First controlled Study to Show any Benefit for Chloroquine or Hydroxychloroquine

One minor side effect of the pandemic is that perhaps more people will learn about what drug research and clinical trials can really be like. Today’s example: we have a clinical trial of hydroxychloroquine from Wuhan that has just published on a preprint server. What’s good is that this one is blinded, randomized, and controlled (like the earlier hydroxychloroquine which one I blogged about here from Zhejiang University, so we can actually talk about it rather than just spend all our time wondering what the heck is going on.

Amen to this.

This is actually the first controlled study to show any benefit for chloroquine or hydroxychloroquine therapy against the coronavirus – it may sound odd to say that, but all the positive reports we have had up to now are anecdotal reports and open-label studies without control groups.

So my opinion of this latest study is “cautious approval”, and that probably sums up my feelings about hydroxychloroquine as a therapy in the Covid-19 epidemic in general. It’s a long way from “This is the cure and it’s unethical to disagree”, that’s for sure. More data will be coming, and we’ll revisit the topic then.


Good to see a real trial, even if it is small. I would say that from this study I would support doctors moving ahead with using the drug, and have national or global systems in place to report adverse effects. There are many subsets of patients that a small trial like this simply can’t test, such as pregnant women, diabetics, heart conditions, immunosuppressed patients, and other possible complications.


Why haven’t we heard anything from the WHO megatrial?

Here are the latest data from Raout regarding his treatment based on HCQ and AZM. It seems he was on the right track after all.

Interpreration: The HCQ-AZ combination, when started immediately after diagnosis, is a safe and efficient treatment for COVID-19, with a mortality rate of 0.5%, in elderly patients. It avoids worsening and clears virus persistence and contagiosity in most cases.

No, there aren’t any controls.

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Gee, @Giltil, I read the Raoult abstract and see mention of plenty of adverse outcomes in his treated subjects. Why are you of the opinion that he is “on the right track”?

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The death rate of his cohort is ~0.5%, which is lower than what is generally observed. But I grant you that with the abstract alone, it is difficult to assess whether some biases may exist. Only when the full article is published will it be possible to conclude. Maybe.

I think we agree on all of this.

On the other hand, looks like a manuscript is under review at NEJM reporting a quasi-randomised trial of HCQ that found no benefit:

That tweet is no longer available.

Maybe not surprising, it was a screenshot of what looked like an email from the journal to a reviewer, so it was breaching confidentiality.

That’s a pretty egregious breach of confidentiality. Pity a preprint of the paper hasn’t been posted, though (at least that I’ve heard of).

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