EFFORTS to prescribe unproven treatments to tackle COVID-19 outside of clinical trials should be avoided until evidence is available to support their use, academics believe.
In an article published in Australian Prescriber, by researchers including Royal Brisbane and Women's Hospital Pharmacy Department Director, Ian Coombes, and ASCOT study investigators, Jason Robers and Andrew Redmond, urged prescribers against the use of "medicines with putative benefit for COVID-19".
"There are no medicines with any robust evidence of clinical benefit, including the antimalarial hydroxychloroquine, the antibiotic azithromycin and the antiretroviral combination of lopinavir with ritonavir," they said.
"Indeed, now is the time to investigate which drugs may improve clinical outcomes in COVID19 by conducting well-designed clinical trials, rather than making assumptions based on preliminary data and low-quality clinical studies.
"Some clinicians and consumers may believe that hydroxychloroquine should be available on compassionate grounds for patients with COVID19 who are not eligible or do not give their consent for recruitment into a clinical trial.
"Hydroxychloroquine should only be prescribed after the patient or their carer has been made aware of the drug's potential toxicities and its lack of proven efficacy in COVID19, and consent has been given."
However, the authors flagged concerns that inappropriate prescribing of hydroxychloroquine could adversely impact patients who have been prescribed the drug for approved conditions.
"Due to inappropriate prescribing and dispensing, hydroxychloroquine is now in short supply in Australia and globally," they said.
"This has caused serious challenges for patients receiving ongoing treatment for chronic diseases such as lupus for which there often is not an effective alternative, and even temporary withdrawal can lead to serious harm.
"It is encouraging that pharmacy and medical professional organisations are also conveying similar messages regarding the limited evidence of drug efficacy and safety in COVID19, as well as the importance of ongoing access to essential treatments for chronic diseases."
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