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Tom Chavez
In Praise of Chloroquine and Hydroxychloroquine
On March 16, SpaceX founder Elon Musk tweeted that the anti-malaria drug chloroquine “may be worth considering” as a treatment for COVID-19. On March 18 our own Gregg Wilson recommended quinine in this forum. Following in Gregg’s footsteps, President Trump, on March 19, touted chloroquine at a press conference.
Quinine has a long track record in medicine, having been used since the 1940s as an antimalarial. The modern drug is made from the bark of the Cinchona plant, which was taken as an herbal remedy by indigenous Peruvians four centuries ago to treat fever.
A small study in France has shown encouraging results for hydroxychloroquine combined with other drugs.
Although it was not a randomized trial, the sample size was small, and the treatment and followup duration were too short, the findings are nonetheless “potentially interesting and justified,” according to Ying Zhang, a professor of microbiology at Johns Hopkins Bloomberg School of Public Health.
Brian Fallon, a research scientist and clinical trials investigator at the Columbia University Irving Medical Center, agreed. He warned that high doses carry “serious risk of cardiac arrhythmias.”
Scientists say larger, more rigorous studies must answer questions of efficacy, dosing, duration, and potential adverse drug interactions — for this and other COVID treatments.
Researchers at the University of Minnesota are testing 1,500 people to probe hydroxychloroquine’s effectiveness in preventing the development of COVID-19, following laboratory experiments in China that found hydroxychloroquine inhibited the infection.
According to clinicaltrials.gov, researchers at the University of Oxford plan to give it to 10,000 health care workers and others at high risk of contracting COVID-19. Both drugs are generally well tolerated at prescribed doses but can cause stomach pain, nausea, vomiting, headache and itchiness.
Both medications can interact with other drugs; doses should be adjusted to account for drug interactions. Those with psoriasis should not take either drug, the CDC notes. In their current form, the drugs are also not safe for those with heart arrhythmia, or those with impaired kidneys or liver.
Both chloroquine and hydroxychloroquine are in short supply. The FDA will take measures to increase the nation's supply, and to ensure chloroquine remains available for patients who take it for severe and life-threatening illnesses such as lupus.
<Extracted reports from Forbes, TheScientist, and LiveScience>
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