More studies needed on Hydroxychloroquine, say experts

Ritika Srivastava
File photo: Anti-malaria drug Hydroxychloroquine

File photo: Anti-malaria drug Hydroxychloroquine

Even as the world is engaged in a frantic search to find a cure to COVID-19, the anti-malaria drug Hydroxychloroquine is catching everyone’s attention.

World leaders are heaping lavish praise on the medicine. While U.S. President Donald Trump said his country will never forget India’s decision to clear its exports to America, Brazilian President Javier Bolsonaro has written to Prime Minister Narendra Modi calling it the ‘Sanjeevani Booti’ or the holy medicine mentioned in the Ramayana.

So why does the world think hydroxychloroquine is a viable treatment for COVID-19 pandemic?

What is Hydroxychloroquine

Hydroxychloroquine is an anti-malarial drug that is in use since the 1940s. Less toxic than chloroquine and used to treat rheumatoid arthritis and lupus, it is available as tablets in both generic and branded forms.

The United States approved it for medical use in 1955. It figures in the World Health Organisation’s List of Essential Medicines. In 2017, it was the 128th-most-prescribed medication in the United States, with over five million prescriptions.

How Does it Work

Hydroxychloroquine is a disease modifying anti-rheumatic drug (DMARD) that regulates the activity of the immune system. It works by modifying the underlying disease process, rather than simply treating symptoms.

HCQ has been effective against many viral infections. It inhibits acidification of endosome of a cell that is essential for the virus to replicate and spread the infection. In addition, it could also inhibit the entry of the SARS-Cov 2 virus in the cell.

Use of HCQ in Covid-19 Cases

On March 21, US President Donald Trump said a combination of HCQ and Azithromycin (antibiotic) has “a real chance to be one of the biggest game changers in the history of medicine.”

The statement turned global spotlight on Hydrochloroquine.

Soon after, the US Food and Drug Administration authorised the use of anti-malarial drugs hydroxychloroquine and chloroquine for emergency Corona virus treatment.

Last month, an ICMR advisory said the drug was found to be effective against Corona virus in laboratory studies.

Dr Sandeep Nayar, Director and Head of Department at BLK Centre for Chest and Respiratory Diseases in New Delhi says, “It is recommended for those who are likely to come across COVID positive patients like healthcare workers etc. As far as treatment in COVID positive patients is concerned, the drug is used along with Azithromycin.”

The ICMR advisory however added that the intake of hydroxychloroquine should not instil a sense of false security and health workers must follow all prescribed measures.

Jury Still Out

Given the size of trials so far, experts believe that studies are not conclusive on the matter. Larger studies are currently underway to ascertain the effectiveness of the drug  as a treatment for Covid-19, but the results are likely to take some time.

Side Effects

Common side effects of HCQ include headache, dizziness, vomiting, diarrhea etc. But more serious side effects like retinal damage, cardiac arrhythmia and severe drop in blood sugar have also been reported.

The ICMR advisory says the drug has to be given only on the prescription of a registered medical practitioner.

Dr Nayar advises, “We must watch for its side effects. It is not recommended for children less than 15 years of age for prophylaxis. Even heart patients must be careful as this may cause cardiac toxicity and if given with Azithromycin, chances of cardiac toxicity is more.”

As of now, only studies will tell if hydroxychloroquine is the miracle drug.