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Hydroxychloroquine: What we know, what we don't know

Some studies are showing benefit, some show harm, and most show no benefit one way or the other

HARTFORD, Conn — Hydroxychloroquine might be the most controversial drug in the country right now, especially after the president said he took some to try to prevent Covid-19, but even before then, the debate over the drug has led to a lot of public relations spin by both supporters of the drug, and critics of the president.

Doctor Michael White of the UConn School of Pharmacy knows the drug well, he was part of a group that just finished a comprehensive review of studies on hydroxychloroquine. He said the interest in the drug was understandable, especially given the urgency of the situation.

“One of the things that was really attractive about it was that it was relatively inexpensive and manufacturers were already making it so the chance that they would be able to gear up and have adequate supply of the drug, over a relatively short period of time, was high,” he said.

However, that advantage only works if the drug works. Dr. White said many small studies were done on patients very sick with Covid-19, and to say they were inconclusive was an understatement.

“If you focus on the controlled studies, the ones that some people got hydroxychloroquine and then other people who were in a similar hospital in a similar circumstance did not get hydroxychloroquine, what you see is that the studies are all over the place. Some studies are showing benefit, some studies are showing harm, and then some studies, actually most of the studies for the endpoints that they’re looking at show no benefit one way or the other,” said Dr. White, “and then, on top of that, the methods that they’re using are really, really bad.”

He said, on top of being poorly constructed, those were studies on single cells, which have limited value.

“Those things don’t always pan out when you look at human studies, though, so it gives you an initial lead, something to start with,” Dr. White said.

Doctor white said there are currently no studies as to whether hydroxychloroquine can prevent Covid-19, which is why the president said he was taking it.

What about the risks? Doctor White said the possibility of cardiac arrhythmias and other problems is there, especially at higher doses, but many people are exaggerating those probabilities as well.

“So if somebody comes up to you now and they say, ‘I know hydroxycholoroquine is great and that everyone should be taking it,’ they either don’t know what they're talking about or they're lying,” he said.

“If somebody says that hydroxychloroquine does not work, that they know it doesn’t work, and that it will kill everyone who takes it, they’re also either lying to you or they’re misinformed,” Dr. White said.