Will Antimalarial Drugs Save Us From Coronavirus

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Doctors and hospitals are turning to decades-old antimalarial drugs to treat patients infected with the disease caused by the new coronavirus, as they work to repurpose existing therapies in a race to find effective treatments.

Antimalarial drugs chloroquine phosphate and hydroxychloroquine have both shown early signs of improving symptoms of some patients diagnosed with Covid-19, the respiratory disease caused by the coronavirus, based on reports by doctors and researchers in South Korea, France and China. Physicians in the U.S. are also using the drugs. 

Chloroquine, approved for Americans in the 1940s, and hydroxychloroquine, greenlighted the next decade, are also prescribed for patients with lupus and rheumatoid arthritis. The drugs are considered relatively safe for most people although chloroquine is slightly more toxic.

Academic researchers and drug companies are studying a range of potential vaccines and drugs for Covid-19, although it could be months before any may be widely available.

Anti-inflammatory drugs, including those from Regeneron Pharmaceuticals Inc. and Roche Holding AG , have been used to treat patients’ lung inflammation. AbbVie Inc.’s HIV therapy Kaletra didn’t provide a benefit to infected patients, Chinese researchers reported this week in the New England Journal of Medicine.

LATEST ON THE CORONAVIRUS

  • More than 10,000 deaths and more than 245,000 confirmed cases globally
  • The U.K. orders all bars, pubs and restaurants to close
  • Italy reports highest single-day number of deaths
  • Deaths in the U.S. more than quadruple in week to 205
  • 14,250 confirmed cases in the U.S.
  • California orders its 40 million residents to stay home

Researchers at Harvard University and Massachusetts General Hospital are proposing trials that would test using inhaled nitric oxide, a compound known to increase blood flow, to treat patients or prevent healthy people from contracting the disease. Lorenzo Berra, MGH’s medical director for respiratory care and one of the principal investigators of the planned studies, and his collaborators posit that nitric oxide could help Covid-19 patients with moderate or severe respiratory distress.

The University of Minnesota this week began enrolling patients in the first U.S. coronavirus clinical trial to test hydroxychloroquine, evaluating the drug in health-care workers and people who live with infected patients.

Chloroquine is among the drugs to be studied in a multicountry trial announced this week by the World Health Organization, and it is already recommended treatment by China and South Korea governments.

Since Thursday, at least four drugmakers have said they are donating hydroxychloroquine tablets to institutions or increasing production of the compound.

The two drugs received praise Thursday from President Trump as treatments for coronavirus, who said chloroquine was “approved by prescription,” although it is currently approved for other uses. Stephen Hahn, commissioner of the Food and Drug Administration, said that chloroquine’s effectiveness on Covid-19 should be evaluated in a clinical trial.

Chloroquine is a synthetic form of quinine, a centuries-old compound for malaria that is found in small amounts in products such as tonic water. As focus on the drug’s promise emerge, sellers have jacked up prices on a form of chloroquine that is sold to be used in aquariums to kill organisms, according to an analysis from social-media intelligence firm Storyful.

These products won’t be effective for coronavirus because prescription drugs are much more potent, said Matthew Might, director of the Hugh Kaul Precision Medicine Institute at the University of Alabama at Birmingham.

There are already concerns from health systems whether there is enough supply of both drugs.Premier Inc., one of the largest U.S. organizations that does purchasing of drugs and other supplies for hospitals, this week saw spot shortages for both therapies, with hospitals increasing purchases as more supportive research emerged, said Soumi Saha, senior director of advocacy.

“Because these products aren’t typically used, most hospitals don’t have stock with them,” said Ms. Saha. “Should either become front-line treatment I do not believe current capacity can meet demand.”

Pharmacies have found it challenging to buy the products in recent weeks. Both drugs are listed in shortage, according to the American Society of Health-System Pharmacists. The FDA doesn’t list them in shortage.

There has been “extraordinary” demand for chloroquine, though any previous supply issues have been resolved, said Ira Baeringer, chief operating officer for Rising Pharma Holdings Inc., the only U.S. company believed to sell chloroquine. He said the closely held company isn’t marketing or promoting the drug to treat Covid-19 but increasing production and donating it for research.

In January, Rising Pharma nearly doubled its chloroquine prices, the first price increase since 2015, according to data from Rx Savings Solutions, which sells software to help employers and health plans. The price of a 500-milligram, 25-tablet container of chloroquine rose to $496.95.

Mr. Baeringer confirmed the increases but said the company reverted to the original price this week and planned to lower it again because of the outbreak. He said the timing of January’s increase was unrelated to the coronavirus’ spread and was planned in conjunction with an investment in expanding manufacturing capabilities.

German pharmaceutical giant Bayer AG said Thursday it donated three million tablets of chloroquine, which it sells under the brand name Resochin, to the U.S. government, although the company isn’t approved to sell the drug in the U.S. The company discovered the drug in 1934.

At least 10 companies manufacture hydroxychloroquine for the U.S., according to analysts at Piper Sandler Cos. Teva Pharmaceutical Industries Ltd. said Thursday it was donating more than six million doses to U.S. hospitals while MylanNV said it has restarted manufacturing the drug in the U.S. with hopes of supplying it by mid-April

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