Hydroxychloroquine-based treatments in the Covid-19 pandemic
Press release from the National Academy of Medicine and the National Academy of Pharmacy
March 26, 2020
The National Academies of Medicine and Pharmacy note, in the light of current scientific evidence, that the clinical efficacy of hydroxychloroquine has not been demonstrated to date. However, presumptions exist, in particular the negativation of the viral load of a certain number of patients, which justify its consideration by the urgent implementation of clinical trials to test this product on clinical criteria.
The French National Academy of Medicine considers that the release by public authorities of hydroxychloroquine for hospitalized patients in respiratory distress cannot be an appropriate response for patients whose viral load is, at this stage, most often non-existent and whose disease is no longer virosis stricto sensu but pulmonary failure (acute respiratory distress syndrome) linked to the inflammation induced by Sars CoV-2.
The National Academies of Medicine and Pharmacy consider that the European Discovery trial, whose methodology meets international criteria for good clinical trial practice, will make it possible to determine whether hydroxychloroquine or other antiviral molecules are effective in Covid-19 patients.
However, beyond the debates for or against the use of hydroxychloroquine for a particular stage of the disease, the National Academies of Medicine and Pharmacy are concerned about the following points:
– the numerous purchases of hydroxychloroquine by unaffected persons, often for preventive rather than curative purposes, whereas any prescription outside the market authorization should be the sole responsibility of the prescriber in hospital;
– the use of this product in individual doses without strict medical supervision, because of possible adverse effects which are particularly harmful in elderly subjects; –
– the possible, if not probable, use of this drug without initial electrocardiographic monitoring or follow-up, in particular because of the possibility of cardiomyopathy or induction of cardiac rhythm disorders;
– the danger of unknown drug interactions in patients between hydroxychloroquine and some of the drugs they usually take, if hydroxychloroquine were to be used in large numbers of subjects, even for a short period of time, particularly in elderly patients who are receiving multiple medications;
– the possible confusion among population between chloroquine and hydroxychloroquine;
– the sale of hydroxychloroquine on the Internet, or even the sale of falsified medicines under that name, whereas the supply of this medicine must imperatively comply with the official medical and pharmaceutical circuits;
– the foreseeable difficulty in obtaining hydroxychloroquine for patients with autoimmune diseases or inflammatory rheumatism, whereas it is essential for the continuation of their usual treatment;