- There was a shortage of drugs to treat the conditions they are meant for
- A few studies found that that the drugs could be dangerous in treating Covid-19
- An expert says it's reckless to encourage people to take them to treat the virus
A new study finds that prescriptions rose sharply for two drugs that President Donald Trump claimed could help prevent or treat Covid-19.
This happened despite the fact that multiple studies found the medicines might only bring harm to patients with coronavirus illness.
The study, conducted by researchers at Harvard-affiliated Brigham and Women's Hospital in Boston, found that prescriptions for the two drugs – hydroxychloroquine and chloroquine – rose by a staggering 2 000% during the week of 15 March to 21 March.
Early in the pandemic, Trump repeatedly touted hydroxychloroquine and chloroquine as a potential means of preventing or treating coronavirus illness.
No benefit to patients
On 21 March, Trump tweeted, "HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game-changers in the history of medicine." Azithromycin is an antibiotic often used to fight infections.
But a slew of studies have all found that any early promise from the drugs has quickly fizzled.
Research conducted at multiple sites found that hydroxychloroquine provides no benefit to patients, and has even been tied to a higher rate of dangerous heart arrhythmias and death.
In fact, safety concerns over hydroxychloroquine prompted the World Health Organization to remove the drug from a global trial of potential Covid-19 therapies earlier this week.
Still, Trump said on Sunday he had just finished taking a two-week course of the malaria drug to guard against Covid-19 infection after two White House staffers tested positive for the coronavirus.
The new study sought to determine what influence statements made by Trump and others might have had on patient requests for hydroxychloroquine and chloroquine.
Dramatic surge in prescriptions
"There have been indications that hydroxychloroquine prescribing had increased and shortages had been reported, but this study puts a spotlight on the extent to which excess hydroxychloroquine/chloroquine prescriptions were filled nationally," study co-author Dr Haidar Warraich said in a hospital news release.
His team tracked prescribing rates over a 10-week period: 16 February 16 to 25 April. Comparing rates to the same dates one year ago, the researchers tracked data on prescriptions for hydroxychloroquine/chloroquine, the antibiotic azithromycin, and the other top 10 most prescribed drugs in the United States.
They found that between 15 and 21 March prescriptions for azithromycin, amoxicillin and the painkillers hydrocodone/acetaminophen declined, and rates for heart medicines remained stable.
In contrast, there was a dramatic surge in prescriptions for hydroxychloroquine/chloroquine: from 2 208 prescriptions in 2019 to 45,858 prescriptions in 2020 – an increase of more than 2 000%.
And over the full 10 weeks of the study, there was an excess of almost a half-million prescription "fills" of hydroxychloroquine/chloroquine compared to the year before.
"This analysis doesn't include patients who were prescribed hydroxychloroquine/chloroquine in a hospital setting," Warraich noted. "This means that patients could have been taking the drugs at home, without supervision or monitoring for side effects."
Suggestive of shortage
Hydroxychloroquine/chloroquine are legitimately used by people with lupus to help control the immune disorder. But the Brigham team say they noticed a concurrent decline in the types of long-term prescriptions those patients might require – suggestive of a shortage.
In fact, the US Food and Drug Administration began to report a drug shortage of hydroxychloroquine beginning on 3 March, the researchers noted.
All of this has physicians concerned.
Dr Matthew Heinz is a hospitalist and internist at Tucson Medical Center in Arizona. Reacting to Trump's announcement earlier this month that he was taking the drug, Heinz said that, "I cannot stress enough how reckless it is to encourage anybody to take hydroxychloroquine or any other unproven remedy for SARS-CoV-2."
"Chloroquine and hydroxychloroquine are not benign substances and can cause serious, sometimes life-threatening, adverse effects," including sometimes fatal cardiac arrhythmias, he noted. "This is especially true when so many people already have underlying cardiac and other medical conditions – they are even more susceptible to such side effects."
The new study was published on 28 May in the Journal of the American Medical Association.
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