President Donald Trump needs to leave medical treatment and advice to the nation’s doctors. Wielding the bully pulpit as he did over the weekend to promote hydroxychloroquine as a breakthrough COVID-19 drug is premature and potentially harmful.
This is not a medication for Americans to take on their own or insist upon over all other drugs should they become ill with this mysterious new virus. Political pronouncements are not a substitute for medical expertise.
Sold under the name Plaquenil, hydroxychloroquine is in the spotlight because there is no medication approved through regular channels to treat COVID-19. Doctors are rifling through the existing pharmaceutical toolbox to find something that may help.
Hydroxychloroquine is one drug that’s under consideration. It’s been used since the 1950s to treat lupus and is also a malaria preventive. But it’s not the only candidate that may hold promise.
Remdesivir, an antiviral developed to treat Ebola, was used successfully to treat one of the first Americans infected with COVID-19. Losartan, a hypertension medication that may block the COVID-19 virus from entering human cells, could also have benefits.
At this point, it’s too soon to call any of these drugs a “game changer,” Dr. Tim Schacker of the University of Minnesota told an editorial writer in a recent interview.
Large clinical trials are underway here and elsewhere to determine what works best. That means doctors are providing cutting-edge treatments to those who become ill and swiftly analyzing results. This work is accelerated, but it’s not clear if one drug works or if it’s better than others.
The small studies of hydroxychloroquine that have been done so far are not a replacement for rigorous trials at academic medical centers like the University of Minnesota. That the results from this early, limited research on hydroxychloroquine are mixed underscores the need to scale-up scientific scrutiny.
One recent study involved 30 patients in China. The report, published by the Journal of Zhejiang University, was released last month. Hydroxychloroquine was given to patients who became ill with COVID-19. “Patients who got the medicine didn’t fight off the new coronavirus more often than those who did not get the medicine,” according to a Bloomberg story.
A different study done in France did report a benefit from treating an even smaller number of COVID-19 patients with hydroxychloroquine and azithromycin, a drug that fights bacteria, not viruses. This study has proved controversial, with critics contending that the sickest patients were left out of the analysis (which would skew the results). And, that the statistical methods used to analyze the data were not the ones that would typically be used in this kind of study.
Trump’s promotion may have unfortunately inspired some Americans to try buying hydroxychloroquine without a doctor’s prescription. A recent story in the Dallas Morning News said some people are crossing the southern border to buy it.
This is not a drug to take outside a doctor’s supervision. Hydroxychloroquine has what is known as a “narrow therapeutic window,” meaning there’s not much room between helpful and harmful doses. In addition, it can cause potentially fatal heart rhythm abnormalities. This is not a new concern but one that should be front of mind with the drug’s use potentially expanding.
Sequestering the drug for COVID-19 treatment may also lead to shortages for patients who take it for lupus and other conditions.
We hope Trump is proven right about hydroxychloroquine. But the responsibility for determining which drug, if any, is game changing treatment lies with the nation’s doctors and scientists. Let their work, not political wishful thinking, guide the battle against the coronavirus.
