Russia and Ukraine treat COVID-19 with outdated methods: pharmaceutical companies urge to update recommendations

The Association of Clinical Research Organizations (AOKI), which includes world pharmaceutical companies, sent a request to the Russian Ministry of Health to exclude hydroxychloroquine, lopinavir and ritonavir from the guidelines for the treatment of coronavirus. A few days ago, another cessation of studies of these drugs for the treatment of patients with COVID-19 was announced at WHO. Writes about it with the BBC.

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The current recommendations “do not fit well with the latest evidence on adequate treatment options,” the letter to ACCO said.

The Ministry of Health’s manual suggests using hydroxychloroquine and a related mefloquine, which are usually used to treat rheumatoid arthritis and malaria, including for the prevention of coronavirus. A combination of lopinavir and ritonavir, drugs used to treat HIV infection, is also recommended.

“All of these drugs, according to the results of recent studies, can be considered to have lost their status as potentially effective against a new coronavirus infection,” the association’s letter said.

The Food and Drug Administration (FDA) revoked the emergency use of hydroxychloroquine and chloroquine for the treatment of coronavirus, the authors note, and the WHO stopped recruiting patients for the hydroxychloroquine study group.

In the current version of domestic guidelines, hydroxychloroquine and the combination of lopinavir-ritonavir appear in 12 of 16 treatment regimens for mild, moderate and severe forms of the disease caused by the new coronavirus, the letter said.

The authors speak of “extreme alarm” that hydroxychloroquine was widely used among Moscow doctors to prevent coronavirus infection. The prevention program with this drug among them was completed on June 17, the Moscow Department of Health reported in response to a request from ACKO.

“According to the report on the progress of the mentioned “prevention program,” more than four thousand medical workers were exposed to needless risk for several months based on the current recommendations of the Russian Ministry of Health,” the letter says. To substantiate their position, pharmaceutical companies cite a study that states that the use of hydroxychloroquine for prevention does not provide benefits compared to placebo, but the likelihood of adverse events is greater.

Instead of these drugs, AOKI is urged to include dexamethasone, which is used in the treatment of autoimmune, infectious and rheumatic diseases, and which is now called the first drug in WHO who showed a decrease in mortality in severe patients with Covid-19.

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AOKI is a non-profit organization that unites participants in the Russian clinical research market. It, in particular, includes the world's largest pharmaceutical companies Pfizer, AstraZeneca, Bayer, etc.

The Ministry of Health, in response to a request from journalists about the letter, explained that the revision of the recommendations “is carried out promptly when new scientific data, results of clinical trials and registration of new drugs appear.” The working group is conducting a comprehensive assessment of the effectiveness and safety of various medications in different categories of patients, the department noted.

What the WHO and FDA said about these drugs

On Saturday, July 4, WHO announced the suspension of trials of hydroxychloroquine and the combination of drugs lopinavir and ritonavir. This recommendation was made by the international steering committee of the “solidarity trials”, which was created by the organization to find effective treatment for patients hospitalized with coronavirus.

According to preliminary data, hydroxychloroquine and lopinavir / ritonavir do not significantly help to reduce mortality among patients with coronavirus or do not affect it at all, according to the WHO.

An FDA review released Wednesday, July 1, says patients who are treated with hydroxychloroquine and chloroquine may experience heart rhythm disturbances and other complications related to blood and lymphatic system diseases, kidney damage, and liver problems.

For the first time, WHO suspended a study of hydroxychloroquine a month ago. Then the reason was a study published in the journal Lancet, in which it was concluded that the use of hydroxyloroquine is ineffective, and can also increase the likelihood of patient death.

The magazine later issued a rebuttal of the publication, which stated that the underlying data was provided by a little-known company Surgisphere, and it was probably incorrect. WHO then stated that it was ready to continue research.

The fact that he takes hydroxychloroquine for preventive purposes, said US President Donald Trump. In June, he said that he had drunk a two-week course.

Hydroxychloroquine is a later and less toxic version of the drug chloroquine and has more pronounced antiviral and anti-inflammatory effects.

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Chloroquine is usually prescribed for the treatment of malaria, certain protozoal infections, rheumatoid arthritis, and lupus erythematosus.

Both drugs have cardiotoxicity and can cause arrhythmias and tachycardia, especially in patients with existing cardiovascular diseases, the U.S. Food and Drug Administration warned.

Ukraine is negotiating the purchase of Remdesivir

As of the end of June, Ukraine still used antimalarial drugs to treat coronavirus.

On June 8, it became known that the Ministry of Health of Ukraine is negotiating the possibility of purchasing the drug Remdesivir in an amount sufficient to treat 19 thousand patients from COVID-8, writes "Ukrinform".

This was announced at a briefing by the Minister of Health Maxim Stepanov.

“We have already held certain negotiations with companies that have received a license from Gilead. We look forward to purchasing this drug. There is a preliminary agreement to purchase it in quantities designed to treat 8 thousand patients. Now we are carrying out coordination and negotiations. This is a medicine that can be effectively used in the treatment of coronavirus disease,” Stepanov said.

He noted that Remdesivir was included by Ukrainian specialists in the COVID-19 treatment protocol.

As ForumDaily wrote earlier:

• The United States purchased almost entire world stock of remdesivir, an antiviral drug that can accelerate the recovery of patients infected with coronavirus.

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