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Combination of hydroxychloroquine risky for cancer patients with Covid-19: Study

CHICAGO (REUTERS) – Cancer patients with Covid-19 who were treated with a drug combination promoted by U.S. President Donald Trump to fight the coronavirus were three times more likely to die within 30 days than those given both drugs alone , American researchers reported on Thursday (May 28).

The preliminary results suggest that for these patients, doctors don’t want to prescribe the decades-old malaria treatment of hydroxychloroquine with the antibiotic azithromycin until more research has been done, researchers said.

“Treatment with hydroxychloroquine and azithromycin was strongly associated with an increased risk of death,” said Dr. Howard Burris, president of the American Society of Clinical Oncology (ASCO), in a briefing with reporters on the results.

The drug combination was initially thought to help Covid-19 patients, but recent data has cast doubt on the regimen.

The preliminary findings, presented this week at ASCO’s virtual scientific meeting, show that the combination may pose a significant risk to cancer patients.

“Taking the combination has a three-fold increased risk of dying from any cause within 30 days,” said Dr. Jeremy Warner from the Vanderbilt University Medical System to reporters.

Trump, who has often promoted hydroxychloroquine, potentially called the combination in a March 21 tweet “one of the greatest game changers in the history of medicine.” That was based on a study of less than 40 patients in the International Journal of Antimicrobial Agents. More recent studies have shown little or no benefit and increased risks.

Warner and colleagues analyzed data from 925 cancer patients who became infected with the coronavirus between March and April. Thirteen percent of the patients died within 30 days of diagnosis.

In general, patients whose cancer was active at the time of infection were five times more likely to die within 30 days than those who were in remission or had no current evidence of cancer.

In the study, 180 patients took hydroxychloroquine in combination with azithromycin and 90 patients took hydroxychloroquine alone.

The U.S. Food and Drug Administration has authorized health care providers to prescribe the drugs for Covid-19 through an emergency permit, but has not approved treatment.

The governments of France, Italy and Belgium moved on Wednesday to stop the use of hydroxychloroquine for Covid-19 patients following a decision by the World Health Organization on Monday to interrupt a major trial of the drug for safety reasons.

Warner said that hydroxychloroquine alone was not a significant risk factor in adjusting for other risks, noting that the number of individuals using the drug alone was relatively small.

He said carefully designed studies are needed to clarify the risks and benefits of these drugs alone or in combination.

Nonetheless, Warner said his findings were largely consistent with a retrospective analysis published last week in the medical journal Lancet, which looked at more than 96,000 people who were hospitalized with Covid-19. That study found that hydroxychloroquine was associated with an increased risk of death and arrhythmias.

Dr. Richard Schilsky, ASCO’s Chief Medical Officer, said there is “insufficient evidence to support the routine use of hydroxychloroquine” to treat Covid-19 in patients who also have cancer, and urged caution until more data become available.

Schilsky said the treatment should only be used in the context of a clinical trial, according to FDA guidelines. Only two of the patients in the study used the drug as part of a clinical trial.

“This will certainly exercise a degree of caution when combining these two drugs in a cancer patient receiving therapy for COVID-19,” said Dr. William Cance, scientific director of the American Cancer Society.

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