Keith R. Brill , MD

Here is a summary of the NSMA document on the lack of evidence on hydrocholorquine use in covid19.

While we are always concerned about physician autonomy with regards to the patient-physician relationship, the NSMA generally supports the governor’s order restricting the prescription of hydroxychloroquine to hospitalized patients and patients already receiving it for rheumatic diseases. The surge in prescriptions for mild cases of COVID-19, prophylaxis and apparent hoarding, has resulted in a serious shortage of the drug.
This prescribing has been fueled by social media responding to an ill-conceived, small, poorly controlled, open label study from Marseille, suggesting more rapid viral clearance in HCQ treated patients than controls. Two subsequent studies have failed to confirm that observation. Current studies are ongoing.
There are no clinical studies of outcome of HCQ therapy for COVID-19. The resulting shortage has left patients with rheumatoid arthritis and lupus unable to refill their prescriptions. Abrupt withdrawal from HCQ in these patients can be life-threatening. The shortage also threatens our ability to use HCQ for critically ill patients with COVID-19 in the hospital. The drug is likely not as safe as represented in the social media for patients with SARS-CoV2 cardiomyopathy.
NSMA joins the AMA, American College of Physicians, the American Thoracic Society, the American College of Rheumatology, the Arthritis Foundation, and the American Pharmacists Association in warning against widespread prescribing of HCQ for COVID-19, until current double-blind, randomized, controlled studies demonstrate safety and effectiveness of the drug for COVID-19. As new evidence emerges, and the shortage lessens, we will work with the Governor’s office to make appropriate changes based on the best research available.