Hydroxychloroquine is not approved in the USA; chloroquine is used against malaria. While there are only anectodic reports for use with Covid-19, the potential benefits outweigh the previously known risks, according to the FDA. The agents may only be used in adults over 50 kg body weight and only in patients who are not an option for inclusion in a clinical study. Distribution and monitoring are part of the Strategic National Stockpile (SNS) program.
In a first Chinese clinical trial, chloroquine had been shown to be effective against Sars-CoV-2. The mechanism of action of the former antimalarial against coronaviruses has not yet been fully elucidated. To put it simply, it can be said that chloroquine reduces the acid content in certain compartments within the cells: This means that viruses are less able to penetrate and there is no increase. Studies in cell cultures have shown that chloroquine has a certain activity against Sars-CoV-2. However, the doses required for a sufficient effect are very high, so that the intake is associated with a variety of side effects and can sometimes lead to symptoms of intoxication.
The US government has high hopes for the drug, which is over 60 years old. At a press conference, President Donald Trump described chloroquine and hydroxychloroquine as “game changers”. “I feel good about it,” said Trump. The combination should be used “IMMEDIATELY”, he asked on Saturday on Twitter. “What do we have to lose?” He asked afterwards at a press conference in the White House. The director of the National Institute for Infectious Diseases, Professor Dr. Anthony Fauci then tried in the White House to put Trump’s enthusiasm into perspective: there have only been isolated reports of the drug’s effectiveness so far, but no serious clinical studies. According to Fauci, it is now a matter of using the drug in a controlled and limited manner in order to obtain data on its effectiveness.
The Solidarity Study is now to change that. New knowledge is to be gained as to whether the drug is sufficiently effective against Covid-19. Originally, the World Health Organization (WHO) scientific committee wanted to exclude the two active substances from the study, but due to the high level of interest worldwide, the WHO had decided to include the two drugs in the scope of the study.
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