Oxford scientists have confirmed that there is no clinical benefit from using hydroxychloroquine on COVID-19 patients in hospital.
The findings were published in the New England Journal of Medicine.
Hydroxychloroquine was one of the potential COVID-19 treatments being studied as part of the RECOVERY Trial, the world’s biggest trial looking at whether existing treatments can tackle the symptoms of COVID-19.
Since it began in March 2020, the trial, which is supported by the NIHR Oxford Biomedical Research Centre (BRC), has recruited almost 13,400 patients across 176 NHS hospitals.
The trial is led by Professor Peter Horby of the Nuffield Department of Medicine and Professor Martin Landray, of the Nuffield Department for Population Health and the Big Data Institute.
The latest paper explains that, among patients hospitalised with COVID-19, hydroxychloroquine did not improve 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death.
Some 1,561 patients were randomised to the drug plus usual care, while 3,155 patients were randomised to usual care alone.
“Unfortunately, we found no evidence of benefit from using hydroxychloroquine on any of the pre-specified endpoints, nor in any of the pre-specified subgroups of patients. It is a disappointing, but nonetheless important, finding,” Professor Landray, the BRC’s Theme Lead for Clinical Informatics, said.
“It should be noted that we did not study the use of hydroxychloroquine for prophylaxis (prevention) or for treatment of patients outside hospital with milder forms of COVID.”
Earlier this week, the RECOVERY team confirmed, in a paper published in The Lancet, that the antiviral drug combination lopinavir-ritonavir was also not an effective treatment for COVID-19 patients admitted to hospital.
However, in June the trial had found that one of the drugs they were testing, dexamethasone, a cheap and widely available steroid, reduced the risk of death in COVID-19 patients on ventilators by a third, and by a fifth in those on oxygen.
Other treatments being tested by the RECOVERY trial are azithromycin, a commonly used antibiotic, tocilizumab, an anti-inflammatory treatment, and convalescent plasma collected from donors who have recovered from COVID-19. The trial announced in September it would evaluate the potential benefits of an anti-viral antibody cocktail, REGN-COV2, developed by the pharmaceuticals company Regeneron to tackle the virus.
“The RECOVERY trial has now answered three questions for hospitalised COVID patients: hydroxychloroquine and lopinavir-ritonavir are not effective, but dexamethasone does reduce mortality for patients on oxygen or mechanical ventilators. All three results have changed medical practice and benefited patients,” Prof Landray said.
“We push on with the study of four further treatments, with the same rationale: we think they might work, we need to know if they do work, how well and for whom.
“As ever, we would like to thank everyone involved – funders, researchers, data scientists, doctors, nurses, pharmacists, across the whole UK. But most of all, our thanks go to the amazing and ongoing contribution of the more than 13,000 patients who have taken part in RECOVERY.”