medwireNews: Preliminary findings from a small open-label study suggest that repurposing hydroxychloroquine – an antimalarial agent and DMARD – may be a feasible strategy for COVID-19 that merits further investigation.
Among 20 hospitalized patients aged an average of 45.1 years with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection who were treated with oral hydroxychloroquine sulfate 200 mg thrice daily for 10 days, 70.0% achieved virologic clearance in nasopharyngeal samples at the 6-day follow-up.
By comparison, virologic clearance was reported in 12.5% of 16 control patients who did not receive hydroxychloroquine because they did not meet inclusion criteria, refused study treatment, or were treated at another center.
Didier Raoult (IHU-Méditerranée Infection, Marseille, France) and team note that six participants received the antibiotic azithromycin (500 mg on day 1, then 250 mg/day for 4 days) in addition to hydroxychloroquine “to prevent bacterial super-infection,” and rates of viral clearance in these patients “suggest a synergistic effect of the combination.” All six patients receiving both treatments achieved virologic clearance at day 6, compared with 57.1% of the 14 treated with hydroxychloroquine alone.
While the investigators believe that their findings “should be shared with the scientific community” in light of “the urgent need for an effective drug against SARS-CoV-2,” they caution that their preliminary investigation has a number of limitations, including small patient numbers and limited duration of follow-up.
“Further works are also warranted to determine if these compounds could be useful as chemoprophylaxis to prevent the transmission of the virus, especially for healthcare workers,” they write in the International Journal of Antimicrobial Agents.
The ACR has issued a statement acknowledging that the US FDA has been asked to fast-track potential treatments for COVID-19, including chloroquine and hydroxychloroquine, for evaluation.
“Rheumatologists have extensive experience using these drugs and understand their safety and efficacy, including for our patients with rheumatic disease who take these medications on a regular basis,” says the ACR, and calls for “pragmatic clinical trials of these drugs [that] can be done quickly to determine how well they work, who should get them, and at what point in the illness.”
medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature group
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Int J Antimicrob Agents 2020; doi:10.1016/j.ijantimicag.2020.105949