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Hydroxychloroquine falls out of use in Hudson County

Other therapies now favored over the drug at area hospitals

The drug is no longer widely used in favor of other treatments.

Just a month ago, Hydroxychloroquine was the drug on everyone’s tongue. Now, it’s largely fallen out of use at hospitals across Hudson County.

Hydroxychloroquine, used to treat malaria and lupus, became a household name after President Trump repeatedly promoted it. At the onset of the pandemic, the drug was used at Bayonne Medical Center, given to patients battling COVID-19.

And while Trump had peddled the drug, some officials have said that the downsides of Hydroxychloroquine are too great to ignore, including irregular heart rates that increase the risk of a potentially fatal heart arrhythmia.

Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, is a leading expert and senior adviser during the ongoing crisis who has said that there is no clinical evidence that supports the claims that Hydroxychloroquine is an effective treatment against COVID-19.

Still, the drug was widely used at hospitals across the country.

Dr. Vijay Singh, Chief Medical Officer of the CarePoint Health Medical Group and CEO of Bayonne Medical Center (BMC), previously used Hydroxychloroquine at the hospital. Now it seems things have changed in Bayonne and across the county.

Dr. Tucker Woods, Chief Medical Officer at Christ Hospital in Jersey City, said that Hydroxychloroquine is  no longer used for the most part, in favor of more promising treatments.

“I think in the beginning [Hydroxychloroquine] was promising based on some data coming out of China,” Woods said. “After some studies that were published here in the United States, now I think it’s lost a lot of its initial hopes.”

Dr. Nizar Kifaieh struck a similar tone at Hudson Regional Hospital in Secaucus.

Doctors at the hospitals were trying everything to save patients, including the use of Hydroxychloroquine. Pedro Gonzalez was one of the first COVID-19 patients at Hudson Regional. He was intubated on a ventilator for 22 days, and recovered after receiving the drug, but he was also treated with other therapies.

Saving two lives at once

Woods said that hope has arrived with the drug Remdesivir, which was approved for emergency use by the FDA.

The drug shortens hospitalization duration by 30 percent, according to Woods, and has been in use at Christ Hospital since the start of the pandemic.

A 21-week pregnant patient with the virus was intubated and put on a ventilator, but nothing was working.

The doctor treating her said her “lungs were like rocks” and reached out to Gilead, maker of Remdesivir, to request the drug for her, though it had been approved only for compassionate care.

This was back in April, before the FDA authorized the emergency use of Remdesivir. Gilead approved the request and sent the drug the next day. She was administered the Remdesivir, improved, and two days later was taken off the ventilator. Woods said she’s now 25 weeks pregnant and recovering at home on oxygen until full recovery.

More innovative solutions

Hospitals have seen success with another drug from the start. An ICU physician at BMC, Dr. Yuriy Takhalov, thought of an innovative treatment for the virus when his 47-year-old uncle contracted COVID-19 in late March.

The hospital started researching the use of an IL-6 inhibitor, Actemera, for ICU patients.  However, the drug is used only in certain circumstances, under strict criteria.

The physician’s uncle at BMC was one of the patients who fit the criteria and received the drug. Nearly 72 hours later, he was discharged from BMC and now Singh said that the man is healthy and doing well. The drug may have been a factor.

Now the hospital is treating more than a dozen patients with the drug. The medication works to fight COVID-19 by stopping the cytokine storm created by the virus. A cytokine storm occurs when the virus activates the proteins lining the blood vessels and turns them against the body.

This reaction causes inflammation, swelling vessels, blood clot, and loss of lining in the lungs. Actemera reportedly stops the cytokine storm, leading to patient improvement and the removal of ventilators.

Woods said that Christ Hospital also saw promise with Actemera.

Front-line therapies

Another promising treatment is convalescent plasma therapy, which involves the distribution of the collected COVID-19 survivor blood plasma containing antibodies that can overcome the virus. Currently, the therapy is in an experimental phase.

Convalescent plasma therapy seems to be the most common treatment among area hospitals, having been used to fight other viral outbreaks, including Severe Acute Respiratory Syndrome (SARS), according to Hackensack Meridian Health Palisades Medical Center.

Doctors first seek a small blood sample from those recovered or recovering patients who volunteer for antibody testing, with the goal of finding those who developed the highest levels of targeted antibodies. Those patients with the highest level of antibodies will be asked to return to provide a larger plasma donation, which may be used to infuse into very sick COVID-19 patients.

The treatment is in use at BMC, Christ Hospital, Hoboken University Medical Center, Hudson Regional Hospital, and Palisades Medical Center.

According to Singh, there have been 70 donors in the past few weeks at BMC as the hospital continues to study the donor antibodies. Woods said that 38 patients at Christ Hospital registered for the treatment and that 26 had already received it as of May 6.

Due to a national shortage in donor plasma, hospitals may have to wait for patients to receive the convalescent plasma therapy. In some cases, Woods said patients died waiting for donor materials during the shortage in late April. However, as the Red Cross receives more donations, turnaround time is reduced as plasma becomes more widely available.

Timing is everything during a pandemic. When the state begins to open up, a solid treatment option will be necessary to ensure New Jersey can cope with the pandemic in the long term.

For updates on this and other stories, check www.hudsonreporter.com and follow us on Twitter @hudson_reporter. Daniel Israel can be reached at disrael@hudsonreporter.com.

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