The Article of the Month of April – “Chloroquine, Quesaco?” – Dr. Poutet
Who hasn’t heard of chloroquine and Professor Raoult yet? Chloroquine is a molecule, as old as the world (I’m exaggerating just a little bit), known to all frequent travelers in the world, patients with lupus or rheumatoid arthritis…
A controversial comeback of chloroquine?
Professor Raoult, infectiologist and world-renowned specialist in emerging tropical infectious diseases, assures that a treatment with hydroxychloroquine + Azithromycin would make the viral load disappear within a few days in patients who are positive for Covid-19. It reduces the risk of deterioration of the general condition of the patient, provided that this treatment is started at an early stage, as soon as the first symptoms appear.
The controversy comes from the fact that Professor Raoult’s “studies” (1st study carried out on 24 patients, the last on 80 (27/03/2020)) present a certain number of biases:
- the low number of patients
- the absence of a group of patients taking a placebo, principle of a double-blind study *
There is also the open letter from Dr. Zev Zelenko who practices in the state of New York. He claims that after treating 500 patients based on hydroxychloroquine + Azithromycin + zinc sulfate (zinc slowing viral replication in the cell, hydroxychloroquine helps it to penetrate) there are no deaths, no hospitalizations, no intubation and that only 10% of patients would have transient side effects (nausea, diarrhea). This treatment requires medical monitoring and can in no case be taken in self-medication, more information here.
Geneticist Axel Khan estimates that Professor Raoult’s results are similar to known data showing 600,000 cases that have progressed in the same way, without treatment!
Others rely on the existence of 2 Chinese studies which show that 10 days after the onset of symptoms in patients with moderate disease, 90% have a controlled viral load, which would not seem to show a major effect of hydroxychloroquine on viral load.
It is clear that at all times in medicine, as elsewhere, such “controversies” have taken place! These allow medicine to move forward and in this climate of urgency, the debate will make it possible to find a solution faster for patients.
It seems to me essential that access to hydroxychloroquine and azithromycin remains reserved for primary care physicians (as is the case today in most of our hospitals).
Extensive European research (Discovery, cohort of 3,200 patients) has been underway since March 22nd. This clinical trial provides 5 modes of treatment given to patients by lot, including hydroxychloroquine. Hopefully the results of this test will come to us soon.
In the meantime, let’s not play the sorcerer’s apprentice with our Plaquenil supplies. Hydroxychloroquine looks promising, but let the specialists work with all the means necessary to combat this terrible scourge.
Take care of yourself and your loved ones. Stay home.
* A double-blind study is a way of verifying the effectiveness of a treatment or a substance, in which one or more groups of well-established subjects receive treatment on an experimental basis, without these subjects or the investigators themselves are not aware of the treatment received, to remove any a priori judgment.