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The controversy over hydroxychloroquine intensifies

American scientists concluded in a study that chloroquine was ineffective against Covid-19. The release of the study coincided with bad news about the US drug Remdesivir.

Published: May 24, 2020, 9:08 am

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    In response, the French Minister of Health, Olivier Véran, announced on Saturday, May 23, that he would ask the High Council of Public Health (HCSP) to decide after an American study published in the scientific journal The Lancet concluded that a treatment with hydroxychloroquine was ineffective against the Covid-19, but also presented an increased risk of mortality, reported French daily Le Figaro.

    Véran asked that light be shed on the prescriptions. “I asked the HCSP to analyze it and suggest to me within 48 hours a revision of the derogating prescription rules,” he said on Twitter.

    This antimalarial drug, advocated in the treatment of Covid-19 patients by Marseille specialist Prof. Didier Raoult, has been highly controversial for several weeks, some talking about an effective remedy, others pointing out its side effects on the heart rate. US President Trump’s admission that he is taking the drug, has now heightened the political implications for his re-election.

    In the study published in The Lancet, the researchers claim to have been “unable to confirm a benefit of hydroxychloroquine or chloroquine […] on the prognosis of hospitalized Covid-19 patients”.

    This conclusion contradicts a Chinese study published in early May, according to which treatment with hydroxychloroquine is “significantly associated with a decrease in mortality” in severely ill patients.

    Prof Dr. Frank Ruschitzka, Director of the Heart Center at University Hospital Zurich who also co-authored The Lancet study said: “Several countries have advocated use of chloroquine and hydroxychloroquine, either alone or in combination, as potential treatments for COVID-19. Justification for repurposing these medicines in this way is based on a small number of anecdotal experiences that suggest they may have beneficial effects for people infected with the SARS-CoV-2 virus. However, previous small-scale studies have failed to identify robust evidence of a benefit and larger, randomised controlled trials are not yet completed. However, we now know from our study that the chance that these medications improve outcomes in COVID-19 is quite low.”

    A fervent defender of chloroquine since the start of the crisis, is also the mayor of Nice who denounced the “media lynching” which the Marseille professor has been subjected to.

    Since the beginning of the health crisis, Christian Estrosi has publicly defended Prof. Raoult. The mayor of Nice is all the more complimentary towards the director of the Marseille University Hospital Institute since he himself was treated with hydroxychloroquine when he was diagnosed with Coronavirus.

    Invited by BFMTV on Friday, May 22 in the morning, the mayor denounced the “media lynching” which Didier Raoult is the subject of, according to him.

    Estrosi praised the work of the man he considers to be “the greatest researcher” in France, before speaking about the effectiveness of chloroquine to treat Covid- 19. “Perfect or imperfect, there was a solution. I do not understand why we indulged in this kind of media lynching of someone who works, someone who does not want to get involved in all these debates, someone who, instead of spending his time to be a commentator on the television sets, prefers to devote himself to his patients,” he said.

    The former minister openly criticized “a scientific world” with more “commentators than actors” according to him. “I do not see them locked up from morning to night in their laboratories, but I especially see them occupying all the television sets,” he said, explaining that he preferred to be “behind those who act rather than those who comment”.

    But the greater disappointment however, is the latest news about the American drug Remdesivir. According to a pivotal study published in the New England Journal of Medicine also on Friday, the study found that overall “mortality was numerically lower in the Remdesivir group than in the placebo group, but the difference was not significant”.

    In other words, the alleged “miracle drug” has largely the same effect as a placebo in terms of overall disease mortality.

    In conclusion, while the “preliminary findings support the use of Remdesivir for patients who are hospitalized with Covid-19 and require supplemental oxygen therapy” the study goes on to warn that “given high mortality despite the use of Remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient.”

    The executive director of the World Health Organization’s emergencies programme, Dr. Mike Ryan told a media briefing that the WHO advises hydroxychloroquine to “be reserved” for use in the context of clinical trials only.

    But for some researchers, running such trials is becoming more difficult because of the political controversy around the drug, US National Public Radio reported.

    Dr. Jon Giles, an epidemiologist and rheumatologist at Columbia University, ran into a problem when they started calling potential participants for their trial.

    “Pretty much everybody said, ‘Well that’s the drug that’s dangerous to your heart,’ or, ‘I talked to my friends and they said don’t take it,’ or that ‘I saw on TV it’s dangerous,'” Giles explained.

    Just a month earlier, he says demand for the drug was soaring. Some patients with autoimmune conditions even experienced difficulties in getting their prescriptions filled.

    It is now “almost impossible to get anyone interested,” said Giles. According to Giles, it is a “very, very safe drug” because it’s been used for over 75 years. “When I give someone hydroxychloroquine, I don’t get an ECG or do blood monitoring,” he added.

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    • Rentia Diedericks

      In 2011, The Lancet published a UK study on success with chronic fatigue syndrome. But the data analysis was different from that described in the original protocol. Columbia University as well as Stanford University critics filed Freedom of Information Act requests to get access to the authors’ primary data when Lancet tried to cover it up. In 2016, after some data was released, it revealed that no significant improvement in recovery rates over the control condition was in fact noted. So the Lancet has been less than transparent on some issues before. This seems to be a similar case.

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