Coronavirus: Jordan begins uncontrolled hydroxychloroquine trial

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Hind Al Soulia - Riyadh - Jordan is among the first countries to use controversial anti-malarial drug hydroxychloroquine to treat patients with coronavirus.

Patients began receiving treatment officially on Sunday, said Dr Natheer Obeidat, head of the Jordanian Health Ministry’s National Committee for Epidemics.

“We’ve received approval from the Jordan Food and Drug Administration (JFDA) and the National Committee for Epidemiology, so the Committee for Epidemics agreed to use hydroxychloroquine in the form of a clinical trial,” said Dr Obeidat.

“Patients are given a 400g dosage in tablet form on the first day and then a 200g dose for nine days after that.”

Hydroxychloroquine is a long-standing malaria treatment. However, its use as a treatment for coronavirus has been the topic of hot debate in recent days after US President Donald backed its use, despite contradictory advice from top health officials.

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Speaking during the same address on March 20, Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said the evidence of hydroxychloroquine’s use against Covid-19 was thin and anecdotal.

He added: “What we don’t know is, when you put it in the context of another disease, whether it’s safe.”

In Nigeria, two cases of chloroquine poisoning were reported over the weekend as a result of self-medicating.

Hydroxychloroquine is most commonly associated with the brand name Plaquenil produced by French pharmaceutical company Sanofi.

An internal memo leaked to The National from Sanofi states “to date there is insufficient clinical data to draw any final conclusions over the clinical efficacy or safety of hydroxychloroquine or chloroquine in the management of Covid-19”.

However, it said “in view of encouraging results [of] the pilot study” it would be supporting the French health authorities to further investigate the use of the drug for coronavirus cases.

A World Health Organisation representative said it had “no evidence” that any particular drug is effective in the treatment of coronavirus.

She said: “Most cases are mild and self-limiting, and treated symptomatically. Some patients progress to severe and critical illness and require supportive care interventions, such as oxygen and ventilation.

“WHO is awaiting the outcome of many clinical trials undertaken by different countries or universities.”

Dr Obeidat acknowledged the lack of research when used to treat coronavirus but said he was confident the anti-malarial was safe to use in this context.

All patients will be given the drug, which means the trial will not be controlled, making it difficult to assess the efficacy of the drug. However, the committee felt it unethical to only give some patients the treatment, said Dr Obeidat.

A statement from the Jordan Food and Drug Administration said the use of hydroxychloroquine treatment will be in accordance with protocol, and patients administered the drug would be closely monitored for effectiveness and side effects.

It also stressed not to use the drug as a preventative treatment nor without medical supervision, adding that avoiding contact is the best preventative measure.

The latest confirmed cases of coronavirus in Jordan bring the total up to 112. Of those numbers, one woman, aged 83, is in intensive care and eight patients have pneumonia but are not considered serious.

* Additional reporting by Asmahan Bkerat

Updated: March 23, 2020 12:54 PM

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