Anti-malaria drug hydroxychloroquine ineffective against coronavirus, reveal UK RECOVERY Trials

Hydroxychloroquine (HCQ) is no better than usual care in reducing the chances of death in COVID-19 patients, suggest the results of RECOVERY Trials published Thursday in the New England Journal of Medicine.

RECOVERY or Randomised Evaluation of COVID-19 therapy is a set of clinical trials started in the UK to find an effective treatment for those hospitalised with COVID-19 (suspected or confirmed). The trials team included more than 3,500 medical professionals across the UK including doctors, nurses, consultants, researchers, junior doctors and those newly graduated.

HCQ was the first-ever drug the team had started to study in May 2020. However, by June 5, the HCQ arm of the trials stopped taking more patients since the interim results indicated the inefficiency of the drug.

The story of hydroxychloroquine

Hydroxychloroquine and chloroquine were one of the first drugs suggested to be effective against the novel coronavirus disease that was first reported in December 2019.

Since the disease was contagious but had no available treatment, scientists all over the world quickly started studying the drug to confirm its effectiveness with mixed results. Some studies indicated that HCQ may be effective against the new virus while others claimed it was of no use.

By 21 March, the Indian Council of Medical Research (ICMR) released guidelines for the prophylactic and therapeutic use of HCQ in COVID-19. Soon, studies started to show the possible cardiovascular side effects of the drug. An observational study done by ICMR also indicated something similar. But the drug had got enough coverage worldwide that it was picked up by both the WHO for its solidarity trials and the UK for the RECOVERY trials, in the effort to find an effective treatment for the COVID-19 infection.

However, WHO halted their solidarity trials in May end when a Lancet study suggested that HCQ has potentially life-threatening effects, especially on cardiovascular health. The trials were soon resumed, only to be stopped for good in early July 2020 in the light of the existing evidence of the ineffectiveness of the drug.

More studies keep on pouring in about the inefficacy of the drug. One of the recent ones being by a group of researchers at the University of Pennsylvania, published in JAMA Internal Medicine on 30 September.

Meanwhile, Indian guidelines reportedly continue to recommend taking HCQ as both prophylaxis and treatment of COVID-19.

The RECOVERY trial for HCQ

For the trial, the researchers in the UK randomly assigned 1,561 COVID-19 patients to get HCQ while 3,155 were given a placebo. The aim of the study was to check mortality in patients after 28 days.

Here are the results of the study:

• In 28 days, 27 percent of patients in the HCQ group died as compared to 25 percent in the usual care group.
• Only 59.6 percent of patients in the HCQ group were discharged within 28 days while 62.9 percent in the usual care group were discharged in the same time interval.
• Patients who did not need mechanical ventilation to begin with had a higher likelihood of needing ventilation or dying when they were put on HCQ.
• There was a slightly higher number of patients who died of cardiac issues in the HCQ group but no cases of new cardiac arrhythmia in those patients.

For more information, read our article on Hydroxychloroquine against COVID-19.

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