The Lancet casts doubt over hydroxychloroquine study

In a statement, the medical journal acknowledged “important” questions over the research. (File/AFP)
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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.


Malaysia to reinstate pilots once Pakistani licenses OK’d

Updated 07 July 2020

Malaysia to reinstate pilots once Pakistani licenses OK’d

  • 30 percent of pilots grounded including 107 in foreign airlines

KUALA LUMPUR: The Civil Aviation Authority of Malaysia (CAAM) will reinstate Pakistani pilots as soon as Pakistani authorities verify their permits, an official told Arab News on Monday, after their temporary suspension due to a fake license scandal. 

Pakistan grounded almost 30 percent of its pilots last week after the country’s Aviation Minister Ghulam Sarwar Khan said that they might have falsified their qualifications. 

Pakistan has 860 pilots, 107 of whom work for foreign airlines.

“The CAAM has sent two letters requesting verification from PCAA (Pakistani Civil Aviation Authority) as well as to inform them on the temporary suspension of Pakistani license holders in Malaysia,” Nurilya Anis Rahim, a public relations officer at CAAM, said in an email. 

Rahim added that the pilots’ licenses had been put on hold until further information from the PCAA.

“We are currently still waiting for a response from PCAA. Once an official confirmation has been made, we will reinstate these pilots with immediate effect.”

Captain Chester Voo, CAAM CEO, announced that it would temporarily suspend 20 Pakistani pilots employed with “local operators” such as flying schools, flying clubs and training organizations.

Rahim said that the decision was taken to ensure the safety and security of Malaysia’s civil aviation industry. 

“It is to ensure that all employed pilots in this country hold a valid license and abide by Malaysia’s Civil Aviation Regulation.”

The UK, EU and Vietnam have banned Pakistani pilots and barred Pakistan International Airlines’ (PIA) operations as well.

One analyst said that Malaysia’s stand was part of its “zero-compromises” approach.

“Malaysia has always taken a conservative stance which includes a zero-compromise on the integrity of certification and qualification of pilots,” Rizal Kamaruzzaman, a Malaysian aviation expert and executive director of Tindakan Strategi, told Arab News.

He added that the joint verification approach was an excellent opportunity for regulators in Pakistan and Malaysia to “clean” the register and weed out all pilots with dubious qualifications. 

“The move by the CAAM will also alert the rest of the airlines and general aviation aircraft to review the technical crew manifest flying into Malaysia and will definitely have a ripple effect on the aviation sector.”

He urged aviation regulators from other countries to learn a lesson from Pakistan.

“The trust and mutual recognition among regulators are a sacred pact to ensure safety for aircraft, pilots, crews, engineers and the main client that are the passengers are not compromised anywhere around the world,” he said.

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