Coronavirus: local tests of disputed drug hydroxychloroquine to go ahead

Researchers leading a major clinical trial into hydroxychloroquine have addressed con­cerns over whether they should administer the drug.

Hydroxychloroquine pills. Picture: AP

The researchers leading a major Australian clinical trial into whether the drug hydroxychloroquine is effective in treating corona­virus have addressed con­cerns over whether they should be ­administering the drug, critiquing international studies that have associate­d the antimalarial remedy with elevated death rates.

The trial involves more than 70 hospitals nationwide and will test the efficacy of hydroxy­chloro­quine in preventing severe disease from COVID-19.

The clinical trial will also test the anti-HIV drug lopinavir.

Patients with COVID-19 who are sick enough to require hospit­alisation but not admis­sion to intensive care will be asked to participate in the trial.

A quarter of the patients will be given hydroxychloroquine, currently used to treat arthritis and prevent malaria, and a quarter will be given lopinavir, which is also known as ritonavir. A quarter will be given a combination of the two drugs, and a quarter will be given no treatment.

The trial, led by Steven Tong, a Royal Melbourne Hospital infectious diseases clinician and co-lead of clinical research at the Doherty Institute, is expected to run for 18 months and involve more than 2000 patients. COVID-19-posit­ive patients will also be recruited internationally.

Professor Tong said the trial’s investigators had received questions about whether they should continue to use hydroxychloroquine, given the publication of the results of several international studies that had shown either little benefit to using the drug to treat COVID-19, or potential harms.

One recent study of 368 American patients with coronavirus treated at US Veterans Health Administra­tion medical centres found that those who were administered hydroxy­chloroquine were no less likely to require ventilation and had a ­higher death rate from COVID-19 than patients who took no medication.

The study found 97 patients who took ­hydroxychloroquine had a 27.8 per cent death rate from COVID-19, whereas 158 patients who did not take the drug had an 11.4 per cent death rate.

In another concerning finding, a Brazilian clinical trial was cut short after some patients developed irregular heartbeats and nearly two dozen died after taking daily doses of the drug.

In an article published on the ASCOT trial’s website, Professor Tong critiqued those two studies, saying they did not provide firm evidence that hydroxychloroquine was harmful.

He said in the US study, the ­patients who received hydroxychloroquine were at greater risk of poor outcomes because more of them had several pre-existing risk factors.

Professor Tong said in the Brazilian study, several of the patient­s who received hydroxychloroquine had abnormal heart rhythms.

“We cannot draw any robust conclusions based on this data,” he said, adding it was appropriate to continue to use the drug in the ASCOT trial.