Trump tweets support of hydroxychloroquine study; doctors warn against politicizing medicine

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A bottle and pills of Hydroxychloroquine sit on a counter at Rock Canyon Pharmacy in Provo, Utah, on May 20, 2020. - GEORGE FREY/AFP/Getty Images North America/TNS

DETROIT — Medicine shouldn’t be political, said Dr. Steven Kalkanis, Henry Ford Health System’s chief academic officer.

But the social media response to a study the Detroit-based health system published Thursday about the use of the anti-malarial drug hydroxychloroquine as a treatment for COVID-19 has become just that.

President Donald Trump took to Twitter Monday night, alleging Democrats disparaged the drug. But he pointed to the study of about 2,541 coronavirus patients hospitalized March 10-May 2 at Henry Ford’s six Michigan hospitals as proof that hydroxychloroquine, which also is used to treat some autoimmune disorders like lupus, saves the lives of COVID-19 patients.

“The highly respected Henry Ford Health System just reported, based on a large sampling, that HYDROXYCHLOROQUINE cut the death rate in certain sick patients very significantly,” Trump tweeted. “The Dems disparaged it for political reasons (me!). Disgraceful. Act now”

The Henry Ford study was published Thursday in the International Journal of Infectious Diseases and found that among 2,541 patients hospitalized between March 10 and May 2, 26% who did not receive hydroxychloroquine as part of early treatment died, compared with a 13% mortality rate among patients who were given hydroxychloroquine.

“We’re scientists, not politicians,” Kalkanis said. “We’ve never had a preconceived agenda with this study or any study regarding hydroxychloroquine. We simply wanted to use the resources and the opportunity of COVID, given that Detroit was such a hard-hit region, to find out which treatments worked and which treatment didn’t.

“So early on, we embarked on several different studies, and we wanted to let the data lead us to what is appropriate for patients. We stand behind the results of our study, we found that, you know, among 2,500 patients, the use of hydroxychloroquine cut the death rate in half.”

Trump has repeatedly touted hydroxychloroquine as a treatment for the coronavirus, often speaking about it during his White House task force briefings in April and May, despite a lack of research supporting his claims.

He even said he was taking the drug, hoping it would prevent him from contracting the virus.

People who use hydroxychloroquine to treat autoimmune disorders complained that Trump’s praise of the medicine to stave off or help people fight coronavirus put the drug in high demand and made it difficult for them to fill prescriptions.

Since then, several studies have been published that suggest hydroxychloroquine could cause heart rhythm problems in some patients and lead to worse outcomes for coronavirus patients.

On June 15, the U.S. Food and Drug Administration withdrew emergency use authorization of hydroxychloroquine and chloroquine to treat hospitalized COVID-19 patients who are not part of a clinical trial.

“We made this determination based on recent results from a large, randomized clinical trial in hospitalized patients that found these medicines showed no benefit for decreasing the likelihood of death or speeding recovery. This outcome was consistent with other new data, including those showing the suggested dosing for these medicines are unlikely to kill or inhibit the virus that causes COVID-19.”

The World Health Organization issued a statement Saturday, saying it was also abandoning the testing of hydroxychloroquine for hospitalized coronavirus patients, saying there was “little or no reduction in the mortality of hospitalized COVID-19 patients when compared to standard of care” but that there were some safety concerns.

Kalkanis said there’s no question that the outcome of the Henry Ford study contradicts some other research.

“We fully realize that our study differs from others that are out there, but I don’t think it’s necessarily a point-counterpoint conflict,” he said. “You have to look at the specifics of the patient population and who benefited, and that helps everybody figure out how best to use a drug and to offer hope to people.”

Kalkanis explained that the Henry Ford patients were given hydroxychloroquine earlier than those in other studies. They received the drug within a day or two of hospital admission, before the patients’ immune systems “launched what is called the cytokine storm, when the inflammatory process takes over,” he said.

“We actually screened patients for preexisting conditions like cardiac disease and monitored patients very closely, and also the dosing that we gave was quite different. A lot of studies gave the drug at much higher doses that had some side effects, whereas ours didn’t.”

And while it would have been ideal to conduct a randomized, controlled double-blind study, that simply wasn’t possible at the height of the coronavirus surge in metro Detroit, Kalkanis said.

“That absolutely is the gold standard,” he said. “But none of these studies that have been touted were randomized, controlled because it just was not simply possible to do in the surge of a pandemic where you had thousands of patients showing up near death, and needed treatment.”‘

What the discrepancies show, he said, is that more research is needed.

“Now that we have flattened the curve and we’ve gotten through that initial surge, we can step back and plan these more rigorous studies,” Kalkanis said.

“In medicine, we love criticism. It makes us better. We’re used to sort of a debate and a rigorous sort of discussion of the evidence whenever a paper comes out,” he said.

“I think in this climate when everyone is viewing comments through a political lens, it becomes more difficult.

“We continue at every turn to let the data speak for itself. Again, you know, people in healthcare don’t have preconceived agendas, we want to do what’s right for our patients and getting politics out of the way and making these resources and drugs available so that they can be used in a controlled setting so that we can get to an answer. That’s going to help everybody.”

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