Fact Check: Did the American Journal of Medicine Recommend Hydroxychloroquine For COVID?
As COVID-19 continues to wreak havoc across the country, health experts continue to provide updates on how to stay safe and treat the virus.
Former President Donald Trump frequently endorsed treating COVID-19 with hydroxychloroquine (HCQ), a drug originally used to treat malaria that now treats autoimmune diseases like lupus and rheumatoid arthritis.
After several clinical trials last spring, the Food and Drug Administration (FDA), the National Institute of Health and the larger scientific community have warned against the use of the drug to treat COVID-19, citing ineffectiveness, lack of benefits and risk of heart rhythm problems.
A new article published in this month's edition of The American Journal of Medicine (AJM) circulated on social media this week led many people to believe the journal is now endorsing the use of HCQ to treat COVID-19 as a political move after Trump left office.
Dr. Joseph S. Alpert, editor-in-chief of the AJM, said the journal does not endorse HCQ treatment for COVID-19.
"This article does not mean the journal recommended this therapy," he said. "The authors recommended it just as others recommend other interventions. We just publish their findings and recommendations."
Alpert said the journal often presents multiple sides of a scientific argument.
"We have also published articles from other authorities that said don't use it [HCQ treatment]," he said. "This is still controversial with two sides saying different things. Often we have editorials that dispute the article's recommendations. We are a scientific journal and do not push or recommend any specific thing. The authors do that."
The article was put together last spring and was published online in August, all when Trump was still in office. When the article was submitted to the journal, Alpert said the data was controversial but not unreasonable at the time.
The article presents data from the time showing that in a test tube lab, the drugs interfered with the normal reproduction of the coronavirus. Therefore, the authors advocate for more testing into the effect of HCQ and other agents on COVID-19.
Alpert said the authors of the article were coming from a place of desperation, as the coronavirus continued to take more lives.
"You see this a lot in clinical medicine," he said. "When you're desperate, you say, 'Here are things that look like they worked in the laboratory and it may be worth trying.' But sometimes just because it has effects in a test tube, doesn't mean it always works in human trials."
Subsequent studies came out that showed the drug did not work on patients who were already sick. Alpert said the drug may be useful as a preventative measure but those studies have not been widely done.
"We need more data, it's a new virus and we don't have all the answers right now," Alpert said. "Science is a constantly evolving entity. What is true today can be false tomorrow with new studies and new observations."
This article does not mean the journal recommended this therapy. The authors recommended it just as others recommend other interventions. We just publish their findings and recommendations.
Dr. Joseph S. Alpert
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical adviser in the Biden administration, constantly pushed back against Trump's support of HCQ treatment.
In August 2020, Fauci told MSNBC's Andrea Mitchell that the trials for HCQ have "consistently" shown that the drug is "not effective" for the treatment of COVID-19.
"If a study that's a good study comes out and shows efficacy and safety for hydroxychloroquine or any other drug that we do, if you do it in the right way, you accept that scientific data," Fauci said. "But right now today, the cumulative scientific data that has been put together, and done over a number of different studies, has shown no efficacy."
In June 2020, the FDA revoked their emergency use authorization (EUA) from March that allowed chloroquine phosphate (CQ) and hydroxychloroquine sulfate (HCQ) to be used to treat patients hospitalized with COVID-19.
In a statement to Newsweek, the FDA said as it continued to review the scientific evidence available for HCQ and CQ to treat COVID-19, it determined that the statutory criteria for EUA are no longer met.
"Specifically, FDA determined that CQ and HCQ are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA," the statement said. "Additionally, in light of ongoing serious cardiac adverse events and other serious side effects, the known and potential benefits of CQ and HCQ no longer outweigh the known and potential risks for the authorized use. This conclusion warranted the revocation of the EUA for HCQ and CQ for the treatment of COVID-19."
While some new studies show the use of the HCQ drug can reduce hospitalizations for people with COVID-19, these studies are limited and suggest further investigation into the drug's effectiveness for outpatient treatment of COVID-19.
A recent study from Hackensack Meridian Health found that HCQ use in outpatient settings was associated with a reduction in hospitalization rates in mildly symptomatic individuals with COVID-19. The study calls for additional testing of the drug.
"We hope our findings lead to further investigation of this drug as a potentially viable oral outpatient therapy for early-stage COVID-19," said Dr. Andrew Ip, the lead investigator on the study.
The study was conducted early in the course of the pandemic and had a few limitations, including a small sample size, lack of confirmation of full adherence to the complete course of HCQ therapy and the inability to account for hospitalizations outside of Hackensack Meridian Health network.
The researchers "further caution that results from an observational study cannot be used to assert a causal relationship, and that the findings need to be validated in a randomized controlled clinical trial."
The American Journal of Medicine does not endorse the use of hydroxychloroquine to treat COVID-19.