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WHO advises against use of hydroxychloroquine even as ICMR approves

The World Health Organization (WHO) has advised against the use of the anti-malaria drug hydroxychloroquine, saying it found no evidence, in randomised clinical trials, of drug’s effectiveness for coronavirus treatment.

Speaking to India Today TV on Friday, the WHO Executive Director Michael J Ryan said, “At present, there is no evidence from a randomised control trial of the effectiveness of HCQ in the treatment of prophylaxis against Covid-19”.

Michael Ryan pointed out that the drug has been used under randomized trials to study its effectiveness but should only be given in clinical settings under clinical supervision considering its side effects.

This comes on a day when the ICMR released an advisory backing the usage of HCQ as a preventive treatment against the novel coronavirus even outside clinical settings.

Quoting one of the three studies done in India, the ICMR said, “Amongst healthcare workers involved in Covid-19 care, those on HCQ prophylaxis were less likely to develop SARS-CoV-2 infection, compared to those who were not on it.”

The new advisory recommended the use of hydroxychloroquine as a preventive medication for asymptomatic healthcare workers working in non-Covid-19 hospitals, frontline staff on surveillance duty in containment zones, and paramilitary/police personnel involved in coronavirus infection-related activities.

NEW STUDY

Meanwhile, The Lancet, a premier medical journal, published a large observational study on 14,888 coronavirus patients. It found that those being treated with HCQ and chloroquine are at a higher risk of death and irregular heart rhythms.

The researchers from Harvard Medical school, University Hospital Zurich and the University of Utah said, “We were unable to confirm a benefit of hydroxychloroquine or chloroquine when used alone or with a macrolide [azithromycin or clarithromycin], on in-hospital outcomes for Covid-19.”

The researchers further claim that their “large-scale, international, real-world analysis supports the absence of a clinical benefit of chloroquine and hydroxychloroquine and points to potential harm in hospitalised patients with Covid-19.”

The study has drawn sharp reactions from independent experts.

Prof Stephen Evans, Professor of Pharmacoepidemiology, The London School of Hygiene and Tropical Medicine, said, “A definitive answer still awaits the results of the randomized trials, but it is clear that the drugs should not be given for the treatment of Covid-19 other than in the context of a randomised trial”.

Some experts also pointed out the limitations of the Lancet study. Prof Babak Javid, Principal Investigator, Tsinghua University School of Medicine, Beijing, and Consultant in Infectious Diseases at Cambridge University Hospitals, said, “This was a retrospective analysis, not a prospective randomised controlled trial. Therefore, one cannot formally state that HCQ or CQ is not associated with benefit, but it certainly casts a great deal of doubt”. – India Today

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