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Clinical Updates

Promising Therapeutics: Benefits of Hydroxychloroquine as a Prophylactic Requires More Investigation

An article in the New England Journal of Medicine (NEJM) reports the results of a controlled, randomized clinical trial involving 821 individuals who were asymptomatic for COVID-19, a large percentage of whom were at high risk of recent exposure (719 of 821 [87.6 percent]). The incidence of new illness compatible with COVID-19 did not differ significantly between participants receiving hydroxychloroquine (49 of 414 [11.8 percent]) and those receiving placebo (58 of 407 [14.3 percent]); the absolute difference was −2.4 percent. Side effects were more common with hydroxychloroquine than with a placebo (40.1 percent versus 16.8 percent), but no serious adverse reactions were reported. The investigators concluded that after high-risk or moderate-risk exposure to COVID-19, hydroxychloroquine did not prevent illness compatible with COVID-19 or confirmed infection when used as a prophylaxis within four days after exposure.

NEJM published a response to the study in which the author cites the limitations of the trial and asserts that the results are more provocative than definitive, suggesting that the potential prevention benefits of hydroxychloroquine remain to be determined.