Tag Archives: chloroquine

Health service providers urge to stop using hydroxycholoroquine for COVID-19 | Instant News


The sacred oaths taken by doctors during graduation from medical school to “First do no harm,” the first words of the Hippocratic Oath, provide a powerful impetus for comments that have just been published in The American Journal of Medicine.

Researchers from Florida Atlantic University’s Schmidt School of Medicine and collaborators from the University of Wisconsin School of Medicine and Public Health urge all health care providers to prioritize compassion with reliable evidence about efficacy and security.

They recommend a moratorium on prescription chloroquine or hydroxychloroquine, with or without azithromycin, to treat or prevent COVID-19, with the exception of getting the evidence needed in randomized trials and loving use.

Despite the fact, or maybe partly due to the fact that there are no therapeutic or preventative measures for the COVID-19 pandemic in the United States, which accounts for less than 5 percent of the world’s population and about 30 percent of cases and deaths, prescription drugs are widespread nine times bigger than in the last few years.

This widespread use leads to national deficiencies in patients with lupus and rheumatoid arthritis, for whom hydroxychloroquine has been an approved indication for decades. These patients cannot fill their prescriptions.

On March 28, the US Food and Drug Administration (FDA) issued an emergency use permit for chloroquine and chloroquine hydroxy for the treatment of COVID-19. However, on April 24, the FDA issued a drug safety communication warning regarding chloroquine hydroxy disorders and heart rhythm disorders that can cause sudden cardiac death.

If this drug needs to be prescribed for patients with COVID-19, initial evaluation and serial monitoring are an absolute necessity. “

Richard D. Shih, M.D, Study First Author and Professor of Emergency Medicine, Florida Atlantic University

Shih is also a division director and founding program director for emergency medicine residency programs at FAU’s Schmidt College of Medicine.

Furthermore, the authors suggest that the convincing safety profile of chloroquine may be more real than it really is.

Data on safety comes from decades of prescription by healthcare providers, especially for their patients with lupus and rheumatoid arthritis, both of which have a greater prevalence in young and middle-aged women, whose risk of fatal cardiac outcomes due to hydroxychloroquine is very convincing. low.

In contrast, the risk of hydroxychloroquine for patients with COVID-19 is significantly higher because of fatal cardiovascular complications due to these drugs is much higher in older patients and those who have heart disease or risk factors, both of which are mostly male .

In basic research, hydroxychloroquine and chloroquine are structurally related and have similar mechanisms to inhibit the virus that causes COVID-19. Despite their structural similarities, in vitro, hydroxychloroquine seems to be more effective.

Additionally, when used for lupus and rheumatoid arthritis, hydroxychloroquine has fewer side effects, less drug interactions and is less toxic in overdoses.

The authors note that the evidence currently available is limited to eight published studies, five on hydroxychloroquine alone; two in chloroquine hydroxy plus azithromycin; and one in both in combination or alone.

Of these only three were randomized trials enrolling 225, 62, and 30 patients – all of them too small to provide reliable evidence. All three tested hydroxychloroquine alone versus the standard of care in China.

One showed no significant difference in cleansing the virus at 28 days, second, there was no difference in cleansing the virus at seven days, and third, some improvements in fever, coughing and chest computed with tomographic findings.

“With regard to hypothesis testing, only large-scale randomized trials with sufficient size, dosage and duration can reliably detect the most reasonable small to moderate effects, which can have enormous clinical and public health impacts,” said Charles H. Hennekens, MD, Dr.PH, senior writer, first professor Sir Richard Doll and senior academic advisor at FAU’s Schmidt College of Medicine.

Source:

Journal reference:

Shin, R D., et al. (2020) Hydroxychloroquine for Coronavirus: Urgent Need for Prescription Moratorium. American Journal of Medicine. doi.org/10.1016/j.amjmed.2020.05.005.

