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Hydroxychloroquine

This keeps coming up again and again. I wanted to provide you all with a timeline of the scientific evidence. Because, honestly, I was curious too…

May 2005: Scientists found chloroquine was protective against SARS among PRIMATES (this is what prompted that viral doctor video). This is a good start but does not have ANY bearing on the impact of hydroxychloroquine on COVID19 among humans.

April 2020: There were two small studies conducted…

  • France: 20 patients were given hydroxychloroquine. This was NOT a randomized control trial, but they found a beneficial effect of hydroxychloroquine.
  • China: 62 patients were randomly placed in control and treatment groups. The treatment group (i.e. hydroxychloroquine) did better than the control group.

April 2020: FDA authorized emergency use of hydroxychloroquine. This drug started to became a household name.

May 2020: Two large randomized studies (1446 patients in NYC and 1438 patients in 25 hospitals in NY state) found no beneficial effect of hydroxychloroquine. The NIH to recommend that hydroxychloroquine NOT be used in routine care (only for research).

May 2020: A Lancet article was published (96,000 patients across the US) which found no beneficial effect of hydroxychloroquine. However, the veracity of the data and analyses was questioned. So, Lancet attempted to conduct a third-party review to replicate the findings. The data source (Surgisphere Corporation) would NOT share their data for this “double check”. Lancet retracted the paper.

June 2020: Four large studies were conducted…

  • Nashville: A randomized trial (470 patients) was told to STOP because there was no beneficial effect of hydroxychloroquine. Continuing the study would unethical to study participants.
  • UK: (11,000 patients in 175 hospitals) No beneficial effect of hydroxychloroquine. They also had to STOP the study.
  • US and Canada: A large randomized study (821 patients) tested whether this drug prevented COVID19 BEFORE infection compared to a placebo. No beneficial effect of hydroxychloroquine
  • China: 150 patients randomized to hydroxychloroquine. No beneficial effect of hydroxychloroquine.

June 15: FDA deauthorized emergency use of hydroxychloroquine

July 2020: In the US, a large randomized study (491 patients) found no beneficial effect of hydroxychloroquine.

There are some scientific principles that are certain. They are called scientific laws (think the law of thermodynamics). EVERYTHING ELSE IS FLUID. Science if ever-changing and extends itself. The virus doesn’t change, but our understanding of the virus changes. Because of this, scientific and medical recommendations adapt. ESPECIALLY when there is a novel disease like COVID19. If this WASN’T happening, then we wouldn’t be doing our job.

Everyone needs to have a more realistic expectations of what science can and can’t do.  

Love, your local epidemiologist

Data sources: Peer-review articles are linked throughout the post above.

12 replies on “Hydroxychloroquine”

Thanks for your fact-based insight—you are now my go-to source for getting honest covid information backed by science. With the new hydroxychloroquine video that was released yesterday, I’m hearing armchair quarterback wanna-bee scientists on Facebook say that we need studies on HCQ where it is given to patients immediately after symptoms onset or diagnosis of covid-19, and that the dosage should be much lower than most of the studies you referenced, maybe 200mg of HQC twice a week. Are there any studies out there that hit both of these parameters? And what about the studies referenced by this Yale epidemiologist in Newsweek here: https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535. Thanks!

I would like to know this as well. The so-called “white coat doctors” were claiming hydrochloroquine had to be taken with zinc and either Zithromax or doxycycline (I think).

Thanks for fantastic information! What shop you mean by “the virus doesn’t change”? I thought that viruses have the ability to mutate. I’ve got someone dismissing your whole post because of this one line 🙄 so hoping for some clarity.

The study by Ford was retroactive, not randomized, and didn’t consider or control for other treatments being administered, such as steroids.

Thanks YLE for your continued updates and helping to keep track of data that informs important decisions at all levels – from hospital to federal. New study to add to the list: https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext?fbclid=IwAR1jZZQ49Sv0v5EjyKwwgD35c7XXxXHHdA6xyeGgPeoGx5g9eh8VhygAxh4
Looks at the effects of combined drug approaches started early in the disease progress.
US based. Non-randomized, retrospective. Specifically states prospective/randomized studies are still needed, though its a large study and their propensity score matching is a nice addition.
Thanks!

1. Accurate and helpful summary. Love this and will share.
2. “..the virus doesn’t change” is somewhat inaccurate as viruses can change due to mutations and that can affect pathogenesis and identification of effective treatments/vaccines.
3. It is worth while adding that the reason given for the breakdown of the peer review process of the Lancet paper was that Surgisphere said sharing patient information would “violate client agreements and confidentiality requirements.”

Some viruses do tend to mutate quickly while others seem not to. Think about Influenza vs Measles. Both diseases are caused by a virus, but one you have to get vaccinated for every year (Flu) and the other is good for a lifetime (MMR vaccine).

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