From The Lancet 17 years ago and Ignored by Big Pharma and Dogmatic US Medicine

April 16, 2020 | Categories: Guest Contributions | Tags: |  Print This Article

From The Lancet 17 years ago and Ignored by Big Pharma and Dogmatic US Medicine

https://www.sciencedirect.com/science/article/pii/S1473309903008065

The studies reviewed here show that chloroquine/ hydroxychloroquine has in-vitro antiviral effects and anti-inflammatory properties that may be of interest in those viral infections associated with inflammation and/or immune activation. Before analysing the potential effects of a drug on a disease, safety criteria have to be met, to estimate the risk/benefit ratio.

Chloroquine/hydroxychloroquie has a well-studied toxicity profile. The half-century-long use of this drug in the therapy of malaria demonstrates the safety of acute administration of chloroquine to human beings. The use of chloroquine/hydroxychloroquine in rheumatic diseases and for antimalarial prophylaxis showed a low incidence of adverse events during chronic administration of this drug for periods of up to a few years. In these cases, the most serious toxic effect is a macular retinopathy, which depends on the cumulative dose rather than on the daily dose, and permanent damage may be prevented with regular visual monitoring during treatment.27, 28, 29 A recent study30 provided encouraging results on the safety of a high dosage of the drug (up to 500 mg of chloroquine base per day) even during pregnancy.

We conclude that chloroquine/hydroxychloroquine administration presents limited and well-preventable toxicity and may thus result in a low risk/benefit balance at least when it is used in life-threatening conditions.

Conclusions

At present it is difficult to answer the question of whether old chloroquine will be able to live a “second youth”. Due to its main effect—ie, raising endosomal pH—the drug has an exceptionally broad spectrum of antimicrobial activity that could be exploited in many infections. Results obtained in the prophylaxis of Q fever indicate that chloroquine/hydroxychloroquine can be successfully used in the clinical management of infections other than malaria.59 As regards viral diseases, what is clear is that the drug has antiviral and immunomodulatory effects that warrant particular consideration.