Coronavirus: Jordan begins uncontrolled hydroxychloroquine trial

The antimalarial drug was backed by US President Donald Trump, and its use against coronavirus is now being explored

A Jordanian policemen stand guard at a check point on the first day of full curfew in Amman, Jordan, 21 March 2020. EPA

As part of the measures of protection against the spread of Covid-19 coronavirus disease, Jordan Prime Minister Omar Al Razzaz announced on 20 March that the country will be placed in full curfew from 21 March. EPA

Inhabitants of the kingdom are not allowed out of their homes and from March 24, food and life essentials shopping will be allowed under specific terms and timings. EPA

A municipal worker carries out disinfection at a street in downtown Amman, Jordan, 22 March 2020. EPA

A municipal worker carries out disinfection at a street in downtown Amman, Jordan, 22 March 2020. EPA

Jordan’s King Abdullah II holding a video conference meeting in the capital Amman with government officials including Prime Minister Omar Razzaz. Jordanian Royal Palace via Afp

Jordanian police personnel guard at a checkpoint during the second day of a nationwide curfew, amid concerns over the spread of coronavirus disease, in Amman, Jordan March 22, 2020. Reuters

Jordanian police personnel guard at a checkpoint during the second day of a nationwide curfew. Reuters

The streets of the Jordanian Capital are seen empty during the second day of a nationwide curfew. Reuters

Jordanian army members stand guard outside a hotel transformed into a quarantine station amid concerns over the coronavirus in Amman. Reuters

A Greater Amman Municipality employee sanitises public transport at one of stations. Reuters

Jordanian soldiers stand guard outside a hotel that was transformed into a quarantine station amid concerns over the coronavirus in Amman, Jordan. Reuters

A Greater Amman Municipality employee sanitises public transport at one of stations. Reuters

Jordanian soldiers stand guard outside a hotel that was transformed into a quarantine station amid concerns over the coronavirus in Amman, Jordan. Reuters

Tourists visit the Amman Citadel, an ancient Roman landmark, in Amman, Jordan. Reuters

People shop in a mall amid concerns over the coronavirus spread in Amman, Jordan. Reuters

Jordanian soldiers stand guard outside a hotel that was transformed into a quarantine station amid concerns over the coronavirus in Amman, Jordan. Reuters

Tourists pose for a picture during their visit to the Amman Citadel, an ancient Roman landmark, in Amman. Reuters

A cashier wearing a face mask and gloves amid concerns over the coronavirus spread works at a mall in Amman, Jordan. Reuters

Jordan is among the first countries to use the antimalarial drug hydroxychloroquine to treat patients with Covid-19.

Patients began receiving treatment officially on Sunday, said Dr Natheer Obeidat, head of the Jordanian Health Ministry’s National Committee for Epidemics.

“We’ve received approval from the Jordan Food and Drug Administration and the National Committee for Epidemiology, so the Committee for Epidemics agreed to use hydroxychloroquine in the form of a clinical trial,” Dr Obeidat said.

“Patients are given a 400g dosage in tablet form on the first day and then a 200g dose for nine days after that.”

Hydroxychloroquine is a long-standing treatment for malaria and some autoimmune diseases. But its use in coronavirus patients has been a topic of hot debate since US President Donald Trump backed its use in a tweet on Saturday, despite contradictory advice from top health officials.

Speaking during the same address on March 20, Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said the evidence of hydroxychloroquine’s use against Covid-19 was thin and anecdotal.

“What we don’t know is, when you put it in the context of another disease, whether it’s safe,” he said.

In Nigeria, two people poisoned themselves with chloroquine, the drug’s more toxic predecessor, after taking it without medical advice.

Hydroxychloroquine is most commonly associated with the brand name Plaquenil produced by French pharmaceutical company Sanofi.

An internal memo seen by The National from Sanofi states: "To date there is insufficient clinical data to draw any final conclusions over the clinical efficacy or safety of hydroxychloroquine or chloroquine in the management of Covid-19."

But it also said that “in view of encouraging results of the pilot study” it would support the French health authorities to further investigate the use of the drug for coronavirus cases.

A World Health Organisation representative said it had “no evidence” that any particular drug was effective in the treatment of the virus.

She said: “Most cases are mild and self-limiting, and treated symptomatically. Some patients progress to severe and critical illness and require supportive care interventions, such as oxygen and ventilation.

“WHO is awaiting the outcome of many clinical trials undertaken by different countries or universities.”

Dr Obeidat acknowledged the lack of research when used to treat Covid-19 but said he was confident the antimalarial was safe to use in this context.

All patients will be given the drug, which means the trial will not be controlled, making it difficult to assess the efficacy of the drug. But the committee felt it unethical to give only some patients the treatment, Dr Obeidat said.

A statement from Jordan Food and Drug Administration said the use of hydroxychloroquine will be in accordance with protocol, and patients taking the drug would be closely monitored for effectiveness and side effects.

It also stressed not to use the drug as a preventive treatment nor without medical supervision, and said avoiding contact was the best preventive measure.

The latest confirmed cases of coronavirus in Jordan bring the total up to 112. Of those, one woman, aged 83, is in intensive care and eight patients have pneumonia but are not considered to be seriously ill.

* Additional reporting by Asmahan Bkerat