Limited global stocks may scupper plans to use the antimalarial medications, chloroquine, and hydroxychloroquine, to lessen the signs of COVID-19 infection or ward it off altogether, say Italian scientists in a letter issued online today in the Annals of the Rheumatic Diseases.
The results of initial lab tests have helped investigators to suggest that these medications be used to treat sufferers with a disease created by the COVID-19 virus. This approach has already been involved in Chinese guidelines on how best to control the temperature.
Various studies over the past decade have shown that antimalarial medications can reduce the impact of viral diseases, including COVID-19. And clinical tests are now started to see whether these medications might help ward off the attack altogether.
Side Effects
Chloroquine and hydroxychloroquine have been used to treat the autoimmune disorder, including rheumatic conditions, since the 1940s, and have established safe and well-tolerated in most cases, say the authors.
Side effects are frequently mild to moderate, with serious difficulties, such as retinal and cardiac illness, rare and related to increasing doses over a long period.
There is a moral issue; however, as there is as yet no hard data from clinical trials that these medications can stop the range of COVID-19, they point out.
“Is it lawful to take a managed risk in the event of a pandemic?” they ask. “In such a case: would it be wise to reconsider antimalarials as primary prophylaxis in healthy citizens living in most significant risk regions or, at least, to use them in those testing positive for COVID-19, but still asymptomatic?”
Possible Outcomes
The security and effectiveness of these medications make them good candidates for mass defensive treatment programs, they add, and investigators seem to be leaning towards adopting this way.
But, conclude the authors: “If mass prophylaxis were accepted as an option worldwide, this would suggest the question of whether there is enough amount of [chloroquine] and [hydroxychloroquine] to support this program.”
The European League Against Rheumatism (EULAR), which co-owns the Annals of the Rheumatic Diseases with BMJ, states that the use of these medicines to tackle COVID-19 could have critical relationships for people with rheumatic conditions across Europe.
Balanced Approach
EULAR President, Professor Iain McInnes, says that global efforts to boost the database for the use of these antimalarial medications to treat COVID-19 are especially welcome.
But he adds: “EULAR is involved, however, that the change of drug stores away from people with rheumatic and musculoskeletal conditions may jeopardize the health of this material and a sizeable group of sufferers in Europe and beyond.”
EULER’s patient membership group (PARE) is now collecting on the manufacturers of these medications to boost production to meet the predicted surge in demand quickly.
“A balanced approach that meets the imperatives of the continuing pandemic, but which also takes account of the inadequacies of sufferers already taking these drugs is necessary,” insists Professor McInnes.
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