The Lancet casts doubt over hydroxychloroquine study

In a statement, the medical journal acknowledged “important” questions over the research. (File/AFP)
Short Url
Updated 03 June 2020

The Lancet casts doubt over hydroxychloroquine study

  • Its publication last month triggered the WHO to announce it was pausing clinical trials of the drugs
  • France was among the countries to also halt COVID-19 treatment with hydroxychloroquine

PARIS: The Lancet has issued an “expression of concern” over a large-scale study of hydroxychloroquine and chloroquine it published that led to the World Health Organization suspending clinical trials of the anti-viral drugs as a potential treatment for COVID-19.
In a statement, the medical journal acknowledged “important” questions over the research, after dozens of scientists issued an open letter last week raising concerns about its methodology and transparency around the data, which was provided by the firm Surgisphere.
“Although an independent audit of the provenance and validity of the data has been commissioned by the authors not affiliated with Surgisphere and is ongoing, with results expected very shortly, we are issuing an Expression of Concern to alert readers to the fact that serious scientific questions have been brought to our attention,” The Lancet said Tuesday.
While an expression of concern is not as severe as a journal withdrawing a published study, it signifies that the research is potentially problematic.
The observational study looked at records for 96,000 patients and concluded that treatment with hydroxychloroquine, which is normally used to treat arthritis, and chloroquine, an anti-malarial, showed no benefit and even increased the likelihood of patients dying in hospital.
Its publication last month triggered the WHO to announce it was pausing clinical trials of the drugs.
France was among the countries to also halt COVID-19 treatment with hydroxychloroquine.
It has whipped up fresh controversy over hydroxychloroquine, which has been endorsed by public figures including US President Donald Trump despite concerns over its side effects and a lack of evidence that it is effective.
The study’s authors, led by Mandeep Mehra of the Brigham and Women’s Hospital in the US, looked at data from hundreds of hospitals between December and April and compared those who received treatment with a control group.
It followed numerous smaller studies that suggested hydroxychloroquine is ineffective in treating COVID-19 and might even be more dangerous than doing nothing.
But in an open letter last week, a group of scientists raised “both methodological and data integrity concerns” about it.
These included a lack of information about the countries and hospitals that contributed to the data provided by Chicago-based health care data analytics firm Surgisphere.
While The Lancet corrected a discrepancy in data from Australia, the authors said they stood by their findings and announced an independent review.
But concerns over the underlying data continued, and this week the New England Journal of Medicine also issued an expression of concern over another study using the Surgisphere database that looked at cardiovascular drugs and COVID-19.
Among the most outspoken critics of The Lancet study has been Marseille-based professor Didier Raoult, whose own work has been at the forefront of promoting hydroxychloroquine and has also been subject to criticisms over methodology.
But other critics, like Francois Balloux of University College London, raised concerns over the way the study was conducted, even though they are skeptical the drugs themselves would work as a treatment for COVID-19.
Peter Horby, professor of emerging infectious diseases and global health at Oxford University said the controversy should spark “serious reflection” over the quality of the peer review process.
“Scientific publication must above all be rigorous and honest. In an emergency, these values are needed more than ever,” he said.
He added, however, that decisions to halt trials on the basis of an observational study were “completely unjustified.”
A spokesman for the WHO last week said a comprehensive review of the drugs was expected to reach a conclusion in mid-June.


Duterte to skip Philippine trial of Russia virus vaccine

Updated 13 August 2020

Duterte to skip Philippine trial of Russia virus vaccine

  • Duterte had offered himself up as a guinea pig for the very first jab, expressing “huge trust” in the vaccine
  • The Philippines has logged the highest number of confirmed infections in Southeast Asia

MANILA: The Philippines will begin large-scale human testing of Russia’s coronavirus vaccine in October, but President Rodrigo Duterte will not receive the inoculation until regulators guarantee its safety, his spokesman said Thursday.
Duterte had offered himself up as a guinea pig for the very first jab, expressing “huge trust” in the vaccine, despite growing skepticism about its effectiveness.
But his spokesman Harry Roque said the president was scheduled to receive the vaccine no earlier than May 1 — weeks after the Russian-funded Phase 3 clinical trial in the archipelago is due to end in March.
The country’s Food and Drug Administration is expected to approve the vaccine — developed by the Gamaleya research institute and the Russian defense ministry — in April.
“May 1 is when the PSG (presidential security group) may allow him, once all requisite tests have been finished,” Roque told reporters.
Moscow says it has developed the world’s first vaccine offering “sustainable immunity” against the coronavirus and is in the final stage of tests involving 2,000 people.
Roque said Philippine experts will review next month the results of Russia’s Phase 1 and 2 clinical trials before the Southeast Asian country starts its Phase 3 testing.
“We will do it simultaneously with Russia,” Roque said.
Philippine officials from the science and technology department met with Gamaleya on Wednesday to discuss the protocols for the trial of the vaccine, which is dubbed “Sputnik V” after the pioneering Soviet satellite of the 1950s.
The Philippines, which is struggling to contain the virus, has accepted Russia’s offer to participate in production of the vaccine.
Anna Lisa Ong-Lim, an infectious disease professor at the University of the Philippines College of Medicine, said the government’s timeline to have a vaccine available by May was “very optimistic.”
The country is also set to start on August 17 clinical trials for the Japanese antiviral drug Avigan to treat coronavirus patients.
The Philippines has logged the highest number of confirmed infections in Southeast Asia with more than 147,500 cases and over 2,400 deaths.