AP

A study found no evidence of benefit from a malaria drug promoted as a treatment for coronavirus. Hydroxychloroquine did not lower the risk of dying or needing a breathing tube in a comparison that involved nearly 1400 consecutive patients in New York.

A New Zealand Covid-19 study looking at the efficacy of weekly prophylactic hydroxychloroquine regimes for high risk frontline healthcare workers has abandoned the use of the controversial drug.

Based on the lack of evidence around the effectiveness of the anti-malaria drug which was controversially promoted by US President Donald Trump and Brazilian President Jair Bolsonaro the study wont move onto recruitment and trials.

The drug, which has been suggested as a possible Covid-19 treatment, is yet to be used in trials in New Zealand. It was to be included in three studies that received funding from the Health Research Council (HRC) and Ministry of Health in April.

Given the rapidly emerging evidence on potential Covid-19 treatments from other international trials, all three trials have adapted significantly and have removed hydroxychloroquine as a candidate for treatment or prevention, the council spokesperson said.

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The drug has been at the centre of many global studies. Researchers in the US found it to be ineffective against mild Covid-19 cases, and the World Health Organisation (WHO) withdrew it from its Solidarity Trial after finding it produced little or no reduction in mortality rates of hospitalised cases.

The front line healthcare workers study will be funded until its set-up phase. The remaining $300,000 in funding hasnt been reallocated.

Completing the set-up phase would enable the researchers to be in a position to reinitiate a healthcare worker prophylaxis study in [the] future, should there be a major second wave of Covid-19, or an influenza pandemic, the spokesperson said.

If this were to happen, the study would recommence with an alternative medicine, not hydroxychloroquine.

The small amount of Covid-19 cases in New Zealand has also impacted progress of two other HRC-funded studies REMAP-CAP COVID and ASCOT.

Low case numbers in New Zealand has meant recruitment to the two patient trials has not begun, the spokesperson said.

As such, hydroxychloroquine has not been, and will not be, used in New Zealand Covid-19 patients.

REMAP-CAP COVID is an adaptive study that focuses on critically ill Covid-19 patients requiring intensive care. It is open in New Zealand but hasnt begun recruitment.

ASCOT enrols hospitalised Covid-19 patients who dont need intensive care. It is yet to open and recruit participants. The use of lopinavir/ritonavir, another drug the WHO withdrew from its study, has also been removed.

Ben Margot/AP

Hydroxychloroquine wont be used in any New Zealand studies.

Instead of using hydroxychloroquine, researchers in New Zealand and Australia have pivoted the two existing studies to focus on convalescent plasma.

Convalescent plasma involves transfusing antibodies in the plasma of recovering patients into newly infected patients. This treatment method was previously used during the 2009 influenza pandemic, and SARS and MERS outbreaks.

Over 20,000 patients in the United States have safely received convalescent plasma for Covid-19. While conceptually attractive, we still need clinical trials to demonstrate efficacy for patients with Covid-19, said ASCOT principal investigator, associate professor Steven Tong from Australias Doherty Institute.

The REMAP-CAP COVID study is also evaluating other therapies such as immune-modulation treatments, anti-coagulation strategies, vitamin C, and ventilatory strategies.

"This means that patients within these trials are randomised to treatments that are more likely to be beneficial, while interventions determined to be inferior are discontinued, the HRC spokesperson said.

They explained that both the council and the Ministry of Health see the importance of these studies progressing, especially if community transmission becomes an issue again.

In the absence of a vaccine, the clinical trials provide access to the latest emerging evidence on prophylaxis and treatment.

There are 22 active Covid-19 cases in managed isolation and quarantine facilities. None are receiving hospital-level care.

No confirmed cases have been hospitalised in New Zealand for a considerable amount of time, and over 90 days have passed since there was last evidence of community transmission.

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Coronavirus: Hydroxychloroquine use in NZ studies abandoned due to lack of evidence and Covid-19 cases - Stuff.co.nz