A malaria drug widely touted by US President Donald Trump for treating the new coronavirus and stockpiled by Israel showed no benefit in a large analysis of its use in American veterans hospitals. There were more deaths among those given hydroxychloroquine versus standard care, researchers reported.
The nationwide study was not a rigorous experiment. But with 368 patients, it’s the largest look so far at hydroxychloroquine with or without the antibiotic azithromycin for COVID-19, which has killed more than 177,000 people as of Wednesday.
The study was posted on an online site for researchers and has not been reviewed by other scientists. Grants from the National Institutes of Health and the University of Virginia paid for the work.
Researchers analyzed medical records of 368 male veterans hospitalized with confirmed coronavirus infection at Veterans Health Administration medical centers who died or were discharged by April 11.
About 28 percent who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. About 22% of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival.
Hydroxychloroquine made no difference in the need for a breathing machine, either.
Researchers did not track side effects, but noted a hint that hydroxychloroquine might have damaged other organs. The drug has long been known to have potentially serious side effects, including altering the heartbeat in a way that could lead to sudden death.
Israel has stockpiled both chloroquine and hydroxychloroquine on the assumption that if trials find that it is beneficial in the treatment of COVID-19 this would spark a buying war for the drugs.
Speaking to the financial daily Globes last week, Prof. Ronni Gamzu, a former director general of the Health Ministry who now heads the Ichilov Hospital in Tel Aviv, said the hospital had used chloroquine, but had seen no evidence of its efficacy in treating COVID-19.
Jacob Moran-Gilad, a member of the Health Ministry’s Epidemic Management Team, told The Times of Israel earlier this month that Israeli doctors are allowed to prescribe hydroxychloroquine to their patients, and some are doing so. But he stressed: “The fact there is a stockpile of the drug does not mean there is official endorsement or encouragement to liberally use this drug.”
Moran-Gilad said that the Epidemic Management Team discussed whether to give hospitals any directions regarding hydroxychloroquine, and decided not to. “At the moment there is no official guidance or endorsement by the Health Ministry that it should be used for COVID-19,” he said. “We discussed this in the national management team and we decided not to give guidance as there is no data to support the use of this drug.”
Earlier this month, scientists in Brazil stopped part of a study testing chloroquine after heart rhythm problems developed in one-quarter of people given the higher of two doses being tested.
On Tuesday, the NIH issued new treatment guidelines from a panel of experts, saying there was not enough evidence to recommend for or against chloroquine or hydroxychloroquine for COVID-19. But it also advised against using hydroxychloroquine with azithromycin because of the potential side effects.
Many doctors have been leery of the drug.
At the University of Wisconsin, Madison, “I think we’re all rather underwhelmed” at what’s been seen among the few patients there who’ve tried it, said Dr. Nasia Safdar, medical director of infection control and prevention.
Patients asked about it soon after Trump started promoting its use, “but now I think that people have realized we don’t know if it works or not” and it needs more study, said Safdar, who had no role in the VA analysis.
The NIH and others have more rigorous tests underway.