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Rooting for a Venerable Old Drug

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Rooting for a Venerable Old Drug

Years ago, hydroxychloroquine worked wonders on my arthritis; now, it is showing early promise as a potential treatment for those with Covid-19. March 24, 2020
Covid-19
Health Care

It may be an election year, but everyone I know has turned away from the primaries to focus on medical news. In fact, we’ve all become part of that news, dealing with Covid-19 in our own ways and studying the latest case numbers with the intensity of a compulsive gambler scrutinizing odds on the racing form. And we have plenty of time to do it, living in various degrees of quarantine and isolation.

This past week, a note of optimism penetrated the accumulating bad news. Doctors testing the drug hydroxychloroquine—brand name Plaquenil—on patients with Covid-19 have seen remarkable results. Half the patients tested negative after only three days on the medication, and by day six, that number had increased to 70 percent. Even better, 100 percent of patients given both hydroxychloroquine and the antibiotic azithromycin (commonly known as Zithromax, or the Z-pak) tested negative after six days.

Of course, the sample size was very small. Only 36 patients participated in the study, which still hasn’t been published in a medical journal. But in the midst of rising coronavirus-related case numbers and deaths, these positive results caught the attention of many people, including President Donald Trump—who ordered the FDA to fast-track the further use and testing of hydroxychloroquine—and doctors seeking a way to help patients afflicted with the virus.

I took even more interest in this development than others, because I have long experience with hydroxychloroquine. I used it over a period of ten years. In fact, it’s the only long-term medication I’ve ever used in my life. For me, it was a remarkable drug, and my experiences might be encouraging to others if they find themselves using it during the current pandemic.

This medicine, much older than I, is an advanced synthetic form of quinine, which has been used to treat malaria for hundreds of years. Over time, many patients discovered that this malaria drug also had a positive impact on inflammatory and autoimmune disorders, such as arthritis and lupus. In the 1950s, hydroxychloroquine was approved for use in treating these disorders. It was once a widely used medicine, though in recent years it’s been overtaken by newer—and more expensive—pharmaceuticals. The patent expired long ago, and I’m told that eight companies currently produce it.

It’s no exaggeration to say that this drug changed my life—and in a dramatically positive way—after I was diagnosed with arthritis in my thirties. Today, I’m completely pain-free and symptom-free, and I no longer require medication of any sort. Yet here’s the strangest part of the story: none of my doctors wanted me to use hydroxychloroquine, the amazing drug that brought about these results. They viewed it as an old and outdated medicine. One rheumatologist tried to convince me to use a newer, more “high-tech” treatment. “You are using a wimpy drug, and arthritis isn’t a wimpy disease,” he said.

I fought against my doctors’ advice, because the drugs they wanted me to use had side effects and other risk factors that I was unwilling to accept. Some of you may even recall the lawsuits that led to the removal of one “advanced” arthritis drug, Vioxx, from the market in 2004. I was allowed to use this supposedly antiquated medicine only because of my insistence on a safer drug with minimal risks.

Of course, no drug is entirely without side effects—even hydroxychloroquine. I was especially concerned that some patients eventually had retinal problems after long-term use. But remember that I took this drug for around a decade—while Covid-19 patients may need it for only a few days. I can report that I never experienced any side effects from the drug, despite extended exposure.

But there’s even better news here. Because it’s no longer under patent, hydroxychloroquine is available as a low-cost generic drug, and is probably already on the shelves of many pharmacies (though patients will need a prescription). In addition, since it has been used for decades, the side effects and risks are well understood by the medical community. The main reason not to want people to take it now would be to reserve quantities for those who really need it.

Many unanswered questions remain, especially about how a larger sample of Covid-19 patients would respond to this treatment. But for me, hydroxychloroquine was a true miraculous drug. Now, I’m hopeful that those infected with Covid-19 might share in that miracle.

Photo: Dizzy/iStock

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