A study on hydroxychloroquine, known as the drug of malaria, used in the treatment of Covid-19, was stopped by the World Health Organization. The risk of the drug causing side effects such as heart attack was also shown by suspending this research. In addition to malaria, the use of this drug in immune system diseases such as lupus and rheumatoid arthritis has caused concern in patients. Prof. dr. İsmail Balık “The inclusion of advanced stage patients in the study overshadows the decision. He shared important information, saying there is not enough evidence to completely remove this drug from Covid-19 treatment.
Prof. dr. Balık said, “The study, which was conducted by WHO's own organization and published in the respected medical journal Lancet, was conducted on 6 patients in 671 hospitals on 96 continents. While 32 thousand 14 of the cases included in the study were receiving hydroxychloroquine treatment, 888 thousand 81 of them were followed as the control group. However, this study has been found problematic in many respects by the scientific world. It did not satisfy those who approached the drug objectively.
Pointing out that the first use of hydroxychloroquine, also known as the malaria drug, in the treatment of Covid began in China, where the epidemic first appeared, Prof. Dr. Fish said, “Since the studies conducted in China and France at the beginning of the epidemic suggested that this drug was effective in treatment, it became the most widely used drug all over the world. In order for a drug to be used in a disease, it must prove itself in terms of both efficacy and side effects.
This can only happen with the randomized controlled trial type with the highest evidence value of any clinical trial type. Unfortunately, there is no such study on malaria medication in Covid-19 treatment yet. Therefore, we still cannot be certain about the effectiveness or side effects of this drug.
WHO suspended the drug because it could be risky in the treatment of Covid-19, but this drug is used in many other diseases. "This decision does not mean that the use of the drug in malaria and other rheumatic diseases is stopped."
'Many patients applied to us with panic'
Explaining that after this decision of WHO, many patients who took the drug came to them in a panic and started to ask about the risks. Dr. Explaining that there are even patients who want to quit his medication, Balık also mentioned the criticisms made to the decision of WHO:
“This drug is well known since the 1950s and has been used safely in diseases of the immune system such as malaria and lupus and rheumatoid arthritis. When used in these diseases, the rate of cardiac side effects (such as heart attack) is extremely low. This is one of the aspects of WHO's work that creates a question mark. The risk of heart in corona virus patients may be increasing in the advanced stages of the disease, when the heart is also involved. More work needs to be done to know this.
At least, randomized controlled trials can be performed in cases that are not serious and have no heart risk. WHO could have continued this research, which was published in the Lancet, by removing patients at high risk for hydroxychloroquine. Because the whole world wants to know whether this drug works in Covid, or at what stage and in which type of patients it can be used. Contrary to ours, the drug is usually given to patients in many countries when their condition worsens, and this situation is not adequately examined in the study. For this reason, it is emphasized that it would not be surprising that the mortality rate in patients receiving treatment was higher than the group who did not take the drug.
'The most fastidious country is used even in England'
Explaining that malaria medication is used in the treatment of Covid in many countries of the world, and approximately 200 researches are ongoing in the world on this subject. Dr. Stating that even England, one of the most rigorous countries in drug research, does not care about the risk of hydroxychloroquine side effects claimed by WHO, Balık said:
“There is a large randomized controlled trial on this drug led by the University of Oxford: the PRINCIPLE study.
In this study, hydroxychloroquine is used in mild cases of Covid, people aged 50-65 who are in the risk group with an underlying disease, and people over the age of 65 who do not have an underlying disease, and also in patients who are followed up by family physicians outside the hospital.
While the UK allows such a study as well as the use of the drug out of hospital, WHO suspends its studies of hydrochloroquine due to heart risk is viewed with suspicion.
So why didn't the same WHO put a reservation on the use of the drug in malaria? Why did the WHO suddenly ignore the possibility that an inexpensive and easily accessible drug such as hydroxychloroquine, which is on the essential drugs list, might work? These are all questions waiting to be answered. "
treatment protocol in Turkey gave one of the best '
In the process of the pandemic, many things that do better than the world and moreover write an email hydroxychloroquine therapy in most countries that use the protocol to the scientific world about the drug's efficacy and safety in Turkey is describing the condition of making a broadcast Prof. Dr. İsmail Balık ended his words as follows: “We have become one of the countries that manage the treatment process best, thanks to our Covid-19 treatment guide, which was created by the common mind in the scientific board and is constantly updated.
By rapidly changing the guideline, we started using Favipiravir and hydroxychloroquine in the early stage of the infection. After that, the rates of intensive care and mortality decreased rapidly. We will be able to see all these more clearly with a scientific publication.
Of course, caution is required about this drug, but more research and definitive evidence are needed to make a definitive decision. When we look at the available data, it seems that it will be beneficial to start Covid-19 treatment early and to try combined therapies. (Milliyet)
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