Coronavirus | Hydroxychloroquine clinical trials will resume, says WHO

British medical journal The Lancet says that it had concerns about data behind an influential article that found that HCQ increased the risk of death in COVID-19 patients.

June 03, 2020 10:57 pm | Updated June 04, 2020 08:46 am IST

Hydroxychloroquine has anti-inflammatory and antiviral properties.

Hydroxychloroquine has anti-inflammatory and antiviral properties.

The World Health Organisation said on Wednesday that clinical trials of the drug hydroxychloroquine will resume, after having been suspended pending a safety review in the search for coronavirus ( COVID-19 ) treatments.

“On the basis of the available mortality data... the executive group will communicate with the principal investigators in the trial about resuming the hydroxychloroquine arm,” WHO chief Tedros Adhanom Ghebreyesus told a virtual news briefing.

Concerns about data

British medical journal The Lancet said on Tuesday that it had concerns about data behind an influential article that found that HCQ increased the risk of death in COVID-19 patients, a conclusion that undercut scientific interest in the medicine championed by U.S. President Donald Trump .

Hydroxychloroquine with PPE reduces odds of COVID-19 in health workers: ICMR researchers

Hydroxychloroquine — which has anti-inflammatory and antiviral properties — inhibited the coronavirus in laboratory experiments, but has not been proven effective in humans, particularly in placebo-controlled, randomised clinical trials considered the gold standard for data. The debate has become highly politicised, and many scientists have voiced concern.

Open letter

Nearly 150 doctors signed an open letter to The Lancet last week calling the article’s conclusions into question and asking to make public the peer review comments that preceded publication.

Why is India pushing ahead with hydroxychloroquine?

“This is not some sideshow or minor issue,” said Walid Gellad, a Professor at University of Pittsburgh’s medical school, who was not a signatory of the letter but has been critical of the study. “We’re in an unprecedented pandemic. We’ve organised these enormous clinical trials to figure out if something works. And this study stopped or paused a couple of those trials, and changed the narrative around a drug that no one knows if it works or not,” he said.

The observational study was published in The Lancet on May 22. looked at 96,000 hospitalised COVID-19 patients, some treated with the decades-old malaria drug that Mr. Trump said he took and has urged others to use.

Several clinical trials were put on hold after the study was published.

The study, using data provided by healthcare data analytics firm Surgisphere, was not a traditional clinical trial that would have compared hydroxychloroquine to a placebo or other medicine.

The Lancet ’s editors said in a note that serious scientific questions about the study were brought to their attention and an independent audit of the data has already been commissioned.

Surgisphere said in a statement that the audit “will bring further transparency to our work [and] further highlight the quality of our work.”

Earlier on Tuesday, the New England Journal of Medicine (NEJM) said it was concerned about the quality of the data behind a different study it published in May that also used data from Surgisphere and had the same lead author.

Mandeep Mehra, the lead author and a professor of Medicine at Harvard Medical School, defended the use of the Surgisphere dataset as an intermediary step until clinical data is available. “I eagerly await word from the independent audits, the results of which will inform any further action,” Dr. Mehra said in a statement after The Lancet note.

The World Health Organization (WHO) suspended hydroxychloroquine’s use in a large trial on COVID-19 patients after The Lancet study. Following the WHO trial suspension, the governments of France, Italy and Belgium halted the use of hydroxychloroquine for COVID-19 patients.

In March, Mr. Trump, with little scientific evidence, said hydroxychloroquine used in combination with the antibiotic azithromycin had “a real chance to be one of the biggest game changers in the history of medicine.” He later said he took the drugs preventively after two people who worked at the White House were diagnosed with COVID-19.

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