Health

WHO says trials show malaria and HIV drugs don't cut Covid-19 hospital deaths


The World Health Organization (WHO) said on Saturday that it was discontinuing its trials of the malaria drug hydroxychloroquine and combination HIV drug lopinavir/ritonavir for patients in hospital with Covid-19 after they failed to reduce mortality.

The setback came as WHO also reported more than 200,000 new cases globally of the disease for the first time in a single day. The United States accounted for 53,213 of the total 212,326 new cases recorded on Friday, WHO said.

“These interim trial results show that hydroxychloroquine and lopinavir/ritonavir produce little or no reduction in the mortality of hospitalised Covid-19 patients when compared to standard of care. Solidarity trial investigators will interrupt the trials with immediate effect,” WHO said in a statement, referring to large multicountry trials that the agency is leading.

The UN agency said the decision, taken on the recommendation of the trial’s international steering committee, does not affect other studies where those drugs are used for patients not in hospital or as a prophylaxis.

Another branch of the WHO-led trial is looking at the potential effect of Gilead’s antiviral drug remdesivir on Covid-19. The European Commission on Friday gave remdesivir conditional approval for use after it was shown to shorten hospital recovery times.

Hydroxychloroquine, also known by its brand name, Plaquenil, is a drug used to treat malaria. It is a less toxic version of chloroquine, another malaria drug, which itself is related to quinine, an ingredient in tonic water.

A widely publicized study in France where 40 coronavirus patients were given hydroxychloroquine, with more than half experiencing the clearing of their airways within three to six days has led to it being touted in some quarters as a potential cure for Covid-19. This apparent improvement is important as it would curtail the timeframe in which infected people could spread Covid-19 to others.

However, experts have warned that the study is small and lacks sufficient rigour to be classed as evidence of a potential treatment. The French study followed work by Chinese researchers which suggested that hydroxychloroquine can slow infections by blocking the virus behind Covid-19 from entering cells in the body. But more recent, albeit small-scale, research from China has shown that patients who were treated with the drugs fought off coronavirus no more quickly than those who didn’t get it. Indeed, one patient given hydroxychloroquine severely worsened in condition while four patients on the medicine developed signs of liver damage and experienced diarrhoea. US president Donald Trump has claimed he takes hydroxychloroquine despite FDA warnings.

Here is a guide to the scientific studies into hydroxychloroquine and coronavirus carried out so far.

Regardless of these findings, any drug being used for a certain purpose before full clinical trials are completed is, by definition, untested and unproven. It’s too early to say if hydroxychloroquine can have a major benefit or not. The European Medicines Agency, an agency of the EU, has said hydroxychloroquine should not be taken by coronavirus patients except for clinical trials or emergency use programs.

Oliver Milman

The solidarity trial started out with five branches looking at possible treatment approaches to Covid-19: standard care; remdesivir; hydroxychloroquine; lopinavir/ritonavir; and lopanivir/ritonavir combined with interferon.

The director general of WHO, Tedros Adhanom Ghebreyesus, told reporters on Friday that nearly 5,500 patients in 39 countries had been recruited so far into its clinical trials and that interim results were expected within two weeks.

About 18 experimental Covid-19 vaccines are being tested on humans among nearly 150 treatments under development.

Mike Ryan, WHO’s top emergencies expert, said on Friday that it would be unwise to predict when a vaccine could be ready. While a vaccine candidate might show its effectiveness by year’s end, the question was how soon it could then be mass-produced, he said.



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