CRST: Hydroxychloroquine for the Treatment and Prevention of COVID-19
A new article published online in Cataract & Refractive Surgery Today (CRST) provides an in-depth examination of the use of hydroxychloroquine for both prophylaxis and therapeutic treatment of COVID-19.
Authors William B. Trattler, MD; Gary Wörtz, MD; and Sean Ianchulev, MD, MPH, examine the use of hydroxychloroquine, a widely available generic medication that is approved by the FDA. The drug has a good safety profile and a very long half-life, and it is commonly used for a variety of indications, including the treatment of lupus and rheumatoid arthritis and the prevention and treatment of malaria.
The authors argue that basic science evidence supports the use of hydroxychloroquine for both the prevention and treatment of COVID-19. In addition, clinical research suggests that hydroxychloroquine alone and potentially in conjunction with the antibiotic azithromycin can be used to treat patients with COVID-19.
A report published online ahead of print in February indicated that the early clinical experience with both hydroxychloroquine and chloroquine for patients with COVID-19 was very positive.9 In a more recent randomized study from China that evaluated 62 hospitalized patients with COVID-19, 80.6% (25 of 31) treated with hydroxychloroquine 200 mg twice per day for 5 days experienced an improvement in their pneumonia (as evaluated by computed tomography scan) versus 54% (17 of 31) of COVID-19 patients on placebo.7 Fever was also eliminated more rapidly (2.2 vs 3.2 days) in treated versus untreated patients, respectively.
“Rather than wait for symptoms to develop, it may be beneficial to achieve a therapeutic level of hydroxychloroquine in one’s system if there is an increased risk for exposure, such as in first responders, health care workers, or someone who came into contact with a COVID-19–positive individual. The hope is that the hydroxychloroquine onboard would minimize the severity of the COVID-19 infection and reduce the chance of requiring hospitalization,” the authors said.
The full article can be found on the CRST homepage.
7. Chen Z, Hu J, Zhang Z, et al. Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. medRxiv 2020. doi: 10.1101/2020.03.22.20040758.
9. Gao J, Tian Z, Yang X. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. BioScience Trends. 2020;14(1):72-73.