitive evidence that they work.
Chloroquine (CQ) and its derivative, hydroxychloroquine (HCQ), in particular, have been touted as a silver bullet against the deadly virus after renowned Marseille virologist Didier Raoult claimed that their combination with antibiotic azithromycin did wonders in COVID-19 patients.
The announcement led to a rush on pharmacies in France in early March as the epidemic began spreading nationwide, with lines forming outside Raoult's IHU Mediterranean Infection hospital in Marseille to be tested and prescribed the double medication.
The hyped treatment was harshly criticized by then Health Minister Agnes Buzyn and her successor, Olivier Veran, who demanded a more rigorous study of the drug cocktail.
The studies alleging its efficacy were done on a handful of patients without "placebo testing," it turned out. Raoult defended what he said was a test made in emergency, adding it was hard to offer suffering people a placebo in times of crisis.
Several studies of the drug, done following the rules and medical norms in France and at the European level, have since started but have not delivered results yet. A trial in Brazil was stopped in April after participants developed life-threatening side effects.
In the United States, a group of doctors under the leadership of MD Sadakat Chowdhury from the Downstate Medical Centre Department of Emergency Medicine in Brooklyn published a peer-reviewed report last week, saying there was "not enough data available to support the routine use of HCQ and CQ as therapies for COVID-19."
Virologist Jean Ruelle and infectious diseases expert Jean-Luc Gala from UCLouvain university in Belgium were consulted by Sputnik about Raoult's drug cocktail. They cautioned against using HCQ and CQ until more testing was done.
The seven completed studies focusing on the outcome of the use of HCQ and CQ in coronavirus patients showed favorable to no effect. But all of them carried some degree of bias and poor research design.
"My opinion on hydroxychloroquine can be summed up as 'wait and see.' There are a number of studies in progress with a good design this time, the results of which we are awaiting," said Ruelle, the head of UCLouvain's Medical Microbiology Unit.
He argued that more clarity was needed about the moment in the course of coronavirus infection and disease when HCQ was effective. The treatment that works the best after the onset of symptoms � the immune phase � may not be as effective in the preceding phase when the virus replicates intensively.
"We must therefore be attentive to this in the studies presented: which patients have been selected to demonstrate the beneficial effect of a drug? For what future indication: prevention, from the first symptoms, or for severe cases? We don't have that answer yet for hydroxychloroquine, nor for other molecules, so wait and see," Ruelle said.
Jean-Luc Gala, the director of the Center for Applied Molecular Technologies at UCLouvain, said Raoult had lost some credibility in the medical community by promoting studies that do not meet all necessary criteria.
"I have great respect for Prof. Raoult as a virologist over the years, but in this instance I have great doubts about the efficiency of his 'cocktail' of drugs. The studies made until now have been done in 'emergency mode,' have created a lot of publicity, but they had not been 'peer-reviewed' by other doctors," he pointed out.
There is a great desire in the scientific community to see a treatment that works in coronavirus patients but nothing can be said for sure about any drug until complete studies are done with a placebo group to compare results with the patients who have received the molecule, Gala said.
"So let's be careful, but the drug recommended is known for decades to fight malaria, its side-effects are also well-known, so doctors can decide if yes or not, they prescribe it. Maybe the treatment is useless but it cannot be bad," he added.
The World Health Organization said very early in the outbreak that it was concerned by reports of people self-medicating with CQ and causing themselves serious harm. It has since designated the drug as a "treatment option under study."
