Medical Reversals and Controversial Drug Therapies during COVID-19 Pandemic

Authors

  • Faraz Mansoor Shaukat Khanum Memorial Cancer Hospital, Peshawar
  • Kamran Saeed Shaukat Khanum Memorial Cancer Hospital, Peshawar-Pakistan

DOI:

https://doi.org/10.55519/JAMC-02-11403

Keywords:

COVID-19; Controversial therapies; Medical reversal; Azithromycin, Anti- SARS-CoV-2 Monoclonal Antibodies; Convalescent plasma; Chloroquine; Hydroxychloroquine; Ivermectin; Remdesivir; Lopinavir and Ritonavir.

Abstract

Medical reversal can be defined as a phenomenon when statistically more powerful results of new clinical trials leads to a change of clinical practice. While the list of the treatments performed during this pandemic is a lengthy one and the pandemic is still ongoing, we will be mainly focusing on: Azithromycin, Anti-SARS-CoV-2 Monoclonal Antibodies, Chloroquine, Convalescent plasma, Hydroxychloroquine, Ivermectin, Remdesivir, Lopinavir and Ritonavir. One of the main reason of writing this manuscript is to highlight the challenges faced by the healthcare staff in finding a cure for this novel Corona Virus and the prevalemce of medical reversals in our clinical practice. 

References

Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res 2020;30(3):269–71.

Borba MGS, Val FFA, Sampaio VS, Alexandre MAA, Melo GC, Brito M, et al. Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial. JAMA Netw Open 2020;3(4):e208857.

Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents 2020;56(1):105949. Ref no 3&6 are same

Tang W, Cao Z, Han M, Wang Z, Chen J, Sun W, et al. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ 2020;369:m1849.

RECOVERY Collaborative Group. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial. Lancet 2021;397(10289):2049–59.

Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents 2020;56(1):105949. Ref no 3&6 are same

Arshad S, Kilgore P, Chaudhry ZS, Jacobsen G, Wang DD, Huitsing K, et al. Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. Int J Infect Dis 2020;97:396–403.

Ray WA, Murray KT, Hall K, Arbogast PG, Stein CM. Azithromycin and the risk of cardiovascular death. N Engl J Med 2012;366(20):1881–90.

Consortium WHOST, Pan H, Peto R, Henao-Restrepo AM, Preziosi MP, Sathiyamoorthy V, et al. Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results. N Engl J Med 2021;384(6):497–511.

Ader F, Bouscambert-Duchamp M, Hites M, Peiffer-Smadja N, Poissy J, Belhadi D, et al. Remdesivir plus standard of care versus standard of care alone for the treatment of patients admitted to hospital with COVID-19 (DisCoVeRy): a phase 3, randomised, controlled, open-label trial. Lancet Infect Dis 2022;22(2):209–21.

Popp M, Stegemann M, Metzendorf MI, Gould S, Kranke P, Meybohm P, et al. Ivermectin for preventing and treating COVID-19. Cochrane Database Syst Rev 2021;7(7):CD015017.

COVID-19 rapid guideline: managing COVID-19. London: National Institute for Health and Care Excellence (NICE); 2022.

Schoergenhofer C, Jilma B, Stimpfl T, Karolyi M, Zoufaly A. Pharmacokinetics of Lopinavir and Ritonavir in Patients Hospitalized With Coronavirus Disease 2019 (COVID-19). Ann Intern Med 2020;173(8):670–2.

Additional Files

Published

2023-05-16