New York, May 29 Researchers have found a surge in the prescription of anti-malarial drug hydroxychloroquine (HCQ) and chloroquine during the COVID-19 pandemic in the US. Published in the journal JAMA, the study found prescriptions of the drug chloroquine and its analogue hydroxychloroquine dramatically surged during the week of March 15, likely due to off-label prescriptions for COVID-19.
“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,” said study author Haider Warraich from Brigham and Women’s Hospital in the US.
“This analysis doesn’t include patients who were prescribed HCQ in a hospital setting — this means that patients could have been taking the drugs at home, without supervision or monitoring for side effects,” Warraich added.
For the current analysis, the research team looked at prescribing patterns for HCQ/chloroquine as well as many other commonly prescribed drugs. These included angiotensin-converting-enzyme-inhibitors (ACEi) and angiotensin-receptor blockers (ARBs), both of which are prescribed for patients with hypertension or heart failure, as well as the antibiotic azithromycin. The team compared the number of filled prescriptions for each drug to the number of prescriptions filled last year over a 10-week period from February 16 to April 25.
The team found that fills for all drugs, except the antibiotic amoxicillin and the pain reliever combination of hydrocodone or acetaminophen, peaked during the week of March 15 to March 21, followed by subsequent declines.
During this week, HCQ/chloroquine fills for 28 tablets increased from 2,208 prescriptions in 2019 to 45,858 prescriptions in 2020 (an increase of more than 2,000 per cent). Over the full 10 weeks, there were close to half a million excess fills of hydroxychloroquine/chloroquine in 2020 compared to the year before.
In contrast, prescriptions for antibiotics such as amoxicillin and azithromycin and for hydrocodone/acetaminophen declined. After the surge in prescriptions, the authors observed a reduction in longer-term prescription fills for HCQ/chloroquine, which could indicate decreased availability of the drug for patients with systemic lupus erythematosus and rheumatoid arthritis. The US Food and Drug Administration reported a drug shortage of hydroxychloroquine starting March 31.
“During this pandemic, there has been both good information and misinformation about benefits and potential harms of common medications like hydroxychloroquine, and there had been conjecture that proven medications for heart failure may be harmful in this patient population,” said Warraich.
Meanwhile, Tedros Adhanom Ghebreyesus, the World Health Organization’s (WHO) Director-General, on Tuesday said that a clinical trial of hydroxychloroquine (HCQ) on COVID-19 patients has come to “a temporary pause”, while the safety data of the anti-malaria drug was being reviewed.
According to the WHO chief, The Lancet medical journal on May 22 had published an observational study on HCQ and chloroquine and its effects on COVID-19 patients that have been hospitalised.
The authors of the study reported that among patients receiving the drug, when used alone or with a macrolide, they estimated a higher mortality rate. As of Friday morning, the US has 1,721,479 confirmed cases and 101,573 deaths, both tallies accounting for the highest in the world, according to the Johns Hopkins University.