NIH panel issues first guidance on coronavirus drugs

There is not enough data for or against the vast majority of the medicines, including the combination of hydroxychloroquine and the antibiotic azithromycin, the panel said.

Coronavirus treatment guidelines issued by a government panel conclude there is not enough data on some of the most touted drugs — including hydroxychloroquine, which the panel said should not be used outside clinical trials when paired with antibiotics.

The group, organized by the National Institutes of Health, includes physicians, statisticians and other experts from both government agencies and health organizations. Its guidelines break potential Covid-19 treatments into two categories: antivirals such as the malaria drug hydroxychloroquine and Gilead’s experimental drug remdesivir, and immune system-focused therapies like convalescent plasma or certain arthritis medicines.

There is not enough data for or against the vast majority of the medicines, the panel said in its “living document”, while warning against using some outside of clinical trials. Those included the combination of hydroxychloroquine and the antibiotic azithromycin, which President Donald Trump has repeatedly recommended, because of increased risk for heart problems, as well as Eli Lilly’s Olumiant because it can worsen infections.

The panel also advised against a group of drugs known as interferons because of lack of efficacy data. And it warned that an HIV drug combination, lopinavir and ritonavir, did not show a clear benefit on mortality rates or length of hospital stays compared to standard of care in a randomized Chinese trial.

The experts added that there are conflicting results for hydroxychloroquine and chloroquine and advised physicians to monitor their patients with use. The drugs have been on the market for decades to treat malaria and more recently lupus and arthritis. The president has often touted hydroxychloroquine in particular, but has not mentioned it on the press briefing stage in nearly a week.

New York, which is running a large ongoing trial for the drug, sent its first tranche of data to federal agencies on Monday, Gov. Andrew Cuomo said.

The NIH guidelines are posted on a new website,, that the agency said it will update as often as new peer-reviewed data is published.

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