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Bolsonaro Brazil does not receive evidence that chloroquine functions, but can work in some cases | Instant News


PHOTO PHOTO: Brazilian President Jair Bolsonaro adjusted his mask when he left the Alvorada Palace, in the midst of a coronavirus (COVID-19) outbreak in Brasilia, Brazil May 13, 2020. REUTERS / Adriano Machado

RIO DE JANEIRO (Reuters) – Brazilian President Jair Bolsonaro, an advocate of the longstanding malaria drug chloroquine to treat COVID-19, said on Thursday he knew there was no evidence that worked, but said there were several cases that seemed to have had success.

Reporting by Pedro Fonseca; Editing by Chris Reese

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Hydroxychloroquine is combined with azithromycin and abnormal heart rhythms in COVID-19 patients | Instant News


A new study shows that a combination of drugs that were initially praised for COVID-19 – Hydroxychloroquine and Chloroquine combined with azithromycin, can cause abnormal and life-threatening heart rhythms. In patients who are hospitalized with new coronavirus infections or SARS CoV-2, this combination can cause prolonged QT intervals as can be detected on an ECG. The study, entitled, “Risks of QT Interval Extensions Related to the Use of Hydroxychloroquine With or Without Azithromycin Concurrent Among Inpatients Who Test Positive for Coronavirus 2019 (COVID-19),” is published in the latest issue of the journal JAMA Cardiology.

What is this research about?

Research led by Dr. Howard S. Gold of Beth Israel Deaconess Medical Center and Harvard Medical School in Boston is basically observational research. The first author of this study was Nicholas J. Mercuro. The study authors wrote that this combination of drugs was initially cited as a treatment for people who had been diagnosed with COVID-19-associated pneumonia. The main objective of this study was to “characterize the risk and extent of QT prolongation in patients with COVID-19 in connection with their use of hydroxychloroquine with or without concurrent azithromycin.” They measured the correct QT interval for study participants.

QT interval in 3d illustration of ECG signaling. Image Credit: sciencepics / Shutterstock

What was done

This observational cohort study was conducted at a tertiary care center in Boston, Massachusetts. Participants are patients who have been detected at least once with a viral infection. One of their nasopharyngeal swabs has at least tested positive in the polymerase chain reaction test (PCR test) for SARS CoV-2. All of these participants were clinically diagnosed with pneumonia and had received at least 1 day of hydroxichloroquine between 1st March 2020 and 7th April 2020.

Electrocardiogram (ECG) records of patients were measured. On an ECG, several waves are recorded – P, Q, R, S, and T. Intervals between waves are measured. Two significant waves measured include the PR interval and the QT interval. Other potential side effects of the drug or its combination are also noted.

What was found?

For this study, a total of 90 participants who received hydroxychloroquine were included. Of these, 53 have received azithromycin in combination. Among participants, 48.9 percent (total 44) were women, and the average body mass index was 31.5 for all participants. Among patients, 53.3 percent had high blood pressure (48 patients), and 28.9 percent had diabetes mellitus (26 patients). Both of these conditions are most often found among patients.

The results revealed that at the start of the study, the median initial QTc was 455 (430-474) milliseconds. The median QTc for those using hydroxychloroquine is 473 milliseconds (ranging from 454 milliseconds to 487 milliseconds). Among those using hydroxychloroquine and azithromycin, the median QTc was 442 milliseconds (ranging from 427 milliseconds to 461 milliseconds). The extension after administration of a combination of drugs was found to be statistically significant.

The researchers wrote, “Those who received concurrent azithromycin had a greater median (interquartile range) in the QT interval (23). [10-40] milliseconds) compared to those who received hydroxychloroquine alone (5.5 [−15.5 to 34.25] millisecond. “

Serious heart rhythm arrhythmias have been found in some patients. Of the participants, seven (19 percent) who had received hydroxychloroquine alone had a QTc interval that lasted 500 milliseconds or more. Three of the patients had a difference of 60 milliseconds from the start. Among those who received azithromycin, 21 percent (11 of 53 who received the combination) had a QTc interval of more than 500 milliseconds. The change is 60 milliseconds or more between 13 percent (7 out of 53 participants).

The researchers also noted that patients given loop diuretics such as furosemide had a higher risk of extending the QTc interval compared to those who did not receive the drug. The chance ratio was found by the researchers, developing a prolonged QTc among those who received this combination was 3.38. Risk is increased for those who have an initial QTc interval of 450 milliseconds or more (odds ratio 7.11).

