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A BAN ON exports in India, restrictions on GP prescriptions in Australia and a misinformed US President – What exactly is going on with the drug hydroxychloroquine?

It is currently being trialed as a possible treatment for Covid-19. But amid a rush to find a cure to a virus which has claimed over 18,000 lives, mistakes are being made. 

The drug chloroquine has been used for decades to prevent people catching malaria. 

For a number of weeks, doctors have been testing if this inexpensive anti-malaria drug could be an effective treatment for Covid-19. 

Professor Luke O’Neill, Chair of Biochemistry at Trinity College Dublin, says it is not surprising that chloroquine is being tested against Covid-19 considering a number of other drugs are also being trialed by the World Health Organisation at the moment. 

“It’s a widely used drug. Many millions of people have taken it,” O’Neill told TheJournal.ie. “There was a rationale to try it against the virus.”

That rationale started in France where a small, controversial study of about 40 patients hospitalised with Covid-19 in France. took place.

In that study, hydroxychloroquine – a less toxic derivative of chloroquine – appeared to help clear the virus from the bodies of 26 patients who were given the medication, based on samples taken from nasal swabs. Experts, however, criticised the design of the study, calling it interesting but far from definitive.

Premilinary 

Hydroxychloroquine and chloroquine are sold worldwide under a variety of brand and generic names. These drugs may interfere with the coronavirus being able to enter cells, scientists have found. 

According to a laboratory test conducted by the Wuhan Institute of Virology in China, chloroquine was found to be “highly effective” in controlling Covid-19 infection.

The difference in these tests, however, is their scale and length, explains O’Neill. ”Even the doctors who do it say it’s preliminary,” he said. 

Most drug trials go through rigourous stages before being approved for use in treatment, he added. 

Last week, University of Minnesota said it was launching a clinical trial of whether hydroxychloroquine can prevent people catching Covid-19. 

Trial volunteers who have been exposed to someone with known Covid-19, but who are not ill, will be given hydroxychloroquine to test whether it can stop the illness developing or reduce its severity.

The World Health Organisation (WHO) has also included chloroquine as one of the drugs being prioritised under its global Solidarity Trial – an international study bringing together various nations’ efforts to test potential Covid-19 treatments.

Other drugs being focused on for testing include remdesivir, in development as an anti-Ebola virus treatment, and lapinovir/rotinovir, a HIV drug.

‘Miracle drug’

In the meantime, hydroxychloroquine and chloroquine are being seen – and used – as a ‘game-changer’ drug to treat Covid-19, due in no small part to comments made last week by Donald Trump. 

On Friday, infectious disease expert Dr Anthony Fauci publicly sparred with Trump over whether hydroxychloroquine would work to treat people with the coronavirus.

The extraordinary scene played out on national television during the daily White House briefing on the outbreak, in which Americans heard conflicting answers from a just-the-facts scientist and a president who operates on gut instinct.

Reporters asked both men — first Dr Fauci then Trump — if hydroxychloroquine could be used to prevent Covid-19, the disease caused by the virus.

On Thursday, when Dr Fauci was not present, Trump had called attention to the drug. On Friday, Dr Fauci took the reporter’s question and got right to the point.

“No,” he said. “The answer … is no.

“The information that you’re referring to specifically is anecdotal,” Dr Fauci added firmly. “It was not done in a controlled clinical trial, so you really can’t make any definitive statement about it.”

Trump, however, stuck to his guns. As the two men took turns at the podium, Trump said he disagreed with the notion that there is no magic drug for the coronavirus disease.

“Maybe and maybe not,” he said. “Maybe there is, maybe there isn’t. We have to see.”

“I feel good about it. That’s all it is. Just a feeling. You know, I’m a smart guy,” said Trump. 

Trump also proudly proclaimed that the Food and Drug Administration (FDA) had approved the drug for coronavirus treatment only for the FDA chief to come out after the briefing and say this was not the case. 

The media coverage of the drug in the US quickly showed its effect. 

It was reported yesterday that a man in Arizona who confused an aquarium cleaning solution -  with the same name as the anti-viral drug – for chloroquine. 

The man and his wife poured the cleaning chemical – which had the same active ingredient as the drug, only poisonous to humans – into soda in the hope of avoiding contracting Covid-19, drank it and within an hour were rushed to the emergency room. The man later died. 

“What [Trump] said was ridiculous,” says Professor O’Neill, adding that such comments only cause the scientific community to urge further caution. 

‘Unprecedented global attention’ 

Meanwhile, in Australia, the country’s drugs regulator has been forced to restrict powers to prescribe hydroxychloroquine after it was reported doctors were prescribing it to themselves and their family members despite its deadly side-effects, which include heart failure. 

In India, exports of the drug have been banned after a run on existing supplies. “India has some of the world’s largest manufacturers of the finished drug as well as its component ingredients and the move is likely to crimp global supply at a time when the medication is receiving unprecedented global attention,” Bloomberg reported earlier today. 

For now, the scientific community urges caution around using any drug currently being trialed to combat Covid-19. 

Professor O’Neil says it will be weeks before any clinical trials are complete. Only then will we have a better picture of what is – or isn’t – effective in treating coronavirus.