Malaria drug Hydroxychloroquine fails to prevent COVID-19 in a rigorous study

News Network
June 4, 2020

Jun 4: A malaria drug President Donald Trump took to try to prevent COVID-19 proved ineffective for that in the first large, high-quality study to test it in people in close contact with someone with the disease.

Results published Wednesday by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus.

The drug did not seem to cause serious harm, though -- about 40% on it had side effects, mostly mild stomach problems.

 “We were disappointed. We would have liked for this to work,” said the study leader, Dr. David Boulware, an infectious disease specialist at the University of Minnesota.

“But our objective was to answer the question and to conduct a high-quality study,” because the evidence on the drug so far has been inconclusive, he said.

Hydroxychloroquine and a similar drug, chloroquine, have been the subject of much debate since Trump started promoting them in March.

Hydroxychloroquine has long been used for malaria, lupus, and rheumatoid arthritis, but no large studies have shown it or chloroquine to be safe or effective for much sicker patients with coronavirus, and some studies have suggested the drugs may do harm.

Trump took a two-week course of hydroxychloroquine, along with zinc and Vitamin D, after two staffers tested positive for COVID-19, and had no ill effects, according to results of his latest physical released by his doctor Wednesday.

Federal regulators have warned against hydroxychloroquine's use except in hospitals and formal studies because of the risk of side effects, especially heart rhythm problems.

Boulware's study involved 821 people in the United States and Canada living with someone diagnosed with COVID-19 or at high risk of getting it because of their job -- doctors, nurses, ambulance workers who had significant exposure to a sick patient while not wearing full protective gear.

They were randomly assigned to get either the nutrient folate as a placebo or hydroxychloroquine for five days, starting within four days of their exposure. Neither they nor others involved in the research knew who was getting which pills.

After 14 days in the study, 12 per cent on the drug developed COVID-19 symptoms versus 14 per cent in the placebo group, but the difference is so small it could have occurred by chance, Boulware said.

“There's basically no effect. It does not prevent infection,” he said of the drug. Even if it were to give some slim advantage, “we'd want a much larger effect” to justify its use and risk of side effects for preventing illness, he said.

Results were no different among a subgroup of participants who were taking zinc or vitamin C, which some people believe might help make hydroxychloroquine more effective or fight the coronavirus.

There are some big caveats: The study enrolled people through the Internet and social media, relying on them to report their own symptoms rather than having them tracked in a formal way by doctors.

Participants were not all tested for the coronavirus but were diagnosed as COVID-19 cases based on symptoms in many cases. And not all took their medicines as directed.

The results “are more provocative than definitive,” and the drug may yet have prevention benefits if tried sooner or in a different way, Dr. Myron Cohen of the University of North Carolina at Chapel Hill wrote in a commentary in the journal.

Others were glad to see a study that had a comparison group and good scientific methods after so many weaker reports on hydroxychloroquine.

“This fits with everything else we've seen so far which suggests that it's not beneficial," said Dr. Peter Bach, director of a health policy center at Memorial Sloan Kettering Cancer Center in New York.

This study was in younger relatively healthy people, but the results “would make me very discouraged about trying to use this in older people” who are most vulnerable to serious illness from the coronavirus, Bach said.

“If it does work, it doesn't work very well.” Dr. Dan Culver, a lung specialist at the Cleveland Clinic, said there's still a chance that giving the drug sooner than four days after someone's exposure to the virus may help prevent illness.

But the study “takes 'home run' off the table” as far as hopes for the drug, he said.

The study was mostly funded by David Baszucki, founder of Roblox, a California-based game software company, and other private donors and the Minnesota university.

Boulware also is leading a study testing hydroxychloroquine for treating COVID-19. The study is finished and results are being analyzed now.

On Tuesday, the journal Lancet posted an “expression of concern” about a study it published earlier this month of nearly 15,000 COVID-19 patients on the malaria drugs that tied their use to a higher risk of dying in the hospital or developing a heartbeat problem.

Scientists have raised serious questions about the database used for that study, and its authors have launched an independent audit.

That work had a big impact: the World Health Organization suspended use of hydroxychloroquine in a study it is leading, and French officials stopped the drug's use in hospitals. On Wednesday, the WHO said experts who reviewed safety information decided that its study could resume.

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News Network
April 10,2020

Melbourne, Apr 10: Scientists have identified six drug candidates from more than 10,000 compounds that may help treat COVID-19.

The research, published in the journal Nature, tested the efficacy of approved drugs, drug candidates in clinical trials and other compounds.

"Currently there are no targeted therapeutics or effective treatment options for COVID-19," said Professor Luke Guddat from the University of Queensland in Australia.

"In order to rapidly discover lead compounds for clinical use, we initiated a programme of high-throughput drug screening, both in laboratories and also using the latest computer software to predict how different drugs bind to the virus," Guddat said.

The project targeted the main COVID-19 virus enzyme, known as the main protease or Mpro, which plays a pivotal role in mediating viral replication, the researchers said.

This makes it an attractive drug target for this virus, and as people don't naturally have this enzyme, compounds that target it are likely to have low toxicity, they said.

"We add the drugs directly to the enzyme or to cell cultures growing the virus and assess how much of each compound is required to stop the enzyme from working or to kill the virus. If the amount is small, then we have a promising compound for further studies," said Guddat.

After assaying thousands of drugs, researchers found of the six that appear to be effective in inhibiting the enzyme, one is of particular interest.