One participant developed a severe heart rhythm abnormality called torsades de pointes. Ten patients had to stop hydroxychloroquine due to drug side effects, including nausea and low blood sugar.

Conclusions and importance of research

The researchers concluded that participants who were diagnosed with COVID-19 pneumonia given hydroxychloroquine were at a higher risk for prolongation of QTc. This risk increases with the addition of azithromycin. They also wrote that one of their cases of torsades de pointes was the first case reported with this combination of drugs. They called for more detailed research to assess the risks and benefits of using this drug among patients diagnosed with COVID-19. They recommend that all patients require “routine electrocardiogram, and electrolyte monitoring” during therapy.

The authors write, “Doctors must carefully consider the risks and benefits when considering hydroxychloroquine and azithromycin, with close monitoring of QTc and concurrent drug use.”

Editorial accompanying

In accompanying editorial titled “Hydroxychloroquine, Coronavirus Disease 2019, and QT Prolongation,” by Robert O. Bonow, Adrian F. Hernandez, and Mintu Turakhia talk about the complexity of decision making when treating COVID-19 patients.

They emphasize the fact that there is no proven treatment strategy for this infection. They wrote, “Lacking strong trial evidence, doctors are forced to consider all options based on preclinical and small observational studies, often in the heartbreaking arrangement of patients who worsen in the upheaval of severe pneumonia …”

The authors write that hydroxychloroquine is able to extend the QT interval due to “inadequate cellular potassium flow.” Azithromycin also carries a similar risk. They called this finding “welcome and important.” They added, however, that in intensive care settings, it was easy to monitor the patient’s ECG, and if proven useful, the drug could be used.

The authors say that there are two ongoing trials – “Results Associated with COVID-19 Treated with Hydroxychloroquine Among Inpatients With Symptoms of Disease (ORCHID) (NCT04332991) 12 and Randomized evaluation of COVID-19 Therapy (RECOVERY) (ISRCTN50189673) ) “. This will provide a detailed drug safety profile.

They concluded, “Until then, treatment decisions for this disease will remain based on clinical judgment and, ideally, in the context of enrolling patients in clinical trials to provide definitive answers.”

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Coronavirus: Health Canada issues a warning about hydroxychloroquine, use of chloroquine – National | Instant News


Canadian health officials are working to stem the spread new corona virus warns against the use of two so-called several drugs as possible treatments for COVID-19.

Canadian Health the word chloroquine and hydroxychloroquine can have “serious side effects” and should only be used under a doctor’s supervision.

READ MORE:
Preliminary research found hydroxychloroquine did not help COVID-19 patients

Chloroquine and hydroxychloroquine are approved drugs to treat malaria and some auto-immune diseases, but Health Canada warns that they should only be used if prescribed and under a doctor’s supervision.

“Health Canada is concerned that some people might directly buy and use chloroquine or chloroquine hydroxy to prevent or treat COVID-19,” reads a warning posted on the site. Health Canada website on April 25th.










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Coronavirus Outbreak: Dr. Theresa Tam warns against the use of drugs that have not been tested to treat COVID-19

According to Health Canada, drugs are known to potentially cause liver or kidney problems, low blood sugar and nervous system problems, including dizziness, fainting or seizures.

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READ MORE:
The US FDA warns against using malaria drugs in COVID-19 patients outside the hospital

The drugs can also affect heart rhythm, which in most cases is serious, can be fatal, Health Canada said.

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According to the warning, children are “very sensitive” to drugs, which means that even small doses can be dangerous.

To date, Health Canada has not allowed any drug to prevent, treat or cure COVID-19.










Coronavirus Outbreak: CDC Director warns of potentially worse COVID-19 waves in winter


Coronavirus Outbreak: CDC Director warns of potentially worse COVID-19 waves in winter

The ministry said while a number of drugs were being investigated as possible treatments for COVID-19, the results of “large well-designed studies were crucial to determine whether the benefits of chloroquine and hydroxycholoroquine outweighed their risks in COVID-19 treatment. “

“Until now, data from clinical trials are limited, and the results have not conclusively shown that certain drugs are effective against COVID-19,” the warning reads.

