Brasilia – The Ministry of Health has defended the use of chloroquine and hydroxychloroquine to treat Covid-19 patients who are deficient in G6PD (glucose-6-phosphate, an enzyme defect linked to the X chromosome). Medicines, whose effectiveness against Covid has not been proven, are contraindicated in the package leaflet for these people.
The opinion came in a technical note issued by the agency, in April of last year, and published on its website. It was signed by the Department of Science, Technology, Innovation and Strategic Health Requirements, which assessed the safety of these drugs in G6PD patients infected with the virus.
The analysis was conducted after neuroscientist Paula Giovia de Marco, who suffers from a disability, as well as her family, sent an email to the Prime Minister of the Cabinet of the Minister of Health, while Luis Henrique Mandetta was occupying it, to express concern. On the topic.
In the letter entitled “A serious problem with chloroquine,” the researcher warned of the possibility of “high-level side effects” of these drugs in patients with G6PD deficiency in the treatment of Covid.
For this reason, it was suggested that before administering the drug, the laboratories should track the disease “because such patients may die if they use this drug”. She also conducted a study of the disease in a biomedical course at the José de Rosario Villano University in Minas Gerais.
The Ministry of Health, in its technical note, justified that both drugs were recommended by the file as a therapeutic possibility for patients who have been diagnosed with Covid, hospital residents and those afflicted with the acute form of the disease, not a label, that it is, without prior indication in the bull.
Next, he admits that the package leaflet of chloroquine indicates its contraindications for patients with G6P deficiency, and the package insert for hydroxychloroquine warns that its use in these patients should be done with caution.
However, it states that a review of studies by Brazilian researchers, which sought to identify the clinical complications associated with G6PD deficiency in Latin American and Caribbean countries, did not identify the incidence of severe chloroquine-induced hemolytic anemia in patients with this deficiency.
“Chloroquine is contraindicated in the package leaflet for patients with G6PD deficiency and the hydroxychloroquine package supplement recommends its use with caution in these patients. However, the evidence currently available does not indicate an increased risk of using these drugs in patients with G6PD deficiency.
“Thus, screening for G6PD deficiency in all patients eligible for treatment with chloroquine or hydroxychloroquine due to infection with the Coronavirus is not justified,” he points out.
G6PD deficiency is considered hereditary and affects nearly half a billion people worldwide. It manifests itself mainly in erythrocytes, because the enzyme is necessary for the survival of red blood cells. It can get worse when the patient consumes certain foods or types of nonprescription drugs, causing severe anemia, rupture of red blood cells, shortness of breath and even death, depending on the case.
The package leaflet for the drug Quinacris, for example, manufactured with chloroquine by Cristália Laboratory, talks about the disease in the section “Precautions & Warnings”. She says that patients with glucose-6-phosphate deficiency should notice hemolytic anemia during treatment with chloroquine.
The FDA (United States Medicines Regulatory Agency) also recommends evaluating and monitoring the use of these substances in these situations. “Be aware that hydroxychloroquine or chloroquine can cause hemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency,” he says. Hemolysis is the process of destroying red blood cells that release hemoglobin, which is the pigment responsible for transporting oxygen to the cells.
Another study by Hemorio, a blood center at the Rio de Janeiro State Health Secretariat, says that chloroquine should be used with caution by these patients and that hydroxychloroquine should be avoided. He said, “I was planning to open a call, which was rejected, with the Ministry of Health to be careful when referring these drugs to these patients. It is a valid point because their effectiveness, to date, has not yet been proven effective.” researcher.
On March 31 of last year, the Ministry of Health also published an information note on the use of chloroquine as an adjunctive treatment in the treatment of severe forms of Covid. One of the justifications for the portfolio was the lack of specific drug treatments for the disease, at the start of the pandemic.
One of President Jair Bolsonaro’s flags is defending the use of the drug without evidence of its effectiveness in treating Covid. These drugs have been used for decades for other purposes, but they have been ignored by the scientific and medical community to treat Covid because they do not prove the ability to stop the new Corona virus or prevent or treat disease.
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