In the past 24 hours, hydroxychloroquine (HCQ) has been making news again. US President Donald Trump has once again promoted the use of this drug as a cure for the Coronavirus, or COVID-19. The US has also reached out to India to lift the ban on hydroxychloroquine exports, which India had imposed on March 26. It is not just Trump and the US who want India to lift restrictions on exports of what is believed to be the miracle drug to cure Coronavirus. Brazilian President Jair Bolsonaro, among other state leaders, is also believed to have reached out to the Indian authorities in an attempt to have the ban overturned. In fact, the Government of India has already placed an order of 10 crore tablets with Ipca laboratories and Zydus Cadila.
What is Chloroquine? Chloroquine phosphate is a class of drugs called antimalarials and amebicides and is used to prevent and treat malaria, according to the US National Library of Medicine. They add that Chloroquine phosphate is used occasionally to decrease the symptoms of rheumatoid arthritis and to treat systemic and discoid lupus erythematosus, scleroderma, pemphigus, lichen planus, polymyositis, sarcoidosis, and porphyria cutanea tarda. Governments believe that hydroxychloroquine tablets can work as a prophylactic, a medicine that prevents disease, for the health workers working on the frontlines in hospitals and as first responders to possible Coronavirus infection cases.
But is it really the cure?
While all this is happening, there is still no scientific evidence that proves hydroxychloroquine is indeed the answer to the Coronavirus. It may very well be, but there is still no medical evidence to show that it indeed works. And without potentially dangerous side effects. The White House top Coronavirus advisor, Dr. Anthony Fauci told CBS’s Face of The Nation that, “In terms of science, I don’t think we can definitively say it works. The data are really just at best suggestive. There have been cases that show there may be an effect and there are others to show there’s no effect.”
We just don’t know yet
Earlier, the US Food & Drug Administration had said they are working closely with the government and researchers to investigate the use of chloroquine. “The FDA has been working closely with other government agencies and academic centers that are investigating the use of the drug chloroquine, which is already approved for treating malaria, lupus and rheumatoid arthritis, to determine whether it can be used to treat patients with mild-to-moderate COVID-19 to potentially reduce the duration of symptoms, as well as viral shedding, which can help prevent the spread of disease. Studies are underway to determine the efficacy in using chloroquine to treat COVID-19,” said the FDA in a statement. This came after repeated insistence by Trump that hydroxychloroquine was indeed the answer to fighting the spread of the Coronavirus, without much medical research to base the argument on.
There could be some merit in Trump’s insistence, though it has often been seen as trying to force through a drug that has still not been cleared for treatment. A research published in Bioscience Trends on March 16 said, “The coronavirus disease 2019 (COVID-19) virus is spreading rapidly, and scientists are endeavouring to discover drugs for its efficacious treatment in China. Chloroquine phosphate, an old drug for treatment of malaria, is shown to have apparent efficacy and acceptable safety against COVID-19 associated pneumonia in multi-center clinical trials conducted in China.” It also said that the drug is recommended to be included in the next version of the Guidelines for the Prevention, Diagnosis, and Treatment of Pneumonia Caused by COVID-19 issued by the National Health Commission of the People's Republic of China for treatment of COVID-19 infection in larger populations in the future.
The University of Minnesota is conducting a study in which hydroxychloroquine is being given to people who live with a coronavirus patient to understand if it can help in prevention of the infection, according to the New York Times.
Pharma companies are pitching in for health workers
Earlier, pharma giant Bayer said that it will donate 3 million doses of its chloroquine phosphate drug, called Resochin, to the US government. “New data from initial preclinical and evolving clinical research conducted in China, while limited, shows potential for the use of Resochin in treating patients with COVID-19 infection,” the company had said in a statement shared with the media.
Novartis has pledged it will donate as many as 130 million hydroxychloroquine tablets globally, pending regulatory approvals.
According to Drugs.com the Chloroquine sells for around $6.63 per tablet at medical stores in the US. That would be around Rs 500 per tablet, direct conversion, before factoring in taxes and local levies. Chloroquine is an ingredient in multiple drugs sold around the world—for instance, Emquin-DS sold my Merck in India, Resochin sold by Bayer in multiple countries including US, India, Austria, Spain and Bulgaria, Avloclor made by AstraZeneca and Nivaquine made by Sanofi-Aventis, to name a few. Drug companies Cadila Pharmaceuticals, Torrent Pharmaceuticals and IPCA Laboratories also make hydroxychloroquine (HCQ) tablets.
Chloroquine isn’t new. It has been around since the second World War and is derived from the bark of the chinchona tree. However, Chloroquine is not safe for everyone. It is usually not recommended to anyone who suffers from heart arrhythmia, or those with kidney or liver issues.