Bangladesh is yet to decide whether the Hydroxychloroquine, a malaria drug used to treat Covid-19, will be used or not after the World Health Organization (WHO) suspended the clinical trial of the drug due to health risks on Monday night.
Experts will take a decision over the matter as soon as possible, said Prof ABM Abdullah, personal physician to Prime Minister Sheikh Hasina and professor of medicine, also an editorial board member of the Coronavirus treatment protocol and guideline committee.
"We have got good results using hydroxychloroquine in coronavirus treatment," said Prof Abdullah.
"However, we learnt about the WHO decision last night. Since the WHO has postponed the clinical trial of this drug, we will take a quick decision after discussing use of this drug with experts," Prof Abdullah added.
The drugs – chloroquine, hydroxychloroquine and azithromycin – have been recommended in the treatment protocol of Covid-19 patients in Bangladesh, according to the "National Guidelines on Clinical Management of Coronavirus Disease-2019" published on the health directorate's website.
But health experts have questioned the inclusion of these controversial medicines in the treatment guidelines, suggested by the National Technical Advisory Committee, which was formed to advise the government on the ongoing coronavirus situation.
They said any drug can be used at this time of the pandemic to save people's lives. But there is a lack of enough evidence to include the drugs in the guidelines.
Professor Sayedur Rahman, chairman of the Bangladesh Pharmacological Society, told The Business Standard that during a pandemic, drugs are used out of compassion. Doctors are trying to treat patients with whatever arsenal they have. But when it comes to making treatment guidelines, there has to be proper evidence of their effectiveness prior to suggesting any drug in it.
Compassionate drug use means the use of a new, unapproved drug to treat a seriously ill patient.
Professor Sayedur Rahman said it is now proven that hydroxychloroquine is not giving good results in coronavirus treatment, and patients are dying. The WHO has closed clinical trials of hydroxychloroquine based on strong evidence from The Lancet's research. Experts in Bangladesh should quickly review the guidelines and remove this drug from the list of coronavirus treatments.
He added that so far there has been weak evidence of the benefits of the drug, but now there is strong evidence of its harmful impact. The decision over its use may get delayed due to the Eid holidays, but it is necessary to make a quick decision.
Because if the medicine exists in the list, panicked people will take this medicine to save their lives.
We should be careful to include any other medicine in the guideline. This may cause harm to the patient instead of recovery.
The people of our country are not very aware of the situation, and they do not look at the guidelines or take medicine in consultation with the doctor. They buy medicines themselves without consulting a doctor.
A study published in the medical journal The Lancet on May 22, found that the use of hydroxychloroquine in the treatment of coronavirus did not work. In fact it increased the risk of death in hospitalised patients.
Hydroxychloroquine is effective in the treatment of malaria. But there is no evidence that it is effective in the case of Covid-19.
The World Health Organization (WHO) said on Monday that it had "temporarily" suspended clinical trials of hydroxychloroquine as a potential treatment for Covid-19 being carried out across a range of countries as a precautionary measure.
The decision came after the publication last week of a study in the Lancet, indicating that using the drug on Covid-19 patients could increase the risk of death, reports the Independent.
"The executive group has implemented a temporary pause of the hydroxychloroquine arm within the Solidarity trial while the safety data is reviewed by the data safety monitoring board. The other arms of the trial are continuing", WHO Director General Tedros Adhanom Ghebreyesus told an online briefing.
The study, published in The Lancet, looked at 96,000 coronavirus patients in six countries. Of these, 14,888 were given hydroxychloroquine or chloroquine alone or in combination with another antibiotic.
Studies show that patients who were given the drug had an increased risk of death or heart complications compared to other Covid patients admitted to the hospitals.
Among these patients, the mortality rate was 18 percent with hydroxychloroquine, 16.4 percent with chloroquine, and 9 percent among the control group or those who were not given the drug. This means that those who were given hydroxychloroquine or chloroquine had a much higher mortality rate.