M’sia finds a way to test drug on patients, minus the harm

KUALA LUMPUR: Drawing on China’s experience in using hydroxychloroquine to treat Covid-19, Malaysia has found a way to test the drug on patients here without harming them, says a report.

In a paper called “The Malaysian Response to Covid-19: Building Preparedness for ‘Surge Capacity’, Testing Efficiency, and Containment”, Malaysia learned from China that lower doses seem promising, though it acknowledged the need for high quality evidence to support claims that the anti-malarial drug hydroxychloroquine is useful for treating Covid-19 patients.

In the report, Sungai Buloh Hospital consultant infectious disease physician Dr Suresh Kumar said, “We needed to work on what was available. We prescribed hydroxychloroquine early for all symptomatic patients.

“As for issues aired on various forums, we didn’t use high doses of hydroxychloroquine that Brazil said is harmful. We used a lower dose as the Chinese recommended, ” he said, adding that doctors did not use it with azithromycin because of possible cardiac problems.

“We monitored with electrocardiograms and didn’t find anything major. It became our anchor when many patients got sick.

“We also tried various combinations of HIV drugs, like Kaletra (lopinavir/ritonavir), as well as interferon, an antiviral, ” he said in the report prepared by Dr Fifa Rahman (an executive board member of Unitaid) in collaboration with the Drugs for Neglected Diseases Initiative (DNDi), of which the Health Ministry is a founding partner.

The finding was posted by Health director-general Datuk Dr Noor Hisham Abdullah on his website.

The use of hydroxychloroquine became controversial following reports of deaths due to irregular heart beats and cardiac arrest among patients who were given the medication, frequently promoted by US president Donald Trump as a drug that works against Covid-19.

“The jury is still out in terms of whether we made a difference with antivirals. We’re trying to collect data to see whether we made a difference with hydroxychloroquine, and also in the use of anti-inflammatory agents to prevent ICU admissions, ” Dr Suresh said.

Malaysia is active in several Covid-19 clinical trials, such as using tocilizumab for severe Covid-19, the WHO-led Solidarity trial, which includes remdesivir-based regimens, and the Clinical Research Coalition (CRC) for Covid-19.

The report by Dr Fifa said Malaysia had relative success in responding to the pandemic, despite a mass religious event setting off large numbers of infections in early March. It reported 121 deaths as of Wednesday, a case fatality rate of 1.42%.

Dr Noor Hisham attributed the low number of deaths to heeding lessons from China, as well as early planning which included increasing the number of diagnostic laboratories and screenings for Covid-19.

Its previous experience with the Middle East Respiratory Syndrome coronavirus (MERS), and the Severe Acute Respiratory Syndrome (SARS) epidemic from 2002-2003, produced experienced contact tracing teams, and this was also key in enabling a speedy response, the report added.

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