- Dec 12, 2018
A panel of experts convened by the National Institute of Allergy and Infectious Diseases recommends against doctors using a combination of hydroxychloroquine and azithromycin for the treatment of COVID-19 patients because of potential toxicities.
"The combination of hydroxychloroquine and azithromycin was associated with QTc prolongation in patients with COVID-19," the panel said.
QTc prolongation increases the risk of sudden cardiac death.
The recommendation against their combined use would seem to fly in the face of comments made by President Trump suggesting the combination might be helpful. On March 21, for example, the president described them in a tweet as having a "real chance to be one of the biggest game changers in the history of medicine."
As for using the use of hydroxychloroquine or chloroquine alone, the panel said there was "insufficient clinical data to recommend either for or against." It reached the same conclusion about the drug remdesivir.
The expert panel, convened by the NIH Institute that Dr. Anthony Fauci directs, produced a set of guidelines for doctors to use in treating COVID-19 patients. The panelists come from a variety of health care disciplines. For the most part, the guidelines are agnostic about the use of experimental medications, pointing out that strong scientific evidence is lacking to make a firm conclusion one way or the other.
But occasionally, there are recommendations explicitly against certain therapies. For example, the panel recommended against using Lopinavir/ritonavir or other HIV protease inhibitors because of negative clinical trial data. It also recommended against using interferon because it seemed to make patients with SARS and MERS worse. Those diseases are caused by a coronavirus related to the one causing COVID-19.
The panel also concluded that there was insufficient evidence to recommend any kind of treatment either to prevent infection with the coronavirus or to prevent the progression of symptoms in those who are already infectious. That recommendation could change based on clinical trials presently underway.
NIH Panel Recommends Against Drug Combination Promoted By Trump For COVID-19
The group of experts, assembled under the agency run by Dr. Anthony Fauci, warns that using a combination of hydroxychloroquine and azithromycin could result in potential toxicities.