Drug touted as coronavirus ‘cure’ is causing shortages for lupus and arthritis patients
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Adrienne Ruvalcaba of Wood River hopes the drug she takes to battle systemic lupus can help COVID-19 patients, as a study from China released this week shows may be possible.
But Ruvalcaba also hopes that the supply of hydroxychloroquine, which is sold under the brand name Plaquenil, will still be available to her and others who have used the drug since long before President Donald Trump raised the possibility of the drug’s use to fight coronavirus.
The drug has been used with the antibiotic azithromycin, or Zithromax Z-Pak, to treat COVID-19 patients. Trump tweeted last month that the combination has “a real chance to be one of the biggest game changers in the history of medicine.”
As word spread that Plaquenil was being investigated for use as a remedy to pandemic that has killed more than 50,000 people worldwide as of Thursday, those like Ruvalcaba who use it for lupus and rheumatoid arthritis have seen shortages of the drug on pharmacy shelves. The drug and its relative, chloroquine, also have been used to treat malaria patients for decades.
Here’s a timeline of some recent developments regarding Plaquenil and COVID-19:
▪ The New York Times reported on Wednesday that a study of 62 COVID-19 patients in China with mild or moderate illness were given Plaquenil and it “helped to speed” their recovery.
“Cough, fever and pneumonia went away faster, and the disease seemed less likely to turn severe in people who received hydroxychloroquine than in a comparison group not given the drug,” the newspaper reported.
However, the study said more research was needed.
The Associated Press reported last month that two previous studies had been conducted in China and France but described the evidence on whether the drugs can help COVID-19 patients as “not much.”
▪ The U.S. Food and Drug Administration on Sunday issued an “emergency use authorization” that allows doctors to give Plaquenil and chloroquine to “hospitalized teen and adult patients with COVID-19, as appropriate, when a clinical trial is not available or feasible,” according to a news release from the U.S. Department of Health and Human Services. The medicine available for this authorization will come from pills donated to the federal stockpile.
Sandoz has donated 30 million doses of hydroxychloroquine and Bayer Pharmaceuticals donated 1 million doses of chloroquine, the news release said.
“These and other companies may donate additional doses, and companies have ramped up production to provide additional supplies of the medication to the commercial market,” the Department of Health and Human Services said.
▪ The Lupus Foundation of America said it is closely monitoring the supply chain for Plaquenil and chloroquine for patients who need the drugs.
“While it’s still unclear what the full impact of the government’s action will be, it is a step in the right direction to address supply of these medications,” the organization said in a statement.
Need for Plaquenil
For the 38-year-old Ruvalcaba, Plaquenil is a life line. She’s used the medicine since 2009.
When her usual pharmacy did not have her supply last week, she began a frantic search to find the medicine.
“It’s on backorder all over the place,” she said.
Ruvalcaba, who works as a fiction writer from her home, checked with several pharmacies before finally finding one that could fill her three-month prescription. The store would not accept her insurance, however, so she had to pay nearly $200 out of pocket to get her medication.
“If I don’t have my Plaquenil for about a week, … I start getting inflammation in my lungs and that’s very painful. I’ll start getting feverish because that’s just one of the main symptoms of lupus, you know difficulty breathing. I’ll have chest pain,” she said.
Those symptoms closely mimic those of the novel coronavirus, which only added to the stress of Ruvalcaba’s hunt for Plaquenil, she said.
“It’s also an emotional worry for me because all of those things I have experienced in the past and they’re very painful and it’s scary and I don’t want to go through it,” she said. “But on top of that, they also kind of align with the symptoms of COVID-19.
“So if I wasn’t on my medicine, it would be really hard for me to tell if it was something lupus related or if it was the” virus that’s going around.
The Lupus Foundation of America validated Ruvalcaba’s concerns with a statement issued Wednesday about COVID-19.
“Lupus is a chronic autoimmune disease — that means that your immune system is dysfunctional and attacks your healthy tissue,” according to the foundation. “This can make the immune system less effective at fighting infections. Medications that suppress the immune system — which people with lupus often take — can also limit your body’s ability to respond to infections. As a result, people with lupus are less able to fight off bacteria and viruses, like COVID-19.”
Pharmacy supplies
Longtime Belleville pharmacist Steve Clement is dealing with the crunch for Plaquenil during the coronavirus outbreak.
Clement, who has 10 customers at his Copper Bend Pharmacy off Frank Scott Parkway who take the drug for either lupus or rheumatoid arthritis, said he has been able to secure a supply for these patients and calm their fears.
But, for now, he can no longer take new clients who need Plaquenil, he said.
Clement said he has had to refuse requests from medical professionals who are seeking Plaquenil. He also is not filling requests for azithromycin for people who want it to battle COVID-19 because he said it doesn’t work unless it’s combined with Plaquenil.
And it’s this combination that prompted Clement to warn potential users that there are possible negative consequences of taking the drugs.
The two drugs can affect a person’s heartbeat, he said.
Clement said if you are a patient that doesn’t know you have a heart condition and you take these two drugs, you possibly could face “very detrimental” side effects.
This story was originally published April 4, 2020 at 5:00 AM.
