The American Medical Association (AMA) has reversed its initial stance against hydroxychloroquine (HCQ) to treat COVID-19. The association’s reversal now permits physicians to prescribe the medicine at their discretion to address coronavirus infections. Previously, the association dissuaded its member physicians from recommending the drug to their patients with COVID-19.
A recent AMA memorandum released Oct. 30 made the reversal official: “[AMA rescinds] its statement calling for physicians to stop prescribing hydroxychloroquine and chloroquine until sufficient evidence becomes available to illustrate that the harm associated with use outweighs benefits early in the disease course.”
The same memorandum also updated a March joint statement discouraging the use of HCQ. Patients will now be notified that “further studies are ongoing” to determine any potential benefit from the medication and other combination therapies against COVID-19. Lastly, the document reassured patients that AMA supports physicians that prescribe HCQ and other combination therapies “if it is in [their] best clinical judgment.”
AMA previously cautioned in March about prescribing or dispensing medications identified as “potential treatments or prophylaxis for COVID-19” such as HCQ and azithromycin, in light of entities stockpiling these medicines for future COVID-19 use. The physicians’ association “strongly opposes these actions that can lead to supply disruptions for patients who need these medicines for chronic conditions” in its statement. It also reiterated that “no medication has been … [approved] for use in COVID-19 patients.” (Related: Hospitalizations drop by 84 percent in patients treated with HCQ, study shows.)
Meanwhile, the Food and Drug Administration (FDA) previously authorized HCQ for emergency use in late March, but revoked it in June as it was “unlikely to be effective in treating COVID-19.” It elaborated that side effects such as “serious cardiac adverse events” outweighed the potential benefits of HCQ, which no longer satisfied the requirements for emergency approval.
Some drug companies are blocking the use of HCQ in favor of the less-effective remdesivir
President Donald Trump himself espoused the effects of HCQ against COVID-19 infections, tweeting that the drug combined with azithromycin “have a real chance to be one of the biggest game-changers in the history of medicine.” However, he himself did not receive the drug when he contracted the coronavirus in early October. Doctors at the Walter Reed National Military Medical Center gave the president the antiviral drug remdesivir and the steroid dexamethasone, alongside a polyclonal antibody cocktail.
The FDA first granted remdesivir emergency approval in May initially for severe cases, but eventually expanded the approval to include all patients. However, a study by the World Health Organization (WHO) found that remdesivir did not lower COVID-19 mortality rates. Of the more than 2,700 patients administered with the antiviral drug, 11 percent eventually died: A control group with almost the same number registered an 11.2 percent mortality rate. The study’s authors wrote that their findings “absolutely excludes the suggestion that remdesivir can prevent a substantial fraction of all deaths.” (Related: Remdesivir shows “limited benefit” during trial, so why did the FDA approve it?)
Gilead did not take too kindly to the WHO study, expressing its concern through a statement saying the trials “have not undergone the rigorous review required to allow for constructive scientific discussion. The company nevertheless assured procurement agencies such as the United Nations that remdesivir has met “global standards of quality, safety and efficacy.”
Originally used to cure malaria, HCQ gained attention as a COVID-19 treatment after French physician Dr. Didier Raoult used it in combination with azithromycin to treat his patients. Raoult’s success spread like wildfire, eventually catching the attention of Gilead. The company subsequently lobbied France to severely restrict access to HCQ.