In recent weeks there’s been a huge amount of attention being given to the drugs hydroxychloroquine and azithromycin. A study published last week, April 9th 2020, on 1,061 patients that were treated early on in the course of their illness with these two drugs, led to some profound conclusions. The study was conducted by French researcher Dr. Didier Raoult, a well respected but controversial French M.D. The study followed on from a smaller study with a cohort of twenty patients that yielded similar results, which are referred to in the graph below.
The data released showed that:
- 92% had excellent outcomes.
- Ten patients out of the 1,061 patients had to go to ICU.
- 4% of the patients treated had persistent virus beyond the ten day treatment window determined as the cut-off by the researchers regarding whether to attribute success or not.
- 4% had a poor outcome defined as extending their hospital stay beyond the ten days.
- Five patients died.
Results concluded by the researchers established that:
- The treatment was considered safe with no side effects. This is relevant as I’ve used both these drugs for many years in the treatment of chronic Lyme disease and have never seen any side effects for either of them besides nausea from azithromycin, especially if not taken with a full meal. Hydroxychloroquine use requires a six-month ophthalmology checkup to look for retinal changes, which is far beyond the timeline required for the treatment of Covid-19. I should point out that I have never seen these retinal changes in patients on long-term hydroxychloroquine use. The potential retinal damage is related to length of use and dosage. In addition, cardiomyopathy (an enlarged heart) has been detected in a few patients treated with hydroxychloroquine.i ii
- The amount of hydroxychloroquine in a patient’s blood correlated with the success of their outcome. Different absorption rates for different patients was a consideration.
- Some blood pressure medication was associated with much poorer outcomes. ACE inhibitors (angiotensin converting enzyme inhibitors) iii were considered to lead to poorer outcomes while ARB (angiotensin II receptor blockers) ivusers had a better outcome. I’ll be discussing these two drugs in a later post.
- These results were seen to be promising and have resulted in the NIH preparing to begin a 500-person trial
Dr. Raoult did emphasize the importance of excluding cardiac issues before commencing the studies. Dr. Raoult has spoken out strongly about the “dictatorship of the methodologists” that insist on first-class or gold standard research trials, which are randomized and with control groups, before applying the science. He believes it’s inhumane to subject patients to control arms when there’s clear evidence that the treatment would benefit the patients. v
The details of the study
- Patients with COVID-19 infection were treated with hydroxychloroquine and azithromycin.
- Plaquenil 200mg was given three times per day for ten days and azithromycin 250mg was given for five days, twice the first day then once for the next four days.
- In order to avoid cardiac problems, an ECG was performed before starting treatment.
- A low-dose CT scan was also performed to assess any potential lung damage.
- The evaluation of the virologic effect was done with PCR blood test before inclusion.
- The quantification of the viral load was conducted on a nasopharyngeal sample.
- A PCR blood test was repeated on day five to verify that the virus was undetectable or at levels too low to present a contagious risk. This test can detect pieces of viral DNA of the actual virus, although one can’t say if the viral tissue is alive or dead, only that a piece of the virus is in your body.
These drugs are presently unavailable to most pharmacies and are only available to chronic autoimmune patients, who are on them for long-term use. Directives from health authorities in Canada have discouraged prescribing any of the recent popular drugs put forward as potential treatment for Covid-19 with the warning that there are no treatments currently available to treat Covid-19 and that we, as M.Ds, must be cognizant of evidence-based prescribing for recognized conditions. Included in the list of drugs that shouldn’t be currently subscribed were hydroxychloroquine, chloroquine, remdesivir, lopinavir/ritonavir, colchicine, and azithromycin)
Read official documents here:vi
- Presentation of the study: https://www.youtube.com/watch?v=ydcrROJFEU0
- An earlier paper involving only twenty patients published in March 2020 in the International Journal of Antimicrobial Agents featured the following graph: https://www.mediterranee-infection.com/hydroxychloroquine-and-azithromycin-as-a-treatment-of-covid-19/
Disclaimer: Do not take these medications without the guidance of a doctor.
iii Examples of ACE inhibitors include: Accupril (quinapril), Aceon (perindopril, Altace (ramipril), Capoten (captopril), Lotensin (benazepril), Mavik (trandolapril), Monopril (fosinopril), Prinivil, Zestril (lisinopril)
iv The ARBs that are currently available are: azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), telmisartan (Micardis), valsartan (Diovan, Prexxartan), losartan (Cozaar), olmesartan (Benicar)
v Is France’s president fueling the hype over an (Science Mag) unproven coronavirus treatment
vi www.doctoroz.com The Dr. Oz Show Medical Unit
Dr. Bruce Hoffman, MSc, MBChB, FAARM, IFMCP is a Calgary-based Integrative and Functional medicine practitioner. He is the medical director at the Hoffman Centre for Integrative Medicine and The Brain Centre of Alberta specializing in complex medical conditions. He was born in South Africa and obtained his medical degree from the University of Cape Town. He is a certified Functional Medicine Practitioner (IFM), is board certified with a fellowship in anti-aging (hormones) and regenerative medicine (A4M), a certified Shoemaker Mold Treatment Protocol Practitioner (CIRS) and ILADS trained in the treatment of Lyme disease and co-infections. He is the co-author of a recent paper published by Dr. Afrin’s group: Diagnosis of mast cell activation syndrome: a global “consensus-2”. Read more about Dr. Bruce Hoffman.