Doctors cautious over use of malaria drug as virus preventive

ICMR warns against its unrestricted use

25/03/2020, R. PRASAD,CHENNAI

It is still at an experimental stage, the Council said.AFPGERARD JULIEN

A day after the Indian Council of Medical Research (ICMR) approved the use of hydroxychloroquine as prophylaxis by healthcare workers taking care of COVID-19 cases and asymptomatic household contacts of confirmed cases, the Council on Tuesday cautioned against the unrestricted use of the drug, stating that “it is still at an experimental stage and is not recommended for public use.”

Hydroxychloroquine is an antimalarial drug that is also used for treating rheumatoid arthritis. The ICMR’s approval followed a recommendation from its task force for COVID-19.

“The recommendation is for empirical use of the drug based on available evidence and is restricted for use by only two categories of people and under strict supervision of a doctor,” Director-General of ICMR Balram Bhargava told The Hindu.

The clarification comes as none of the drug approving agencies across the world, including the FDA, has cleared the drug for prophylaxis or for treating COVID-19 patients.

The available evidence of the efficacy of the drug is a small study by French researchers involving 26 COVID-19 patients.

The study found “significant” reduction in viral load in over half the number of patients at end of six days of therapy. The results were published on March 17 in the International Journal of Antimicrobial Agents even before the 14-day follow-up was completed.

During a White House press briefing a few days ago, asked if there was any evidence that the drug can be used as a prophylactic or as treatment for COVID-19 patients, Director of the U.S. National Institute of Allergy and Infectious Diseases Anthony Fauci, said: “The answer is ‘no’ as it is [based on] anecdotal evidence.”

Despite Dr. Fauci’s clarification, two Nigerians are reported to have over-dosed on the drug after hearing U.S. President Donald Trump saying the drug could help treat people with COVID-19. A man in Arizona, U.S., died and his wife was hospitalised after they self-medicated with a home remedy of hydroxychloroquine.

Prof. Gagandeep Kang, executive director of the Translational Health Science and Technology Institute (THSTI) in Faridabad, told The Hindu: “At this moment there is no evidence available [about its effectiveness]. There are on-going trials. They must have waited for the results. Even the trials are for treating COVID-19 patients and not for prophylaxis.”