The risk of ventilation was similar in the HCQ group (aHR, 1.43; 95% CI, 0.53 – 3.79; P = .48) and in the HCQ+AZ group (aHR, 0.43; 95% CI, 0.16 – 1.12; P= .09), compared with the no HCQ group.
This study provides another counterbalance to claims of HCQ efficacy, David R. Wessner, PhD, professor of biology and chair of the Department of Health and Human Values at Davidson College in Davidson, North Carolina, told Medscape Medical News.
Interest in HCQ spiked after an open-label, nonrandomized, single-center study of COVID-19 patients in France suggested that hydroxychloroquine helped clear the virus and had a potential enhanced effect when combined with azithromycin.
But as Medscape and Retraction Watch previously reported, the 36-patient trial has since been called into question.
Wait for Convincing Data
Wessner, whose research focuses on viral pathogenesis, says that although the current data don’t definitively answer the question of whether HCQ is effective in treating COVID-19, taking a “let’s try it and see” approach is not reasonable.
“Until we have good, prospective randomized trials, it’s hard to know what to make of this. But this is more evidence that there’s not a good reason to use [HCQ],” Wessner said.
He points out that the small randomized trial from China shows that HCQ comes with potential harms.
Anecdotal evidence is often cited by those who promote HCQ as a potential treatment, but “those are one-off examples,” Wessner continued. “That doesn’t really tell us anything.”
Some HCQ proponents have said that trials finding no benefit are flawed in that the drug is given too late. However, Wessner says, there’s no way to prove or disprove that claim without randomized controlled trials.
Despite lack of clear evidence of benefit for patients with COVID-19, HCQ is recommended off-label by the Chinese National guideline, and the US Food and Drug Administration has issued an emergency-use authorization for the treatment of adult patients with COVID-19.
Conversely, the Infectious Diseases Society of America and a guideline panel convened by the National Institutes of Health each concluded recently that because of insufficient data, they could not recommend any specific treatments for patients with COVID-19.