"We're particularly looking at several leads that have been subjected to clinical trials including for the prevention and treatment of various disorders such as cardiovascular diseases, arthritis, stroke, atherosclerosis and cancer," Guddat said.

Researchers said compounds that are already along the pipeline to drug discovery are preferred, as they can be further tested as antivirals at an accelerated rate compared to new drug leads that would have to go through this process from scratch.

"With continued and up-scaled efforts we are optimistic that new candidates can enter the COVID-19 drug discovery pipeline in the near future," Guddat said.

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News Network
January 6,2020

Sydney, Jan 6: Reserve troops fanned out across fire-ravaged regions in three Australian states on Monday after a horror weekend, as the government pledged $1.4 billion over two years to help recover from the devastating months-long crisis.

Catastrophic bushfires have turned swathes of land into smouldering, blackened hellscapes and destroyed an area about the size of the island of Ireland, according to official figures, with authorities warning the disaster still has weeks or months to run.

Prime Minister Scott Morrison, whose government has been criticised for its slow response to the emergency, pledged Australian $2 billion ($1.4 billion) of taxpayer money for a national recovery fund.

"It's a long road ahead and we will be with these communities every step of the way as they rebuild," Morrison said.

Firefighters joined by fresh teams from the US and Canada were taking advantage of rainy and cooler conditions to tackle out-of-control blazes ahead of rising temperatures forecast later this week.

In the biggest-ever call up of reserves, military teams were deployed across eastern Australia to help emergency services assess the damage, restore power and deliver supplies of food, water and fuel to cut-off communities.

For the first time in Australian history the government also deployed its medical assistance team, normally sent to other nations to lend support in the aftermath of their disasters to help evacuees.

"There is no room for complacency, especially as we have over 130 fires burning across (New South Wales) state still," Premier of New South Wales state Gladys Berejiklian said on Monday.

New normal

Almost five million hectares (50,000 square kilometres) have been razed across New South Wales and more than 1.2 million hectares in Victoria since late September, officials said.

That took the total amount of land burnt close to eight million hectares, around the size of the island of Ireland or South Carolina.

Twenty-four people have lost their lives so far, with over 1,800 homes damaged.

Two people are missing in New South Wales, the nation's most populous state.

In Victoria, Premier Daniel Andrews established a bushfire recovery agency to help devastated towns. It will be a permanent body, he said, as intense fires will become commonplace.

"We should just be honest about the fact that we're going to see more and more fires, more and more damage as each fire season comes... this is the new normal," Andrews told reporters.

The chair of the newly established Victoria state's bushfire appeal fund, Pat McNamara, added that this year's summer bushfire season was a "creeping disaster".

"We're still not even into what we would regard as the peak of the fire season," McNamara told national broadcaster ABC.

In the usually picturesque southeastern town of Eden, Holly Spence said she spent more than 12 hours defending her family's farm on Saturday, less than a week after saving it on New Year's Eve.

"We don't want to go through this for a third time," the 28-year-old told AFP.

Fiona Kennelly, 50, who evacuated with 24 members of her extended family to a motel outside Eden, said she was relieved the easing conditions allowed them to get some respite from the crisis.

"It's good to see daylight at the right time again," she told AFP, adding that the skies had been turning pitch-black in the afternoons.

Public anger

The impact of the bushfires has spread beyond affected communities, with heavy smoke engulfing the country's second-largest city Melbourne and the national capital Canberra.

Some government departments were shut in Canberra as the city's air quality was once-again ranked the world's poorest, according to independent online air-quality index monitor Air Visual.

The disaster has sparked growing public anger with Morrison. Rallies are planned on Friday to call on his government to step up efforts to tackle climate change, which experts say have helped fuel the fires.

In Los Angeles, Hollywood superstar Russell Crowe said he was back home fighting the fires and that the disaster was "climate change-based".

"We need to act on science, move our global workforce to renewable energy and respect our planet for the unique and amazing place it is. That way, we all have a future," he said in a message read out by Jennifer Aniston.

Australian actress Cate Blanchett praised the volunteer firefighters battling the blazes, adding: "When one country faces a climate disaster, we all face a climate disaster. We're in it together."

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Agencies
January 11,2020

New York, Jan 11: The United Nations Security Council (UNSC) on Friday renewed a six-year-long cross-border humanitarian aid deliveries mechanism into Syria.

According to Sputnik, the Security Council voted in favour of a resolution on Friday that allows cross border deliveries to be conducted via Turkey, preserving two checkpoints and excluding the Al-Yarubiyah border crossing with Iraq and the Al-Ramtha crossing with Jordan, until July 10, 2020.

Russia proposed to amend the adopted resolution by replacing a part of the draft which stipulates that humanitarian assistance into Syria should be delivered based on the principles of humanity, neutrality, impartiality and independence by the phrase that such aid should be provided "in accordance with the guiding principles of humanitarian emergency assistance, as contained in UNGA resolution 46/182."

The agreement was reached after Belgium and Germany decided to amend the original version of their joint resolution, which proposed keeping three points for cross-border deliveries into the Arab republic.

In December last year, the United Nations had said that over 235,000 people fled the Idlib region in the last two weeks after Russia and Syria launched airstrikes in a bid to take over the last major opposition bastion.

Russia backed Syria government launched a fresh assault to capture the province.

Syrian Bashar al-Assad regime, backed by Iran, has reportedly promised to take back the rebel-controlled area and broke a ceasefire that was announced in August.

They have since December 19 seized dozens of towns and villages from armed fighters amid clashes that have killed hundreds on both sides.

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