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  • In the past few weeks, we've been hearing these six syllables over and over again.

  • Hydroxy chloroquine hydroxychloroquine.

  • I happened to be taking it, the malaria drug being called a potential coronavirus cure by some and a potentially harmful solution by others, with the World Health Organization halting its trials at the end of May.

  • So what exactly is Hydroxychloroquine?

  • And will it help with the fight against Covid?

  • 19?

  • This is Hydroxychloroquine, a prescription drug and chemical compound modeled after quinine, a once popular natural anti malaria drug made from tree bark as the ideal model for synthetic malaria drugs in the early 19 hundreds.

  • Quinine first paved the way to chloroquine used around World War two.

  • But there was a slight issue.

  • Chloroquine had too many side effects to be widely used, including retinal damage and hearing issues.

  • 1955.

  • A less risky version was made hydroxychloroquine made from this mix of atoms.

  • The only real difference is the addition of a hydroxyl group.

  • That's Dr Neil Schlager, the chief of the division of pulmonary allergy and critical care medicine at Columbia University.

  • And he says, it's this simple addition of an oxygen bound to a hydrogen that makes the drug less risky.

  • So those chemical changes are often made either to improve a drugs activity or to decrease its toxicity.

  • Despite the side effects, chloroquine is still used.

  • In fact, both hydroxychloroquine and chloroquine are considered versatile drugs, a valuable trade in the pharmaceutical industry, which might explain why people thought the drug originally designed for malaria could be a treatment for Covid 19.

  • There are actually two main reasons.

  • This theory has become so popular.

  • One hydroxychloroquine works by limiting the body's immune response and stops it from going into overdrive in the first place.

  • The drug has been proven to be effective in treating autoimmune diseases such as Lupus and rheumatoid arthritis diseases that cause the immune system to inadvertently attack and damage the body.

  • And although it hasn't been proven, experts say the drug may have some role to play in stopping covid.

  • 19 cases from becoming severe to both Hydroxychloroquine and Chlor Queen have shown effectiveness against viral infections.

  • In fact, multiple studies have noted hydroxychloroquine is ability to smother and reduce HIV replication, and notably, researchers have found, chloroquine can actually suppress corona viruses in cell cultures, inhibiting and limiting replication of the human coronavirus SARS one, which emerged in 2000 and two.

  • Scientists believe this comes down to the anti binding ability of Chlor a queen, specifically its effect on the binding capabilities of the ace two receptor on human cells, the entry point for not just the SARS virus but also the Covid 19 virus.

  • All of this pushed scientists to study the effects Hydroxychloroquine and Chlor a queen have on SARS cov two, and they were somewhat correct.

  • Lab based studies found that both have abilities to fight the covid 19 coronavirus, triggering the FDA to approve emergency use of these two drugs on covid 19 patients and many others to propose them as a preventative medication.

  • But and this is a major one.

  • How a drug works against the virus in the lab is not the same as inside a human.

  • Things could be inactivated by a variety of systems in the human body.

  • They could turn out to be too toxic, they could turn out not to be able to achieve a high enough level in the blood to be active in human beings.

  • So the whole host of reasons why lots of things that work and test tubes don't work in human beings.

  • Crucially, Petri dishes don't experience side effects, but humans do.

  • For hydroxychloroquine, side effects can range from headaches, hair loss and nausea to something a lot more dangerous.

  • It's one of a large number of drugs that can affect the electrical activity in the heart in a way that could make people susceptible to developing potentially very dangerous abnormalities of the heart rhythm that could be fatal person to person.

  • These side effects vary dramatically, so it's difficult to know how the drug would individually impact someone, which is why doctors have warned against immediate widespread use and individual use without medical advice.

  • First, because of the FDA emergency approval, however, thousands of Covid 19 patients have taken hydroxychloroquine, which has led to large observational patient studies and some not so promising results, bringing us back to Dr Neil Schlager and his colleagues.

  • We saw no association between receiving the drug and a favorable outcome or an unfavorable outcome for that matter, and Schlager study wasn't the only one to come to this conclusion.

  • But we analyzed data from 1376 patients just a few days after a very similar analysis on a very similar number of patients was published in JAMA, almost the identical results.

  • In fact, Hydroxychloroquine could actually be making things worse.

  • A substantial study published in late May concluded that both hydroxychloroquine and chloroquine were associated with higher mortality among covid 19 patients.

  • And while a few small studies showed improvements when tested with humans, experts question the reliability of those studies methods.

  • So I think that's sort of the state of things right now that these large observation all studies have found no evidence of benefit and perhaps some evidence of harm.

  • As a result, the World Health Organization halted its sizable randomized trial use of hydroxychloroquine for covid 19 patients.

  • Still, this probably isn't the last we'll hear of the drug.

  • A large scale study testing the potential preventive effect of the drug is currently ongoing in the UK, and organizations and researchers are looking into other treatments, such as the drug remdesivir, which has shown promising potential in early stages.

  • But those positive studies have not concluded that this is a cure for the disease.

  • So as of late May 2020 there is no proven treatment for Covid, 19, a lot of good ideas in medicine.

  • Just don't pan out.

  • And, uh, the only thing you can do is is do the best studies and let the best drug win.

In the past few weeks, we've been hearing these six syllables over and over again.

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