COVID-19 Clinical Trials of Malaria Drugs Combined with the Antibiotic Azithromycin are Underway

    By Kathleen Berger, Executive Producer for Science & Technology

    UPDATE: Washington University School of Medicine in St. Louis ended the clinical trial before completion of patient enrollments.

    In the search for existing medications that have the ability to fight coronavirus, at least in a test tube, the FDA gave emergency approval for hospitals around the country to use the malaria drugs hydroxychloroquine and chloroquine to treat severe cases of COVID-19. But the treatment strategy remained unproven.

    Washington University School of Medicine in St. Louis is involved in a range of COVID-19 response research, including investigating the anti-malarial drugs.

    “These drugs are being made available for the treatment of a disease and yet we don’t know if they actually do more good than harm,” said Steven J. Lawrence, MD, associate professor of medicine in the Division of Infectious Diseases.

    In April, researchers at Washington University launched a clinical trial combining the anti-malaria drugs with the antibiotic azithromycin.

    “A fully controlled, what we call “gold-standard”, study is needed to be able to confirm if there is both safety and efficacy,” said Lawrence.

    Then in May, the National Institutes of Health launched a clinical trial combining hydroxychloroquine with azithromycin.

    The goal is to determine if the anti-malarial dugs, alone or in combination with the antibiotic, decrease the severity or duration of respiratory symptoms.

    “We have no idea if the combined approach is the best way to go about it,” said Lawrence. “That’s why clinical trials need to be done and are being done.”

    Azithromycin is used to treat many types of infections caused by bacteria, including respiratory, skin, ear and eye infections.

    All three drugs have side effects that are well-known. Hydroxychloroquine and chloroquine in particular can cause heart rhythm problems. Patients are carefully screened for abnormal heart rhythms before being administered these drugs. These drugs also have been associated with vision loss and psychiatric side effects, but researchers say such effects are not typically seen in short-term use of the drugs.

    In past research, chloroquine and hydroxychloroquine showed some effectiveness against related coronaviruses MERS and SARS.

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