NEW YORK — A task force led by the American Thoracic Society in New York has temporarily endorsed using hydroxychloroquine for hospitalized coronavirus patients with “severe pneumonia.”
The group stressed the recommendation applies only to hospitalized patients where the “clinical condition is sufficiently severe to warrant investigational therapy.”
And the endorsement applies only to cases where the patient can be informed of the malaria drug’s possibly lethal side effects, the task force said.
The group further warned its recommendation would not apply in the event of a “shortage of drug supply.”
Hydroxychloroquine is regularly prescribed to treat patients with lupus and rheumatoid arthritis.
The American Medical Association and pharmacists’ groups recently released a joint statement warning about a possible run on the medication due to unnecessary prescriptions and bulk orders related to COVID-19.
“Stockpiling these medications — or depleting supplies with excessive, anticipatory orders — can have grave consequences for patients with conditions such as lupus or rheumatoid arthritis if the drugs are not available in the community,” the joint statement said.
“Being just stewards of limited resources is essential,” it said.
The American Thoracic Society released its new guidelines Friday and posted them on social media Monday.
“The International Task Force strongly agrees with prevailing sentiment that clinical trials are urgently needed to effectively guide management. However, most patients do not have access to clinical trials, trials take time and speculation is that results will not be available until late spring or early fall,” the group said.
In the meantime, it urged physicians to collect data on patients receiving off-label interventions.
President Donald Trump has touted the potential of hydroxychloroquine, and its predecessor chloroquine, as a possible “game changer” in the fight against COVID-19.
He said Saturday he might even take the drug, though doctors have warned it’s unproven and he hasn’t tested positive for coronavirus.
In its new guidelines, the American Thoracic Society does not recommend using hydroxychloroquine for prophylaxis. It also refrains from endorsing the use in people who test positive for the virus but do not have pneumonia.
One concerned physician who spoke to the Daily News said the drug has the potential to cause life-threatening abnormal heartbeats in 1% of patients. He said the results of small studies of hydroxychloroquine published in recent weeks must be viewed with this in mind.
“When you’re only treating 100 people, this 1% at-risk category for the drug causing drug-induced sudden cardiac death is just not going to rear its head,” Dr. Michael Ackerman, a genetic cardiologist and director of Mayo Clinic’s Windland Smith Rice Sudden Death Genomics Laboratory, said.
But if the drug is given to 1 million people, that 1% rate might be a big problem.
“That’s 10,000 people standing close to the edge,” said Ackerman, co-author of a paper on what he called the hydroxychloroquine’s potential “lethal dark side.”
He said ongoing research into the drug is warranted, provided it’s done with a healthy respect for the side effects.
“As a science purist, I would say the data is interesting. It’s encouraging. But I don’t think it rises to the level of necessarily shouting from on high that this medication, hydroxychloroquine with or without azithromycin, is going to be the cure-all,” Ackerman told The News.
“The evidence that we have so far would never be enough to normally lead to an FDA-approved indication,” he said. “It’s still too early to tell for sure.”