Will Hydroxychloroquine tablets be useful against COVID-19 in future?

Shashwat Gupta Ray
Thursday, 16 April 2020

“Some of the earlier case series from China and France found both of these drugs to have some positive effect in viral clearance and recovery, the reason these drugs came in to limelight." 

PANAJI: The reason why US President Donald Trump reportedly got aggressive against India for not exporting anti-malarial drug hydroxychloroquine (HCQ) to treat the growing menace of COVID-19 is because studies have shown that this drug can significantly improve some health parameters in patients with COVID-19.

“Unless we do a well planned randomized trial, we cannot say convincingly that these drugs are highly effective.” – Dr Awadhesh Kumar Singh

But is it going to be really effective while dealing with COVID-19 in the long run?

“Both Chloroquine (CQ) and Hydroxychloroquine (HCQ) is being used in India for several decades for the treatment of Malaria and various autoimmune disease like Rheumatoid Arthritis. HCQ has lesser side effects compared to CQ and both these drugs have been seen to possess some anti-viral activity against COVID-19 in experimental studies,” said Dr. Awadhesh Kumar Singh, MD (Medicine), DM (Endocrinology) Senior Consultant, Diabetes and Endocrinology, G D Hospital and Diabetes Institute, Kolkata (India).

Dr. Singh along with his team members have published a study titled ‘Chloroquine and hydroxychloroquine in the treatment of COVID-19 with or without diabetes: A systematic search and a narrative review with a special reference to India and other developing countries’.

 “Some of the earlier case series from China and France found both of these drugs to have some positive effect in viral clearance and recovery, the reason these drugs came in to limelight. We do have some small scale studies from China and France which found these drugs to be useful, however some of the studies also failed to show any significant benefit. Therefore, unless we do a well planned randomized trial, we cannot say convincingly that these drugs are highly effective,” Dr. Singh said.

Nevertheless, since HCQ is very economical and has been in use since very long in India with an acceptable benefit to risk ratio, there is no harm in trying these drugs with a close pharmacovigilance keeping in mind all possible side effects and contraindications. However, no data currently exist about its role in prophylaxis or prevention of COVID-19.

“I don’t think that use of CQ in COVID-19 will impact the treatment of Malaria as such, however, the rampant stocking of HCQ might hamper the treatment of autoimmune disease as mentioned earlier, if it is out of stock from the market,” he said.

Can then India become hub of anti-Covid fight with mass production of these medicines?

“Only time can tell, however if CQ and HCQ are found to be the best weapon from the results of currently ongoing randomized trial (whose results are expected soon), then surely world has to look towards India for procuring these drugs,” he added.

“In the study, he concluded that since HCQ has been approved for the treatment of diabetes in India, it should be further researched in diabetes and COVID-19, a subgroup where significant mortality has been shown.

There is a clamour for anti-malarial generic drugs used in India  Chloroquine and Hydroxychloroquine as initial studies have found them to be effective against COVID-19. However more extensive trials are required to say convincingly that these drugs are highly effective in treating COVID-19 patients.

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