04/06/2020

Press Release No. 134, 2020

- With scientific evidence supporting the use of two drugs for the treatment of COVID-19, the Ministry of Health opens the possibility for doctors to take them into account.

Bogotá DC, April 6, 2020. The Ministry of Health and Social Protection, with the endorsement of the Colombian Association of Infectious Diseases (ACIN), indicates that after finding scientific evidence for the use of chloroquine and hydroxychloroquine, there is a possibility that medical personnel consider its use for the treatment of COVID-19.

Several in vitro studies of these drugs, which are antimalarial, anti-inflammatory and antigenic processing inhibitors, indicated in diseases such as rheumatoid arthritis and lupus erythematosus, report activity against SARS-CoV-2, but weak scientific evidence of effectiveness.

"The Ministry is constantly watchful for any progress and any treatment or innovation. It has found some clinical studies that say that the use of hydroxychloroquine and chloroquine can help in the treatment of coronavirus disease," said the deputy minister of Public Health and Service Provision, Luis Alexander Moscoso regarding these two drugs, noting that after consulting scientific societies, it was found that, while the level of evidence is low, it is recommended for use.

Therefore, the Ministry of Health leaves open the possibility for health professionals in hospitals and clinics to consider these medications as a possibility for the treatment of COVID-19, and for this purpose, it would indicate:

1. The evidence for the use of medicines is not strong enough, but it is expected in the context of a contingency. So, if the treating doctor considers its use, a consensus must be reached within the treating institution and the decision harmonized with the recommendations of national scientific societies.
2. Resolution 3512 of 2019, which describes the health services and technologies financed with UPC resources, includes chloroquine (diphosphate or sulfate) in section B, ATC code P01BA01 medicine for use in public health in its currently authorized indications. It is supplied by the Ministry of Health and Social Protection, according to technical standards and care guidelines for diseases of public health interest. Hydroxychloroquine is not described in Annex 1 of said Resolution. Therefore, in the context of the health emergency and the mitigation phase, it must be prescribed by the MIPRES technological tool (via recovery).
3. Hydroxychloroquine has recently been used in combination with azithromycin in COVID-19 (study by Gautret et al), but only loss of the viral presence was evaluated, with a polymerase chain reaction (PCR) and not the clinical response. In the aforementioned study, the benefits discussed above were shown, but the hydroxychloroquine/azithromycin association may prolong QT and this risk has not been specifically assessed. Azithromycin is an antibiotic that has other indications and use is not recommended in this case.
4. Chloroquine studies have been performed in vitro and there is little information in humans.
5. The prescription of medications for Covid-19 must be carried out under very precise medical indications and must not be used in prophylaxis. However, ongoing research is establishing its role in prophylaxis in health workers.
6. The adverse effects of chloroquine should be evaluated, mainly QT prolongation and secondary hypotension (generally more severe than those produced by hydroxychloroquine).

Malaria is a problem at the national level and the purchase of medicines is conducted after annual projections for a certain number of patients, who continue to need treatment despite the current contingency. Therefore, this medicine, currently in the Territorial Health Directorates (DTSs), has specific destinations and cannot be used for the treatment of patients with COVID -19 at this time.