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According to recent scientific reports, hydroxychloroquine – like chloroquine – may be effective in treating COVID-19 disease caused by the SARS-CoV-2 coronavirus. Testing of both drugs has already begun in many countries. Specialists, however, note the potential side effects – both chloroquine and hydroxychloroquine.
Hydroxychloroquine and Chloroquine
Chloroquine, a known antimalarial drug, has been administered to COVID-19 patients for several weeks, including in Italy, Spain, Switzerland and the Netherlands. Also in Poland, the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products issued a positive decision to extend its therapeutic indications to include “adjunctive therapy in beta coronavirus infections, such as SARS-CoV, MERS-CoV and SARS-CoV-2”. At the Medical University of Piastów Śląskich in Wrocław has just started a nationwide program to study the effect of chloroquine on the prevention or reduction of severe pulmonary complications in the course of coronavirus infection.
– We have reason to believe that this drug may be effective in preventing the development of pneumonia, respiratory complications, including the need for treatment in intensive care units in patients infected with COVID-19. However, at the moment we do not know for sure and therefore there is an urgent need to conduct such a study – explains the rector of the university, prof. Piotr Ponikowski.
- More about the program: Wrocław: the first patient qualified for the study of the influence of chloroquine on the course of coronavirus infection
Worldwide studies have so far failed to confirm the serious side effects of chloroquine in patients infected with the coronavirus.
Recently, reports have begun to appear more and more often that it may also be effective in treating COVID-19 hydroxychloroquine, a derivative of chloroquine that exhibits similar (but not the same) properties. Several studies show that it is more potent, and at the same time has an advantage over chloroquine in terms of safety. They write about it, among others Chinese scientists from Peking University Third Hospital and the National Institute for Viral Disease Control and Prevention, and French researchers who published their findings in the International Journal of Antimicrobial Agents.
However, there are voices that these findings are drawn from rash conclusions – these are preliminary reports prepared on the basis of studies involving small groups of patients. Nevertheless, the World Health Organization takes the potential of both chloroquine and hydroxychloroquine very seriously, pointing to the need for further testing.
Clinical data are limited, but hospitals are already using drugs
Clinical trials on the safety and efficacy of hydroxychloroquine in the treatment of adults hospitalized for COVID-19 have recently started in the United States. The first participants qualified for the Vanderbilt University Medical Center in Nashville. The US National Institutes of Health (NIH) reports that in a variety of studies the drug showed antiviral activity and the ability to modify the activity of the immune system, it also has an established safety profile in appropriate doses, leading to the hypothesis that it could also be useful in treating COVID-19. Its use, however, is not without risk as it may cause cardiac arrhythmias, convulsions, dermatological reactions and hypoglycaemia.
Many hospitals in the US are currently using hydroxychloroquine as their first-line therapy in hospitalized COVID-19 patients, despite very limited clinical data confirming its effectiveness. So data on hydroxychloroquine in the treatment of COVID-19 is urgently needed, said Dr. Wesley Self, who is involved in the project.
As we read in “Puls Medycyny”, the Sermo company, which conducts public opinion research for the medical sector, indicates that hydroxychloroquine belongs to the group of drugs that are most commonly used to treat COVID-19. According to Sermo, more than 70 percent of it is prescribed in Spain. doctors dealing with patients infected with coronavirus, in Italy nearly 50 percent
The European Medicines Agency (EMA) in its statement on April 1 stresses that, in the case of COVID-19, chloroquine and hydroxychloroquine should be used in clinical trials and, in addition to clinical trials, can be used in accordance with national COVID-19 emergency treatment programs. The Polish Office for Registration of Medicinal Products, Medical Devices and Biocidal Products emphasizes:
“Both chloroquine and hydroxychloroquine can cause serious side effects, especially when taken in high doses or in combination with other medications. They must not be used without a prescription and without medical supervision ».
- Also read: The Ministry of Health introduces rationing of two drugs. Who can buy Arechin and Plaquenil?
There is a risk, especially in people with heart disease
CNN reports that hospitals in Sweden have received guidance that doctors should not use chloroquine to treat COVID-19 patients outside of clinical trials. Prof. Magnus Gisslén of Gothenburg’s Sahlgrenska University Hospital told the station that the guidelines also apply to related drugs (hydroxychloroquine). The point is that evidence of significant effects on COVID-19 is still weak, and serious side effects cannot be ruled out. Prof. Gisslén explains that these drugs can primarily affect the functioning of the heart, so they threaten patients with cardiovascular diseases, and if given in too high a dose, they can even harm people who do not have any additional diseases.
Last week, the American Heart Association, the American College of Cardiology, and the Heart Rhythm Society issued guidelines on the use of hydroxychloroquine and azithromycin in the treatment of the new coronavirus. They highlighted the need to consider “potentially serious implications for people with cardiovascular disease”.
In the position of the Polish Society of Rheumatology and the national consultant in the field of rheumatology on the principles of prescribing chloroquine (Arechin) and hydroxychloroquine (Plaquenil) during the COVID-19 pandemic, we read:
Patients should not take chloroquine and hydroxychloroquine without medical indications on their own, because it may expose them to serious complications. It should be remembered that the use of chloroquine and hydroxychloroquine, especially in high doses, may involve a risk of retinopathy and irreversible blindness. Patients with ophthalmic contraindications should not use it. Similarly, the use of the drug in patients with cardiological and neurological contraindications may result in the emergence of significant complications. Chloroquine in the treatment of COVID-19 in Poland is currently used in hospital conditions under strict medical supervision.
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