READ MORE:
Rita Wilson claims that she has extreme ‘chloroquine’ side effects while being sick with coronavirus

U.S. President Donald Trump has repeatedly touted hydroxychloroquine during his book corona virus briefing, showing skeptics will be proven wrong. He has offered patient testimony that the drug is a savior.

But a number of early coronavirus studies have shown problems or are of no use.

Especially, preliminary research looking into the results of US veteran patients using hydroxychloroquine with or without azithromycin antibiotics used to treat the disease found no benefit in using malaria drugs.

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Public health officials around the world – including Canada – have also repeatedly warned that promoting the use of drugs will reduce its supply for people who actively need it to treat their immune disease.










Coronavirus Outbreak: Trump says Chloroquine can be a ‘game changer’


Coronavirus Outbreak: Trump says Chloroquine can be a ‘game changer’

In a story published in early April, Global News speaks to a woman who initially couldn’t refill the chloroquine hydroxy recipe he needed to treat his lupus.

On Friday, the US Food and Drug Administration (FDA) also warned against the use of hydroxychloroquine and chloroquine, and other malaria drugs for COVID-19 patients outside the hospital, citing the risk of serious heart rhythm complications.

The FDA statement was issued a day after the European Union’s drug regulatory body warned of the side effects of the drug as well.

– With files from The Associated Press and Global News reporters Amanda Pope and Leslie Young

© 2020 Global News, a division of Corus Entertainment Inc.

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Real claim: Brazilian chloroquine research in COVID-19 patients was stopped after 11 deaths | Instant News


Articles shared on social media make the claim that research to test the effectiveness of the chloroquine drug in Brazilian coronavirus patients was stopped after participants developed irregular heart rates and 11 died ( here , here ).

These articles have been tagged several times as part of Facebook’s attempt to curb misinformation related to the new coronavirus.

The article and main claim are true. Brazilian team findings published online ( here ) And 11 deaths (out of 81 participants) are shown in table 3 on page 28. The study was completely stopped after deaths were recorded.

Some patients are given a higher dose of Chloroquine, while others have a lower dose. Seven deaths were recorded among patients given the higher dose and four in the lower dose group. The higher dose study was stopped earlier because it “appeared to be more toxic,” a doctor involved in the study told Reuters.

“Preliminary findings indicate that higher doses of CQ (chloroquine) (10-day regimen) are not recommended for the treatment of COVID-19 because of their potential safety hazards,” their report said.

When asked to elaborate on the findings of this study, the doctor involved said, “All the average deaths in all deaths in critically ill patients are not higher. The patient died of COVID-19. This disease is very deadly. However, due to the tendency of death higher in the higher dose group, DSMB decided to stop this group. ”

“We still don’t have data on the efficacy of chloroquine for severe patients with COVID-19,” he added.

As of April 17, the number of patients who had died as part of the study did not change.

This experiment was reported by publications including the USA Today and the New York Times ( here ), ( here ).

Claims on social media come after hydroxychloroquine, an antimalarial drug, was recommended by President Donald Trump to treat a new corona virus even though the treatment is still in the testing phase. In an exclusive April 4, Reuters reported that in mid-March, Trump personally urged federal health officials to provide malaria drugs to treat new corona viruses, even though they had not yet been tested against COVID-19, ( here ).

Guidelines from the US Centers for Disease Control and Prevention (CDC) on April 16 stated that “Hydroxychloroquine and chloroquine are being investigated in clinical trials for pre-exposure prophylaxis or post-exposure SARS-CoV-2 infection, and treatment of patients with mild, moderate COVID-19 , and weight, here ).

A safe and effective vaccine for new coronavirus is still more than a year away ( here ). More than 70 vaccine candidates are under development worldwide, with at least five in preliminary testing in humans.

DECISION

True: the Brazilian chloroquine study in COVID-19 patients was stopped after 11 deaths among participants

This article was produced by the Reuters Fact Check Team. Read more about our fact checking work here .

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