“Hydroxychloroquine and Chloroquine
“Hydroxychloroquine and chloroquine are oral prescription drugs that have been used for treatment of malaria and certain inflammatory conditions. Chloroquine has been used for malaria treatment and chemoprophylaxis, and hydroxychloroquine is used for treatment of rheumatoid arthritis, systemic lupus erythematosus and porphyria cutanea tarda. Both drugs have in-vitro activity against SARS-CoV, SARS-CoV-2, and other coronaviruses, with hydroxychloroquine having relatively higher potency against SARS-CoV-2 [1,4,5]. A study in China reported that chloroquine treatment of COVID-19 patients had clinical and virologic benefit versus a comparison group, and chloroquine was added as a recommended antiviral for treatment of COVID-19 in China [6]. Based upon limited in-vitro and anecdotal data, chloroquine or hydroxychloroquine are currently recommended for treatment of hospitalized COVID-19 patients in several countries. Both chloroquine and hydroxychloroquine have known safety profiles with the main concerns being cardiotoxicity (prolonged QT syndrome) with prolonged use in patients with hepatic or renal dysfunction and immunosuppression but have been reportedly well-tolerated in COVID-19 patients.
Due to higher in-vitro activity against SARS-CoV-2 and its wider availability in the United States compared with chloroquine, hydroxychloroquine has been administered to hospitalized COVID-19 patients on an uncontrolled basis in multiple countries, including in the United States. One small study reported that hydroxychloroquine alone or in combination with azithromycin reduced detection of SARS-CoV-2 RNA in upper respiratory tract specimens compared with a non-randomized control group but did not assess clinical benefit [7]. Hydroxychloroquine and azithromycin are associated with QT prolongation and caution is advised when considering these drugs in patients with chronic medical conditions (e.g. renal failure, hepatic disease) or who are receiving medications that might interact to cause arrythmias.
Hydroxychloroquine is currently under investigation in clinical trials for pre-exposure or post-exposure prophylaxis of SARS-CoV-2 infection, and treatment of patients with mild, moderate, and severe COVID-19. In the United States, several clinical trials of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection are planned or will be enrolling soon. More information on trials can be found at: https://clinicaltrials.gov/external icon.
”There are no currently available data from Randomized Clinical Trials (RCTs) to inform clinical guidance on the use, dosing, or duration of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection. Although optimal dosing and duration of hydroxychloroquine for treatment of COVID-19 are unknown, some U.S. clinicians have reported anecdotally different hydroxychloroquine dosing such as: 400mg BID on day one, then daily for 5 days; 400 mg BID on day one, then 200mg BID for 4 days; 600 mg BID on day one, then 400mg daily on days 2-5,” https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html, emphasis added.
No, it isn’t a proven therapy. Certainly not the proven cure the president appears to make it out to be, but the fact is that Hydroxychloroquine and Chloroquine, particularly in combination with azithromycin, are being used WITH GOVERNMENT APPROVAL to treat coronavirus, apparently with at least some beneficial effects. You are wrong to threaten to penalize doctors for using a therapy that even the CDC recognizes to have potential therapeutic effect.
I do not support Pres. Trump. I take what he says with a healthy dose of skepticism. However, just as I did not automatically dismiss everything said by former Pres. Obama - despite my disagreements with so many of his policies and positions - so I also do not automatically dismiss everything said by Pres. Trump, despite my many disagreements with him and general disregard for his character. But let’s not make the mistake of allowing disagreements with, or disregard for him to prevent us from making use of all the tools we have at our disposal for fighting this virus just because he is the one advocating for it.
A petition calling on the governor to rescind this ban can be found here: https://www.ipetitions.com/petition/gov-whitmer-rescind-your-ban-of-off-label?utm_source=facebook&utm_medium=social&utm_campaign="e_id=quote4&title_id=title2&recruiter=15451848&loc=dashboard
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