The suspension by the WHO of trials on hydroxychloroquine could have signaled the end of this possible treatment against Covid-19. But the study responsible for this decision is now under attack from all sides, relaunching the debate on the controversial molecule.
The study on hydroxychloroquine against the coronavirus, published on May 22 in the scientific journal The Lancet, is in turn attacked from all sides. It is based on approximately 96,000 patients hospitalized between December and April in 671 hospitals, and compares the condition of those who received treatment to that of patients who did not.
Dr Mandeep Mehra and his colleagues conclude that the treatment does not appear to be beneficial to hospitalized Covid-19 patients and could even be harmful.
These results, which point in the same direction as several other studies on a smaller scale, had a considerable impact and spectacular consequences.
Three days later, the World Health Organization (WHO) announced the suspension as a precautionary measure of the clinical trials it was conducting on this molecule with its partners in several countries.
Several other clinical trials have been suspended and France has banned the use of hydroxychloroquine for the treatment of Covid-19, to the chagrin of its promoters.
The first of them, the now famous Professor Didier Raoult, also immediately deemed the Lancet study “messy”. His own work, which concludes that hydroxychloroquine is effective in combination with an antibiotic, azithromycin, has been criticized, with other scientists pointing to numerous methodological biases.
Read alsoHow Professor Raoult’s hydocychloroquine went viral
But even researchers skeptical about the interest of the molecule to treat Covid-19 patients have expressed their doubts about the study of the Lancet, questioning in particular the origin of the data used.
In an open letter published Thursday evening, dozens of scientists around the world, from Harvard to Imperial College London, point out that the scrutiny of the Lancet study “has raised both concerns related to the methodology and data integrity ”.
They draw up a long list of problematic points, from inconsistencies in the doses administered in certain countries to ethical questions on the collection of patient data, including the refusal of the authors to give access to the raw data.
“Breaking the trust”
This study data comes from Surgisphere, which markets itself as a US-based health data analytics company.
The company has defended the integrity of its data and claimed that it comes from hospitals that collaborate with it. But according to The Guardian newspaper, his boss Sapan Desai, one of the authors of the study, admitted to having mistakenly classified 73 deaths in “Australia” when they should have been counted in “Asia”.
“This underscores the need for error checking across the database,” claims the scientists in their open letter.
They call for the establishment by the WHO or another agency of a group to conduct an independent analysis of the findings of the study.
Asked Friday on this issue, the WHO noted that the suspension of trials involving hydroxychloroquine was “temporary” and that its experts would give their “final opinion” after examining other elements (notably the interim analyzes of the Solidarity trial), probably by mid-June.
The open letter, signed in particular by Prof. Philippe Parola, collaborator of Prof. Raoult, was immediately relayed by the latter, citing Winston Churchill.
“‘This is not the end. It’s not even the beginning of the end. But maybe this is the end of the beginning ‘… Of the war on chloroquine,’ he tweeted.
But all the signatories of the open letter are far from being supporters of hydroxychloroquine.
“I have serious doubts about the benefits of treatment with chloroquine / hydroxychloroquine for Covid-19 and I can’t wait for this story to end, but I believe that the integrity of the research cannot be relied on only when an article does not go in the direction of our preconceptions ”, commented on Twitter Professor François Balloux, of the University College of London.
Also, “it is with a heavy heart that I added my name to the open letter”.
Signatories or not, many scientists have relayed their concerns about the impact of this affair on science, sometimes with the hashtag #Lancetgate (“Lancet scandal”) or #whats_with_hcq_lancet_paper (“what’s going on with the study of the Lancet ”).
“If the Lancet article is a fraud, it will destroy confidence in scientists in a lasting way”, commented Friday Professor Gilbert Deray, of Pitié-Salpêtrière in Paris. “I await with concern the results of the investigation”.
Asked Friday by AFP, the Lancet said it had sent the many questions on the study to its authors. “They are working to respond to the issues raised”.