What to Know About That New Hydroxychloroquine Study

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Illustration for article titled What to Know About That New Hydroxychloroquine Study [Updated]

Editor’s note: This article originally described a study, published on May 22, which was then retracted on June 5th, due to concerns about the integrity of the dataset used by researchers. The retraction letter can be found on the Lancet’s website. 

These past few months, there has been an intense debate over the drug hydroxychloroquine, which has been touted as a miracle treatment for COVID-19. The hype over the drug has come in spite of a lack of strong evidence showing that it works effectively against COVID-19, as well as concerns about serious side effects.

Chloroquine and its related drug hydroxychloroquine, best known as anti-malarial medications, also have uses in treating autoimmune conditions such as lupus. Both drugs are known to have toxicity problems. The hype surrounding hydroxychloroquine started with a preprint released in March that suggested it could be an effective treatment for COVID-19.

The study was retracted due to concerns over its dataset

A large-scale study looking at patients treated with hydroxychloroquine, published on May 22 in the medical journal the Lancet, was retracted on June 5. This retracted study looked at 96,032 patients from 671 hospitals, all of whom were hospitalized between Dec 20, 2019 and April 14, 2020. Of these patients, 14,888 were part of different treatment groups, while the remaining 81,144 patients served as the control group.

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In the retraction letter, the authors wrote that they were unable to verify the dataset they used, which meant “reviewers were not able to conduct an independent and private peer review,” and therefore the authors could “no longer vouch for the veracity of the primary data sources.”

This retraction is an unfortunate turn of events in an already murky subject. However, it should still be noted that this retraction still doesn’t mean we have evidence that hydroxychloroquine is either safe or effective for treating COVID-19. The original concerns about its safety, as well as its efficacy, still stand.

Lack of evidence hasn’t prevented hype

In a world that made sense, the lack of evidence would be enough to stop all of the talk of hydroxychloroquine as a treatment for COVID-19. However, that is not the world we live in, and we likely haven’t heard the last of this drug.

The evidence for the efficacy of hydroxychloroquine at treating COVID-19 has always been slim at best. The earliest study that suggested it might yield benefits was problematic, as it was small and excluded patients in the study who became critically ill or died. Since this early study, many more experts have voiced their concerns, including the Food and Drug Administration, which cautioned against using chloroquine or hydroxychloroquine outside of a hospital or clinical trial setting. Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease, also stressed that the evidence supporting its use was only anecdotal.

Even given all these concerns, hydroxychloroquine has still been touted as a wonder drug, hype that has no doubt contributed to reports of hydroxychloroquine shortages affecting patients who need it to treat conditions such as lupus or rheumatoid arthritis; a news story about a couple in Arizona becoming deathly ill from eating fish food containing chloroquine phosphate; a lockdown protestor verbally abusing a TV reporter, saying “No, I got hydroxychloroquine, I’m fine”; and, on May 18, President Trump’s announcement that he was taking daily doses of hydroxychloroquine. As with so many issues, the idea of hydroxychloroquine as a cure for COVID-19 has taken on a life of its own in a way that is very hard to counteract.

We still need more evidence

Although by now the fact that there is still a debate over using hydroxychloroquine may not make much sense to people who have been closely following the controversy, to someone who hasn’t been, the back-and-forth is confusing at best, and alarming at worst.

For those who are still undecided about the issue, this latest study is yet another source of confusion. However, even in the midst of this confusion, it is still really important to remember that there is still no evidence hydroxychloroquine is a safe and effective treatment for COVID-19.

Editor’s note: This article was updated on 06/16/2020, to include the retraction of the study published on May 22.