Coronavirus: Hydroxychloroquine trialled over better treatments

More than 1,200 studies looking at treatment and prevention of coronavirus are often too small to provide conclusive results and are focusing too much on one potential therapy, a new analysis reveals. 

Commissioned by STAT News, the report found that one in every six clinical trials studied the anti-malaria drugs hydroxychloroquine or chloroquine despite thin evidence that either are effective at treating patients.

Several have also lacked control groups and have just been comparing groups of patients with mild to severe cases of the disease. 

Meanwhile, two medications with proven efficacy at treating patients are only the focus of a couple dozen studies.   

A trio of recent trials suggest that hydroxychloroquine, the malaria drug touted by Trump, does little to improve survival odds for severely ill coronavirus patients or to treat mildly ill patients when given early

About 200 of 1,200 studies – or one in six – looked at anti-malaria drug hydroxychloroquine (pictured) as a potential treatment for coronavirus

Fewer than 25 studies examined dexamethasone or remdesivir, which have been proven to reduce death rates in separate clinical trials. Pictured: A pharmacist works on the basics of the raw materials for investigation of remdesivir in Cairo, Egypt June 25

Fewer than 25 studies examined dexamethasone or remdesivir, which have been proven to reduce death rates in separate clinical trials. Pictured: A pharmacist works on the basics of the raw materials for investigation of remdesivir in Cairo, Egypt June 25

For the analysis, STAT News teamed up with Applied XLabs, which builds tools to look at health data so patterns and trends can be spotted. 

Researchers collected data from clinicaltrials.gov, which includes records of studies from around the world. 

The approximately 1,200 studies specifically looked at potential coronavirus treatments or drugs that would prevent people from becoming infected.  

Results showed that many studies were quite small – meaning larger-scale trials are needed – or haven’t begun yet.

About 39 percent either planned to enroll or did enroll fewer than 100 participants while around 38 percent had not started the enrollment process yet.

This means that fewer than one-quarter of studies were considered large-scale, and even fewer are randomly assigning patients either a treatment or a placebo. 

‘It’s a huge amount of wasted effort and wasted energy when actually a bit of coordination and collaboration could go a long way and answer a few questions,’ Dr Martin Landray, a professor of medicine at Oxford University, told STAT News.

He’s also one of the lead researchers on the RECOVERY trial, run the UK government, which aims to identify treatment for those confirmed or suspected to have COVID-19, the disease caused by the virus.

In fact, this is the trial that discovered the steroid dexamethasone helped reduce death rates in severely ill coronavirus patients.

Rates were lowered by one-fifth in those receiving supplemental oxygen and by one-third in patients receiving mechanical ventilation.

The only other drug that’s been proven effective is remdesivir, which the National Institutes of Health found helped reduce death rates by 30 percent.

However, neither of these drugs are being widely studied.

Fewer than 25 studies each are looking at dexamethasone ore remdesivir despite researchers having proven their efficacy. 

STAT News reports that seven studies in total have looked at dexamethasone with 13,600 patients enrolled, 12,000 of whom were in the RECOVERY trial.

Meanwhile, at least 200 studies looking at hyroxychloroquine or choloroquine have enrolled 237,000 volunteers.

That’s more than one-third of the 685,000 participants enrolled across all studies that were analyzed.  

It came after early studies showed promising results, such as one from Marseille, France, in which 30 patients were treated with hydroxychloroquine for 10 days combined with azithromycin, an antibiotic.

Although very small, the study ‘showed a significant reduction of the viral carriage’ after the six days and ‘much lower average carrying duration’ compared to patients who received other treatments. 

In March, President Donald Trump hailed the drug as a ‘game-changer’ for treatment of coronavirus.

He would go on to take a two-week course of hydroxychloroquine as a prophylactic.

But in a statement published online, the International Society of Antimicrobial Chemotherapy addressed several concerns with the research.

Officials say they found out the researchers excluded data on patients who didn’t respond well to the treatment and that they did not clarify what they meant when they said patients were ‘virologically cured.’  

Since then, several studies have said there is no evidence the drug is beneficial.

‘If the goal was to optimize the likelihood of figuring out the best treatment options, the system is off course,’ Robert Califf, head of clinical policy and strategy at Verily Life Sciences and Google Health and  former FDA commissioner told STAT News.

source: dailymail.co.uk