Michigan requests hydroxychloroquine from national stockpile to treat COVID-19
The state of Michigan has requested hydroxychloroquine and chloroquine distributions from the Strategic National Stockpile for use on certain patients with COVID-19.
The request is based on the Food and Drug Administration's February announcement that the anti-malaria drug was granted emergency use authorization, said Lynn Sutfin, a spokeswoman for the state Department of Health and Human Services. She did not have immediate information on the amount Michigan requested.
The request comes as several hospitals throughout the state are using the drug “off label” to treat COVID-19 patients.
A Henry Ford Health System official said Tuesday the hospital has treated roughly 800 of its COVID-19 patients, a majority of them with hydroxychloroquine treatments, and has seen some success.
The hospital system has been prescribing the hydroxychloroquine since it started receiving COVID-19 patients three weeks ago and is working to join clinical trials related to the medication, said Dr. Marcus Zervos, division of infectious diseases at the five-hospital system.
The drug is usually paired with azithromycin or doxycycline to cut down on side effects and patients are monitored for potential side effects such as cardiac problems, Zervos said.
Hydroxychloroquine tends to slow or stop the progression of the disease and, in some instances, shorten recovery time, he said.
“We are in a very difficult situation right now where we have to do our best to do whatever we can to prevent complications and prevent people from going into intensive care or even death,” Zervos said.
Michigan reported a total of 6,498 coronavirus cases through Monday afternoon and 184 deaths overall. Detroit alone reported 1,804 positive cases of the virus Monday and 50 deaths.
While there is some evidence hydroxychloroquine could help to prevent COVID-19 or treat mild cases, prescriptions in those circumstances should be reserved in a study environment, Zervos said.
“We are not using it in outpatients,” Zervos said. “We are not using it in patients with mild infection. We are using it, however, in patients who are sick enough to be hospitalized with pneumonia that we feel are at risk of progressing their infection.”
Henry Ford Health is documenting the use of the medication in patients’ electronic medical file to stay in compliance with directives from the Michigan Department of Licensing and Regulatory Affairs, which expressed concerns last week about potential shortages for those who take the drug for other ailments such as lupus and rheumatoid arthritis.
The state last week warned prescribers and dispensers against “stockpiling” hydroxychloroquine or chloroquine or prescribing them “without further proof of efficacy for treating COVID-19.”
In follow-up correspondence last week, the department clarified that physicians and pharmacists should “adhere to the standards of practice and exercise the professional judgment applicable to their professions.”
Several medical, physician and pharmacy associations supported the department’s Thursday letter, noting that the medicine, when used for COVID-19, should be reserved for the state’s “sickest and most vulnerable patients” and physicians should avoid “excessive, anticipatory orders.”
Zervos said the hospital system has not experienced any shortages, but recognizes the potential for one “because coronavirus is so widespread.”
Henry Ford Health has had a “number of success stories” using the drug among “severely ill” patients, he said. It also has other supportive treatments — both trial and established — that it has been using to help COVID-19 patients such as an ongoing trial of the anti-viral Remdesivir, oxygen, steroids and antibiotics.
“We’re doing what we think is best under the circumstances,” Zervos said.