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Coronavirus and hydroxychloroquine: What do we know? Coronavirus and hydroxychloroquine: What do we know?
(1 day later)
A drug normally used to treat malaria has been touted as a potential treatment for coronavirus. Drugs normally used to treat malaria, hydroxychloroquine and chloroquine, have been touted as potential treatments for coronavirus.
Yet scientists have warned about side effects and the World Health Organization (WHO) has temporarily halted several studies around the world because of safety fears. The treatments have been promoted and used by some world leaders, but concerns have been raised about their safety and efficacy.
US President Donald Trump previously said he was taking hydroxychloroquine as a preventative measure against Covid-19, but has now stopped.
Other trials are underway to examine if hydroxychloroquine (and a related drug chloroquine) are effective against the coronavirus.
We've looked at what we know so far about these drugs.We've looked at what we know so far about these drugs.
Who's raised concerns about using them? Why have these drugs gained prominence?
The World Health Organization has said it's concerned by reports of individuals self-medicating and causing themselves serious harm. US President Donald Trump revealed earlier this month that he was taking hydroxychloroquine as a preventative measure against Covid-19, but then said he'd stopped.
These safety concerns have been echoed by a former top US health official. Mr Trump has repeatedly referred to its potential in White House briefings. At a press conference in April, he said: "What do you have to lose? Take it."
Dr Rick Bright, who was removed from his post in April leading the government's vaccine development efforts, says President Trump's focus on these drugs has been "extremely distracting to dozens of federal scientists". President Bukele of El Salvador has said he and "other world leaders" were also taking it,
And the US Food and Drugs Administration, which granted emergency approval for using them in certain settings only, has also warned about some possible side effects. And Brazilian President Jair Bolsonaro claimed in a video that "hydroxychloroquine is working in all places". It was subsequently removed by Facebook for breaching its misinformation guidelines.
Is there evidence they might treat Covid-19? Following Mr Trump's comments, there was a sharp increase reported in prescriptions in the US for both hydroxychloroquine and the related drug, chloroquine.
President Trump has referred to the potential of hydroxychloroquine in White House briefings. At a press conference in April, he said: "What do you have to lose? Take it."
Brazilian President Jair Bolsonaro claimed in a video that "hydroxychloroquine is working in all places". It was subsequently removed by Facebook for breaching its misinformation guidelines.
Following Mr Trump's comments, there was a sharp increase reported in prescriptions in the US for both chloroquine and hydroxychloroquine.
The publicity given to these drugs has also led to a global surge in demand for them.The publicity given to these drugs has also led to a global surge in demand for them.
Tablets containing chloroquine have long been used in the treatment of malaria to reduce fever and inflammation, and the hope has been that they can also work against the virus that causes Covid-19. What are the concerns about safety?
There are ongoing trials in various countries on using the drugs to prevent the illness. As part of these studies, frontline workers who are highly exposed to the virus are taking it as a prophylactic. There is growing alarm in the scientific community about using such drugs to treat coronavirus.
A trial has begun across Europe, Africa, Asia and South America, testing 40,000 people with either hydroxychloroquine, chloroquine or a placebo to see if it's effective on those who might be exposed to the virus. Hydroxychloroquine is safe for treating malaria, and conditions like lupus or arthritis, but so far no clinical trials have recommended it for use against Covid-19.
The World Health Organization (WHO) has temporarily halted several studies around the world because of safety fears raised by studies showing its use can cause heart problems. It had earlier warned about the dangers of self-medicating with the drug.
The WHO announcement came after a study suggested hydroxychloroquine might increase the risk of patients dying from Covid-19.
The Lancet medical journal reviewed the medical records of coronavirus patients, and found that there were no benefits to taking these two anti-malarial drugs - and they could even increase the risk of heart problems.
Is there any evidence they work against Covid-19?
There are trials in various countries on using the drugs to prevent the illness. As part of these studies, frontline workers who are highly exposed to the virus are taking it as a prophylactic.
