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Controversial COVID-19 treatment touted by Trump to be tested in Alberta

Albertans who have been exposed to the coronavirus are being asked to join a clinical trial into the effectiveness of hydroxychloroquine, an anti-viral drug that’s been used for decades to treat malaria and some auto-immune diseases.

It’s one of the drugs that U.S. President Donald Trump has touted as a “game changer.”

Albertans who have been exposed to COVID-19 will form one part of the study, while those who have tested positive for the disease are being asked to join a separate trial.

Researchers are hoping to recruit as many as 600 people across the province.

“For now, this is going to be for people living with somebody who’s known to be COVID positive or somebody who’s a health-care worker that’s been looking after someone who’s known to be positive,” said Dr. Ilan Schwartz, an associate professor of infectious disease at the University of Alberta’s faculty of medicine.

The study is being led by McGill University with participants from Quebec, Manitoba and Alberta expected to include as many as 1,500 people from Canada. Another 1,500 people are enrolled in a similar study in the United States.

At a time of physical distancing, participants will have no contact with medical researchers conducting the study. It means that more Albertans who live outside Calgary and Edmonton and away from the province’s major universities will be able to participate.

Anyone who’s been exposed to the virus is being asked to visit COVID-19research.ca to see if they qualify for the study. If accepted, they’ll receive a five-day course of either hydroxychloroquine or a placebo.

“We’re going to be giving medication to people after they’ve been exposed and possibly infected to see if we can prevent that infection from taking hold,” said Schwartz.

“No medication has proven to be effective in either preventing or treating COVID-19. And that’s why we need to do these studies.”

Evidence lacking

The head of the department of microbiology, immunology and infectious disease at the University of Calgary’s Cumming school of medicine says the results from three, small studies into the effectiveness of hydroxychloroquine as a treatment for COVID-19 have been mixed.

Two studies showed positive results, while the third was negative.

Dr. Chris Mody says the three trials involved a total of 120 patients and their outcomes following a six-day course of hydroxychloroquine (HCQ).

One of the trials showed virtually no difference between those who took the drug and those who didn’t. Another trial showed more people who took HCQ recovered from pneumonia compared with those who received the usual care.

The third trial showed more people who didn’t take HCQ converted from a positive test for COVID-19 to a negative one.

“I wouldn’t say on the basis of that number of patients and two trials that look positive and one that looks negative, that we should be using hydroxychloroquine as the standard of care,” said Mody.

“I would describe the evidence for hydroxychloroquine is that it indicates it should be studied further. That’s about as far as I would go with the evidence there.”

Controversy, warnings, hoarding

HCQ has received a lot of attention since President Trump touted it as a “game changer” in a tweet last month.

He suggested hydroxychloroquine along with azithromycin, an anti-biotic used to treat bacterial pneumonia, would change the world of medicine.

Since the March 21 tweet, a number of people have expressed enthusiasm for the still-unproven claims.

Alberta talk radio host Danielle Smith apologized and deleted a tweet that claimed HCQ cured 100 per cent of coronavirus patients within six days of treatment.

Kathy Macdonald, a University of Calgary senator, said in a recent tweet that HCQ is “the most effective drug!” while retweeting an article that suggested physicians shared the same view.

The University of Calgary distanced itself from Macdonald’s tweet.

“The University of Calgary is committed to developing solutions that are evidence-based and backed by scientific rigour. The views expressed were posted on a personal social media account and do not reflect those of the University of Calgary. We encourage Albertans to look to Alberta Health Services for guidance on best practices in the rapidly-evolving COVID-19 situation.

In a separate tweet, Macdonald questioned why the Alberta government has such a narrow view on potential remedies. Both tweets have since been deleted.

In a statement to the CBC, Alberta Health said in part: “While different research projects are underway to assess the effectiveness of various therapies, there is no robust evidence yet on any treatment. We are closely monitoring the emerging evidence across Canada and around the world. If that changes, we will alert Albertans and take action accordingly.”

However, the ministry acknowledged that more information regarding research studies will be made available as early as this week.

“We know that many Albertan physicians are interested in enrolling patients in research studies underway on experimental therapies,” it said in a statement. “We will be sending information out in the coming days so physicians who want their patients to have access to these therapies can put them in touch with the appropriate people.”

There’s also been concern about the supply of HCQ since it’s been touted as a possible treatment for COVID-19.

The governing bodies for Alberta’s physicians and pharmacists issued a joint warning about prescribing behaviours, misuse and stockpiling of the drugs.

The College of Physicians and Surgeons of Alberta and the Alberta College of Pharmacy said there are “serious concerns about shortages” that could affect patients with chronic conditions who rely on the drugs.

Schwartz says all of the headlines around HCQ and some of the other drugs is a concern, and that it’s important for the research to get underway to safely monitor patients who qualify for the trials.

“We want to avoid people taking this medication until it is proven to be both safe and effective for this purpose,” he said.

Health Canada says so far eight clinical trials have been approved.

Schwartz says just as fast as the COVID-19 pandemic evolves, they’re hoping to get preliminary results from their trials in a matter of weeks.

CBC

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