NatMed - JAMA both show serious side effects of
hydroxychloroquine / chloroquine. US FDA warns against out-of-hospital use
On April 24, two well-known journals, Nat Med and JAMA,
published very important studies, showing that high-dose hydroxychloroquine
treatment of COVID-19 is a very dangerous clinical option.
On the same day, the US Food and Drug Administration (FDA)
issued a warning: Do not use hydroxychloroquine outside the hospital to treat
COVID-19.
Previously, the FDA granted "authorization for emergency
use" for hydroxychloroquine / chloroquine treatment of COVID-19. US
President Trump has repeatedly advocated that hydroxychloroquine / chloroquine
treatment of COVID-19 is "the biggest game-changing drug in the history of
medicine."
Hydroxychloroquine is an old drug widely used in clinic
In a
laboratory test, chloroquine was found to have the potential to fight the new
coronavirus (SARS-CoV-2).
Later small sample clinical studies also showed
that hydroxychloroquine / chloroquine in the treatment of COVID-19, is effective.
On the face of COVID-19, which ravages the planet without any
effective drugs, the results of these studies of hydroxychloroquine will
undoubtedly become a life-saving straw.
It is not only President Trump who has repeatedly expressed
praise for hydroxychloroquine / chloroquine, scientists from all over the world
have also shown great concern for it.
According to a tweet by Jesse Burk-Rafel
on April 6, the most common of the 301 COVID-19 clinical trials at that time
was the study of chloroquine / hydroxychloroquine, which actually reached 45
trials, while the trial against redoxir Only 9 items.
On April 3, the Interim Guidelines for the Treatment of
COVID-19 completed by the International Working Group on New Coronavirus
Diseases composed of 80 clinical experts from 20 countries.
Hydroxychloroquine / chloroquine became the only drug recommended by the
international working group.
Hydroxychloroquine / chloroquine became the most dazzling
star.
However, in further research, the clinical results of Chinese
() and French () scholars published on April 14 showed that hydroxychloroquine
was ineffective in treating new coronary pneumonia and had significant side
effects.
And doctors who are cautious about hydroxychloroquine /
chloroquine have been constantly warning that hydroxychloroquine / chloroquine
and azithromycin can cause fatal arrhythmias.
Two important articles published on April 24 provided the
most serious warning about the side effects of hydroxychloroquine.
JAMA magazine published an important RCT test of chloroquine diphosphate in Brazil
The study enrolled 81 patients with COVID-19, 41 of whom
received high-dose chloroquine (600 mg b.i.d.) and 40 received low-dose (450 mg
b.i.d. on the first day, followed by 450 mg q.d.).
Main results
Mortality rate: 39% in the high-dose group! 15% in the
low-dose group.
Side effects of prolonged QT interval:
The proportion of QT
interval greater than 500ms in the high-dose group was higher than that in the
low-dose group (18.9% vs 11.1%). Among them, 2 patients (2.7%) in the high-dose
group developed ventricular tachycardia before death.
Because of these results, the high-dose chloroquine treatment
group was discontinued.
Nat Med published the analysis results of American cardiologists on the same day
They found that 84 patients who received hydroxychloroquine
(400 mg on the first day, then 200 mg, b.i.d.) + azithromycin experienced
prolonged QT intervals after receiving treatment (mean 3.6 days).
As shown in Figure 1, the QT interval of patients in this
treatment group was extended from the baseline mean of 435ms to 463ms (P
<0.001).
In 11% (9/84) of patients, the QT interval was severely
extended to> 500 ms, which is a sign of high risk of malignant arrhythmia
and sudden cardiac death, and 5 of these 9 patients had normal ECG before
medication.
Based on this, the researchers suggest that patients with
COVID-19 receiving hydroxychloroquine plus azithromycin, especially those with
underlying disease and those receiving other QT prolonged medications, should
repeat QT intervals.
Based on the latest clinical trial data, the US Food and Drug
Administration (FDA) warned on April 24 local time: Do not use
hydroxychloroquine to treat COVID-19 outside the hospital.
The FDA says they are "aware of reports of serious heart rhythm problems in patients with COVID-19 treated with hydroxychloroquine or
chloroquine." The agency said they tried to “remind healthcare
professionals and patients of the known risks associated with
hydroxychloroquine and chloroquine.”
In a statement, FDA Commissioner Stephen Hahn encouraged
healthcare professionals to "screen and monitor carefully" those
patients taking the drug to treat COVID-19.
Hanson interpretation
According to the Johns Hopkins database, 2.89 million cases
of COVID-19 have been diagnosed worldwide, of which 200,000 have died.
New Corona virus itself leaves due to temperature and other reason
According to the current prevention measures in Europe and
America, unless the New Corona virus itself leaves due to temperature and other
reasons, it can hardly be completely prevented and controlled, and moving
towards group immunization has become a helpless reality.
There used to be hope that neither hydroxychloroquine nor
ridcive can currently be an effective choice. In the search for COVID-19,
medical scientists are still struggling.
At the end of this month and next month, more clinical trial
data will be released. Hope to surprise people.
Although we strive to express clearly and accurately, subject
to the editor's level of knowledge and understanding, there may still be a
fallacy, and everyone is very welcome and grateful for your corrections.
This public account tweet is for academic exchange only and
does not constitute an opinion on clinical diagnosis and treatment.
Hanson's clinical research
Hanson's clinical research is presided over by three medical
scientists and two practicing physicians in the United States.
By analyzing SCIpapers, sharing and promoting clinical research design and clinical paper
writing specifications.
By reading classic papers and expert reviews, sharing
medical research progress.
Through member group discussions and expert academic
lectures, providing a communication platform for US and Chinese medical
bioscientists.
Author's Bio
 |
| Dr. Shawna Reason |
Education: MBBS, MD
Occupation: Medical Doctor / Virologist
Specialization: Medical Science, Micro Biology / Virology, Natural Treatment
Experience: 15 Years as a Medical Practitioner
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