A trial has begun across Europe, Africa, Asia and South America, testing 40,000 people with either hydroxychloroquine, chloroquine or a placebo to see if it's effective in preventing the virus.
Other studies are looking into whether it can help patients who already have Covid-19.Other studies are looking into whether it can help patients who already have Covid-19.
In the US, various trials are under way for a combination of drugs including chloroquine, hydroxychloroquine and an antibiotic called azithromycin, for treating Covid-19 patients.In the US, various trials are under way for a combination of drugs including chloroquine, hydroxychloroquine and an antibiotic called azithromycin, for treating Covid-19 patients.
A recent large-scale study published in The Lancet medical journal that reviewed the medical records of coronavirus patients found that there were no benefits to taking these anti-malarial drugs and could even increase the risk of death and heart problems. And Nigeria has said it will continue with its own planned clinical trials, even after the WHO's warnings about safety.
But so far, there is insufficient evidence from this research to draw conclusively as to their effective use in either prevention or in treatment. The country's drugs approval agency said it does not dispute the WHO's advice, but wanted to generate data from tests on the local population.
"We need larger, high-quality randomised clinical trials in order to better evaluate their effectiveness," says University of Oxford's Kome Gbinigie, author of a report on anti-malarial testing for Covid-19. However, Kenya says it will be suspending its planned trials.
There is insufficient evidence from this research so far to draw firm conclusions as to their effective use in either prevention or in treatment.
There are also risks of serious side effects, including renal and liver damage.There are also risks of serious side effects, including renal and liver damage.
Which countries authorised their use? "We need larger, high-quality randomised clinical trials in order to better evaluate their effectiveness," says University of Oxford's Kome Gbinigie, author of a report on anti-malarial testing for Covid-19.
In late March, the US Food and Drugs Administration (FDA) has granted "emergency use" authorisation for these drugs in the treatment of Covid-19 for a limited number of hospitalised cases. Which countries have authorised their use?
The FDA is not saying they definitely work. But it does mean that in specific circumstances, hospitals can request and use the medicines from government stockpiles for use in Covid-19 treatment. In late March, the US Food and Drugs Administration (FDA) did grant "emergency use" authorisation for these drugs in the treatment of Covid-19 for a limited number of hospitalised cases.
But on 24 April, the FDA also issued a warning about the dangers of using the substances because of reports of heart rhythm problems in patients. That means that in specific circumstances only, hospitals can request and use the medicines from government stockpiles for use in Covid-19 treatment.
Other countries are also deploying these anti-malarial drugs to varying degrees. But on 24 April, the FDA issued a warning about the dangers of using the substances because of reports of heart rhythm problems in patients.
Some countries are also deploying these anti-malarial drugs to varying degrees.
Brazil has relaxed its restrictions on the drugs to allow doctors to prescribe them to patients with mild coronavirus symptoms, not just those in a serious condition in hospital.Brazil has relaxed its restrictions on the drugs to allow doctors to prescribe them to patients with mild coronavirus symptoms, not just those in a serious condition in hospital.
France has authorised doctors to prescribe them for patients with Covid-19, but the country's medical watchdog has also warned of side effects. The Indian government has expanded the use of the drug as a preventative medicine - but only under medical supervision - for healthcare workers in non-coronavirus environments and police working in areas with high rates of Covid-19.
The Indian government has expanded the use of the drug as a preventative medicine for healthcare workers in non-coronavirus environments and police working in areas with high rates of Covid-19.
It was previously just for those working among coronavirus patients and households in contact with confirmed cases if they have a prescription from a doctor.It was previously just for those working among coronavirus patients and households in contact with confirmed cases if they have a prescription from a doctor.
Uses of the drug will continue to be under medical supervision, as India's government research body has previously warned against the unrestricted usage of the anti-malarial drug France, which had authorised hospitals to prescribe them for patients with Covid-19, later reversed the decision after the country's medical watchdog warned of side effects.
Several Middle Eastern countries have authorised its use or are conducting trials.
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