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What's Behind The Push To Test Anti-Malaria Drug As A COVID-19 Treatment?

Photo of a doctor holding a prescription of hydroxychloroquine.
Hydoxychloroquine is most commonly used to treat or prevent malaria, but it’s also used for auto-immune diseases like lupus and rheumatoid arthritis. Recently it's been discussed as a potential treatment for COVID-19, but experts are skeptical.";

Updated 1:31 p.m. MDT 4/22/2020

The anti-malaria medication hydroxychloroquine has entered center-stage in the conversation about the coronavirus crisis. President Donald Trump is touting it, health providers are testing it, and experts say it most likely won’t work as a COVID-19 treatment. With so much information and contradiction, here is a breakdown of what the medication is, how it’s being studied and where Utah and federal officials stand on the drug as it relates to COVID-19.

What is hydroxychloroquine and what is it used for? 

Its scientific name is hydroxychloroquine sulfate, but it’s also known by the brand name Plaquenil. Its most common use is to treat or prevent malaria, but it’s also used for auto-immune diseases like lupus and rheumatoid arthritis. If prescribed, the drug is taken by mouth and usually with food. 

The most common side effects are nausea and stomach pain according to the U.S. Food and Drug Administration. But some people who have self-medicated with hydroxychloroquine have died or experienced extreme side effects from taking too large of doses. 

Who’s studying this as a COVID-19 treatment? How are they studying it?

On April 8, Intermountain Healthcare and University of Utah Health announced they would begin testing the effectiveness of this drug on 2,300 high risk COVID-19 patients. 

But the FDA hasn’t approved hydroxychloroquine as a treatment for COVID-19, it’s only been authorized for emergency use. In fact, the FDA still defines it as “experimental” when being used against the novel coronavirus. 

Why do some people say it might help COVID-19 patients?

Some small studies have found that hydroxychloroquine could be effective as an antiviral, according to an article published in The Lancet, an academic journal. Some common antivirals are Tamiflu and Relenza. They work by stopping the virus from taking over a cell. 

But the few studies into hydroxychloroquine’s effectiveness against COVID-19 have been small, and it has proven ineffective as a treatment in humans for other viruses like influenza.

But is it safe or effective?

That’s the big question researchers and federal agencies are trying to answer. So far, there is limited evidence that hydroxychloroquine actually works for people for people with COVID-19. 

The National Institutes of Health COVID-19 treatment panel has also recommended against using the combination of hydroxychloroquine and azithromycin.

People should not use hydroxychloroquine as a treatment unless instructed to do so by a healthcare provider.

And how do Utah health officials view this?

Utah lawmakers passed a bill during the April special session that would amend the state’s “right to try” act. In a major public health emergency, like the coronavirus pandemic, it would provide immunity to health care providers who treat their patients with an “investigational” drug. 

Utah health officials are also looking into buying enough of the drug to treat 200,000 patients. The cost would be covered with state and federal money but as of April 22 a price hasn’t been determined.

This could open the door for hydroxychloroquine to be used on patients as a means to treat COVID-19.

Angela Dunn, the state’s epidemiologist, has also said the decision to treat COVID-19 patients with this drug will have to be made privately between the patient and their healthcare provider and on a case-by-case basis. She said the state will not restrict access to it. 

In March, the Utah Medical Association forwarded to its members a recommendation from the state’s Department of Health regarding dosages for hydroxychloroquine. On March 31, the health department rescinded that recommendation.

Correction 5:58 p.m. MDT 4/20/2020:An earlier version of this story cited the wrong group as the source of the recommendation on hydroxychloroquine dosage. The Utah Department of Health made the recommendation, which was distributed by the Utah Medical Association to its membership. That recommendation was later rescinded.

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