Previously hailed by the former US president, Donald Trump, as a “miracle drug”, the anti-inflammatory was found to have “no meaningful effect” on preventing the spread of coronavirus – with the WHO’s Guideline Development Group (GDG) noting researchers should invest their time exploring more promising treatments.
The GDG, a panel of international experts, wrote in the British Medical Journal that their strong recommendation is based on high certainty evidence from six randomised controlled trials involving over 6,000 participants.
While three of the trials enrolled people who had a known exposure to someone with coronavirus, three others enrolled participants who were unaware if they had been in close proximity to an infected person.
According to the panel, high certainty evidence showed that hydroxychloroquine had no meaningful effect on preventing deaths and hospital admissions, while moderate certainty evidence showed that the drug had no meaningful effect on reducing the number of laboratory-confirmed Covid-19 infections.
It was also concluded, with moderate certainty, that the medicine probably increases the risk of adverse effects which would, ultimately, lead to its discontinuation.
Advising that the drug was no longer a “research priority”, the panel said factors such as resources, feasibility, acceptability and fairness for countries meant they were unlikely to change or withdraw their recommendation that it be shelved.
Previous studies have come to similar conclusions about hydroxychloroquine but this is the first time the WHO has given official guidance on its potential – and indeed the first time there has ever been a Covid-19 drugs guideline.
Back in June 2020, the first randomised study to assess if hydroxychloroquine had preventive measures against the virus found it was was no more effective than a placebo, a vitamin in this case, in preventing the virus.
“The take-home message for the general public is that if you’re exposed to someone with Covid-19, hydroxychloroquine is not an effective post-exposure, preventive therapy,” the lead author of the study, Dr David R Boulware, from the University of Minnesota, said at the time.
Another study, published in The Lancet medical journal, studied 96,000 hospitalised coronavirus patients at hundreds of hospitals across six continents. It found patients who used hydroxycholorquine, or its variant chloroquine, had a significantly higher risk of death than those who did not take the drug.
Mr Trump was heavily criticised last year for repeatedly promoting the “tremendous” drug’s use despite White House officials denying its efficacy.
Dr Anthony Fauci, America’s leading infectious disease expert, publicly rejected claims that the drug was effective as a treatment for the coronavirus – and assistant health secretary Dr Brett Giroir, who was leading the administration’s Covid-19 testing response at the time, told NBC in August that “evidence just does not show” the drug is “effective right now”.
Researchers in the US eventually conducted a trial about the cocktail of drugs Mr Trump touted as an “extremely successful” preventive remedy to catching Covid.
It was found that by taking his recommended dosage of both hydroxychloroquine and the antibiotic azithromycin, a patient’s chance of death increased by 27 per cent.
“There is already a great number of studies that have evaluated hydroxychloroquine alone or in combination and it seems unlikely at this stage that any efficacy will ever emerge,” wrote the study’s authors in the journal Clinical Microbiology and Infection. “Our results suggest that there is no need for further studies evaluating these molecules.”
The new WHO guideline hopes to quash the spread of misinformation as more recommendations for other Covid preventive drugs are added when evidence becomes available.