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Possible COVID-19 Treatment Leads to Shortages of Chronic Disease Drugs

Recent studies and an endorsement from President Donald Trump have promoted the concept that hydroxychloroquine and related compounds could be an effective treatment for novel coronavirus. Now pharmacists are facing an unintended consequence: a shortage of the drug for the lupus and rheumatoid arthritis patients who depend on it. Here are more details.

SMYRNA, GA – Pharmacists might have been surprised to discover almost overnight shortages of a drug widely prescribed for lupus and rheumatoid arthritis.

Yet, the Lupus Foundation of America and other chronic disease advocates are warning of the possibility that hydroxychloroquine might soon be in short supply. The reason? The drug has been touted by President Donald Trump and others as a possible treatment for the novel coronavirus.

The drug, marketed as Plaquenil, is Food and Drug Administration-approved for the suppressive treatment and treatment of acute attacks of malaria due to Plasmodium vivax, P. malariae, P. ovale, and susceptible strains of P. falciparum. It is also indicated for the treatment of discoid and systemic lupus erythematosus, and rheumatoid arthritis.

A French study, presented on YouTube and involving 24 patients, concluded that early indications suggest treatment with hydroxychloroquine would reduce the viral load, adding that results were even more promising with a hydroxychloroquine and azithromycin combination.

In addition, a letter published last month in Nature journal Cell Research concludes, “Our findings reveal that remdesivir and chloroquine are highly effective in the control of 2019-nCoV infection in vitro. Since these compounds have been used in human patients with a safety track record and shown to be effective against various ailments, we suggest that they should be assessed in human patients suffering from the novel coronavirus disease.” Researchers write that they evaluated the antiviral efficiency of five FAD-approved drugs including ribavirin, penciclovir, nitazoxanide, nafamostat, chloroquine and two well-known broad-spectrum antiviral drugs remdesivir (GS-5734) and favipiravir (T-705) against a clinical isolate of 2019-nCoV in vitro.

In response to the news, Trump wrote on Twitter on March 21, “HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains - Thank You! Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents).”

While U.S. health officials have responded that the use of the drug combination is untested, pharmaceutical firms Novartis has promised a global donation of up to 130 million hydroxychloroquine tablets, pending regulatory approvals for COVID-19. At the same time, Mylan is increasing production at a West Virginia facility to make 50 million tablets, while. Teva is donating 16 million tablets to hospitals around the United States. 

The Lupus Foundation of America says it is aware of the potential use of hydroxychloroquine and chloroquine, marketed as Aralen, for the treatment of COVID-19, and is “actively working with our medical and scientific advisors, other patient groups, partners, and the federal government to take steps that ensure people with lupus will be protected from a disruption in access to critical medications.”

The Arthritis Foundation also warns of drug shortages, telling patients they “might have trouble getting a refill from their retail or mail order pharmacy.” It issued a press release quoting Erin Fox, an associate adjunct professor of pharmacology at the University of Utah and an expert in drug shortages, as saying that half of the eight suppliers of the drug reported normal supplies, while the others reported back orders.