‘Drug is not stopping virus’

KUALA LUMPUR: Available data from Malaysia suggests that hydroxychloroquine is unable to stop Covid-19 from progressing to more severe stages of the disease in patients.

Data from patients who are either in Stage 2 or 3 showed that the drug did not prevent their condition from worsening, said Dr K. Suresh, an infectious disease consultant who is also Hospital Sungai Buloh’s head of Medical Department.

He said this at a webinar on updates on clinical management of Covid-19 on Thursday that was moderated by former deputy Health director-general Datuk Dr Christopher Lee.

The preliminary conclusion was based on data from 586 Covid-19 patients from Hospital Sungai Buloh and Hospital Permai (Johor) that did not need oxygen support.

As many as 451 of these patients were given hydroxychloroquine for at least five days, and the results were compared with 135 patients (based on past data gathered before the drug was introduced for treating Covid-19) who did not receive the drug.

Malaysia introduced its national guidelines on hydroxychloroquine for Covid-19 patients in early March.

The results showed that the proportion of patients on hydroxychloroquine who deteriorated to Stages 4 and 5 was 10% (45 out of 451) while 8.9% (12 out of 135) of patients without the drug use showed deterioration.

“Hydroxychloroquine doesn’t seem to prevent the deterioration of severe disease. The results did not show any significant difference between the two groups,” said Dr Suresh.

Based on the local data and the World Health Organisation announcing on Wednesday that it was dropping hydroxychloroquine from its massive clinical study after available data indicated the drug was ineffective for Covid-19, Dr Suresh said Malaysia might also stop using it for the time being.

However, he added that definitive data will come from the United States’ National Institute of Health (NIH), which is studying 2,000 outpatients with early Covid-19, to see if giving them hydroxychloroquine at the very early onset of the disease will prevent the need for hospitalisation, he said, adding that the NIH study will be the conclusive finding on the effectiveness of the drug.

Currently, the Health Ministry’s guidelines provide for lopinavir/ritonavir and favipravir to be prescribed for Stages 4 and 5 patients, said Dr Suresh, who added that interferons will be used if the illness is less than seven days.

To a question from Dr Lee, who asked why ribavirin (an anti-viral) was removed from the Health Ministry’s guidelines for Covid-19 treatment, Dr Suresh said doctors had initially used it, but stopped after patients had problems with anaemia and platelet as well as liver issues.

The webinar was initiated by the Health Ministry’s Clinical Research Centre director Datuk Dr Goh Pik Pin.

The other speaker was Medical Development Division clinical audit unit head (Medical Care Quality Section) Dr Faizah Muhamad Zin.

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