Coalition: Advocacy for prospective clinical trials to test the post-exposure potential of hydroxychloroquine against COVID-19
Stephane Picot,
Aileen Marty,
Anne-Lise Bienvenu,
Lucille H. Blumberg,
Jean Dupouy-Camet,
Pierre Carnevale,
Shigeyuki Kano,
Malcolm K. Jones,
Cláudio Tadeu Daniel-Ribeiro,
Santiago Mas-Coma
Affiliations
Stephane Picot
Malaria Research Unit, ICBMS, UMR 5246, CNRS, INSA, CPE University Lyon, 69100 Villeurbanne, France; Institute of Parasitology and Medical Mycology, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France; Corresponding author at: ICBMS CNRS 5246, Campus Lyon-Tech La Doua, Université de Lyon, Villeurbanne 69100, France.
Aileen Marty
Translational Medicine, HWCOM, FIU Health Travel Medicine Program and Vaccine Clinic Commander, Emergency Response Team Development, Miami, FL, United States
Anne-Lise Bienvenu
Malaria Research Unit, ICBMS, UMR 5246, CNRS, INSA, CPE University Lyon, 69100 Villeurbanne, France; Groupement Hospitalier Nord, Service Pharmacie, Hospices Civils de Lyon, 69004 Lyon, France
Lucille H. Blumberg
Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, 2131 Johannesburg, South Africa
Jean Dupouy-Camet
Faculté de Médecine Paris Descartes, Académie Vétérinaire de France, Paris, France
Pierre Carnevale
Institute of Research for Development (former), Montpellier Centre, BP 64501, 34394 Montpellier, France
Shigeyuki Kano
Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
Malcolm K. Jones
School of Veterinary Science, The University of Queensland, Brisbane, QLD, Australia
Cláudio Tadeu Daniel-Ribeiro
Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz & Centro de Pesquisa de Diagnóstico e Treinamento, Fiocruz. Av. Brasil 4365. CEP 21.040-360, Rio de Janeiro, Brazil.
Santiago Mas-Coma
Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, 46100, Valencia, Spain
Our coalition of public health experts, doctors, and scientists worldwide want to draw attention to the need for high-quality evaluation protocols of the potential beneficial effect of hydroxychloroquine (HCQ) as a post-exposure drug for exposed people. In the absence of an approved, recognized effective pre or post-exposure prophylactic drug or vaccine for COVID-19, nor of any approved and validated therapeutic drug, coupled with social and political pressure raised by publicity both regarding the potential beneficial effect of hydroxychloroquine (HCQ) as well as potential risks from HCQ, we urge the immediate proper clinical trials. Specifically, we mean using HCQ for post-exposure of people with close contact with patients with positive COVID19 rtPCR, including home and medical caregivers. We have reviewed the mechanisms of antiviral effect of HCQ, the risk-benefit ratio taking into consideration the PK/PD of HCQ and the thresholds of efficacy. We have studied its use as an antimalarial, an antiviral, and an immunomodulating drug and concluded that the use of HCQ at doses matching that of the standard treatment of Systemic Lupus erythematous, which has proven safety and efficacy in terms of HCQ blood and tissue concentration adapted to bodyweight (2,3), at 6 mg/kg/day 1 (loading dose) followed by 5 mg/kg/ day, with a maximum limit of 600 mg/day in all cases should swiftly be clinically evaluated as a post-exposure drug for exposed people. Keywords: COVID19, SARS-CoV2, Hydroxychloroquine, Chloroquine, Systemic lupus erythematosus, Immunomodulation, Coronavirus, malaria, antiviral
