Misguided Use of Hydroxychloroquine for COVID-19The Infusion of Politics Into Science

Type Journal Article Author Michael S. Saag URL https://jamanetwork.com/journals/jama/fullarticle/2772921 Series Editorial Publication JAMA Network Date 09/11/2020 DOI doi:10.1001/jama.2020.22389 Abstract This issue of JAMA contains yet another study, and certainly among the best published to date, demonstrating the lack of efficacy of hydroxychloroquine as a treatment of coronavirus disease 2019 (COVID-19).1 This study, from the National Heart, Lung, and Blood Institute PETAL Clinical Trials Network, focused on hospitalized patients with moderate to severe disease. In this well-conducted, appropriately powered clinical trial, the authors randomized 479 patients to receive hydroxychloroquine (400 mg twice daily for 2 doses, then 200 mg twice daily for 8 doses) (n = 242) or placebo (n = 237). The trial was stopped early at the fourth interim analysis for futility. For the primary outcome, clinical status at 14 days measured on a 7-category ordinal scale, there was no significant difference between the hydroxychloroquine and placebo groups (median [interquartile range {IQR}] score, 6 [4-7] vs 6 [4-7]; adjusted odds ratio, 1.02 [95% CI, 0.73-1.42]). None of the 12 secondary outcomes were significantly different between groups, including mortality at 28 days: 10.4% in the hydroxychloroquine group vs 10.6% in the placebo group (absolute difference, −0.2% [95% CI, −5.7% to 5.3%]; adjusted odds ratio, 1.07 [95% CI, 0.54 to 2.09]).1 Thus, the results conclusively show no benefit of hydroxychloroquine over placebo.