Tuesday, May 19, 2020

Global trial to assess chloroquine against COVID-19 in health workers


May 18 (UPI) -- More than 50,000 healthcare workers worldwide will be enrolled in a clinical trial to assess chloroquine's potential in protecting against COVID-19, researchers at the Washington University of St. Louis School of Medicine announced Monday.

The U.S. arm of the study, which will begin enrolling participants later this month, is being led by the school. Results are expected in early 2021, researchers said.

"Because of their repeated close contacts with infected patients, frontline healthcare workers in all parts of the world have a higher risk of contracting COVID-19 than most members of the general public," principal investigator Michael S. Avidan, head of the Department of Anesthesiology at WUSTL, said in a press release.

"In some places, more than 10 percent of those who have become infected are healthcare workers. There is an urgent need to identify drugs that are effective at preventing infection or mitigating its severity," he added.



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Officials at Rising Pharmaceuticals said Monday the company will be donating supplies of chloroquine, which is currently used to treat malaria, for the U.S. arm of the study. The research is being funded through the COVID-19 Therapeutics Accelerator, a partnership that includes the Bill and Melinda Gates Foundation, Wellcome and Mastercard.

Participants enrolled in the study will receive either 300 milligrams of chloroquine weekly, 300 mg. of the drug twice weekly, 150 mg. daily after being administered an "induction dose" of 1200 mg. chloroquine -- or placebo -- in four divided daily doses. New dosage arms may be added or removed as the trial progresses, according to the study design information filed with the U.S. Food and Drug Administration.

The goal of the study will be to determine which, if any, of the chloroquine regimens is most effective at decreasing incidence of severe COVID-19 -- the disease caused by the new coronavirus, SARS-CoV-2 -- without unacceptable side effects or safety events.


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The hope is that the drug can prevent infection, or reduce the severity of symptoms, researchers said.

"When people have to travel to parts of the world where malaria is a problem, they often take low doses of chloroquine to help prevent infection," said Avidan, who is also a professor of psychiatry and surgery. "We want to learn whether this drug might work in a similar fashion in the case of COVID-19, or at the very least, whether low-dose chloroquine might help prevent the severe and life-threatening complications associated with the illness."

In addition to the United States, the trial will enroll healthcare workers from Canada, Mexico and various countries in Europe, Africa and South America, with a particular focus on lower- and middle-income countries. Because of shortages of healthcare workers in many of these countries, protecting them from severe COVID-19 is particularly important, the researchers said.



Google searches for malaria drug spiked after Trump, Musk endo
Searches for two anti-malarial drugs touted by public officials as treatment for COVID-19 shot up nearly 500 percent and 1,400 percent, researchers report.

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April 29 (UPI) -- Google searches for the anti-malarial drug hydroxychloroquine increased by nearly 1,400 percent after high-profile endorsements of possible benefits in treating COVID-19, an analysis published Wednesday in JAMA Internal Medicine said.

Similar searches for chloroquine, another drug that treats malaria, jumped more than 440 percent, the researchers reported.

The analysis of search traffic from the beginning of February through the end of March covers the period from the start of the outbreak of the disease caused by the new coronavirus in the United States, which through Wednesday has infected more than 1 million Americans.

The two drugs were touted as possible treatments for COVID-19 by President Donald Trump and billionaire businessman Elon Musk in mid-March, despite a lack of evidence to support the claims.

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"We hear a lot of talk about misinformation all the time, but it's very nebulous," study co-author Dr. John W. Ayers, a behavioral scientist at San Diego State University, told UPI on Tuesday night. Researchers at the University of California, Harvard, Johns Hopkins and the University of Oxford worked on the study.

"It's like pornography in the Supreme Court in the 1970s: We don't know it until we see it, and even then you don't agree on it," Ayers said. "But with misinformation during the pandemic, there is an acute danger. The stakes are high. We need to address it before it adds to the public health problem we're already facing."

For the study, researchers reviewed daily Google search data from Feb. 1 to March 29 of this year, comparing it to historic trends. Search terms such as "buy," "order," "Amazon," "eBay" and"Walmart," combined with the names of the drugs, were checked.

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Musk endorsed chloroquine and hydroxychloroquine -- drugs used historically to treat autoimmune disorders and malaria -- on Twitter on March 16 and Trump first mentioned them in a press briefing three days later.

The researchers found that the "first and largest" spike in searches for purchasing the drugs corresponded directly with Musk's tweet, with 100,000 additional searches the next day. On March 20, the day after Trump's comments, more than 250,000 additional searches were conducted.

Overall, Google search activity for purchasing chloroquine and hydroxychloroquine increased 442 percent and 1,389 percent, respectively, researchers found. They also noted that even after news reports of a fatal poisoning in Arizona, searches to buy chloroquine or hydroxychloroquine remained 212 percent and 1,167 percent, respectively, above expected levels.

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Consumers turning to the internet for health information is not a new phenomenon. Research has shown that people frequently research their symptoms online before visiting a healthcare provider for diagnosis and treatment.

A study published last month in PLOS Computational Biology found that, during the Zika pandemic in 2016, Wikipedia page-views increased as much as 10 times, and that the rise corresponded directly with media mentions of the mosquito-borne virus.

"Wikipedia represents an important source of information during the current pandemic and its editors are doing their best to provide the most up-to-date information regarding COVID-19," Michele Tizzoni, lead author on the Zika study and research leader at the ISI Foundation in Torino, Italy, told UPI on Wednesday.

"However, as is stated by Wikipedia itself, Wikipedia or other Web sites cannot substitute for the advice of a medical professional," Tizzoni said.

Tizzoni and her colleagues focused on the role of media, especially television, in shaping public opinion.

She noted that during a pandemic, "the diffusion of accurate and reliable information on TV becomes even more important," as public attention -- and fear -- can be "explained by exposure to online and TV coverage, rather than the magnitude or extent of the epidemic itself."

The researchers behind the JAMA Internal Medicine study suggested that regulatory agencies and companies like Google and Bing need to "actively mitigate the negative consequences" of misinformation.

They specifically pointed to Google's integration of educational information into search results related to the outbreak -- an approach they would like to see expanded to and embraced by other platforms.

They also advised retailers to draft warnings or even withhold products that might be linked to use for COVID-19 treatment, as online retailer eBay did when it removed chloroquine products from its site.

The FDA last Friday also imposed restrictions on prescriptions for chloroquine and hydroxychloroquine for the new coronavirus, after research indicated potential dangers associated with their use.


"We thought if we could identify the outbreak of the misinformation and learn how widespread it was, we could start to learn about ways we can correct it and stop it from spreading," Ayers, co-author of the JAMA Internal Medicine study, said.

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