Responsible use of Hydroxychloroquine
From PSHCP Physician Leadership and the Milton S. Hershey Medical Center
The Penn State Health Care Partners (PSHCP) Clinically-Integrated Network (CIN) would like to share the following recommendation made to Penn State Milton S. Hershey Medical Center Medical Staff and Medical Group Members on the responsible use of chloroquine and hydroxychloroquine.
Over the past few weeks there have been some preliminary reports about a potential benefit from the use of anti-malarial drugs (chloroquine and hydroxychloroquine) for treatment of the novel coronavirus. Unfortunately, this has coincided with disturbing reports of physicians and other prescribers who are inappropriately providing prescriptions for hydroxychloroquine for prophylaxis against COVID19 to patients, family members, and even themselves. Please be aware that is inappropriate for the following reasons:
Firstly, this pattern of unnecessary prescriptions has created a national shortage of this medication, limiting access for patients that actually need it. Hydroxychloroquine is used routinely for patients with systemic lupus erythematosus (SLE), dermatomyositis, and other inflammatory connective tissue disorders. There is data from RCTs demonstrating that withdrawal of hydroxychloroquine leads to flares of underlying disease. If this shortage continues we can expect to see an increase in disease flares in these patients. Disease flares are likely to lead to hospitalizations which will divert precious resources away from other patients, in addition to threatening the health of the individual patients.
Secondly, there is no data demonstrating that hydroxychloroquine is effective as prophylaxis against COVID19. Even the data suggesting hydroxychloroquine may be used in combination with other medications for treatment is preliminary and not yet confirmed. Please consider the recommendations of the NIH, CDC, and your local infectious disease specialist when considering the use of any medications for COVID19.
For additional information please see the joint statement from the American College of Rheumatology, Arthritis Foundation, American Academy of Dermatology, and the Lupus Foundation that was released on 3/23/20 urging government leaders to take action to support access to hydroxychloroquine for patients who rely on it.
Additional information on Penn State Health Milton S. Hershey Medical Center resources and up-to-date information can be found here.