'Crazy thing to do': Health experts alarmed by Trump's use of unproven drug

President Donald Trump’s startling admission Monday that he is taking hydroxychloroquine despite testing negative for the coronavirus alarmed health experts, who cautioned that people who follow his lead risk serious heart problems and other complications from the decades-old drug.

The treatment has been shown in observational studies to have limited or no proven benefits for coronavirus patients, and could even be harmful when used in certain combinations. But data from more extensive studies are still forthcoming. Public health experts expressed concern that Trump’s continued advocacy of the drug could cause another run on supplies, with serious consequences for patients with lupus, rheumatoid arthritis and other autoimmune diseases for which it is an approved treatment.

Despite testing negative, Trump told reporters he has been taking the drug in combination with other medicines for a “couple of weeks.” That is around the same time the first two cases of coronavirus were confirmed in the White House.

There have been only limited results from studies on whether hydroxychloroquine could be effective as a prophylactic measure. Given the drug’s potentially harsh side effects, medical experts strongly cautioned they wouldn’t prescribe the drug to patients as a preventive measure.

“That seems to me to be a crazy thing to do,” said David Juurlink, head of clinical pharmacology at the University of Toronto. “If the drug had no side effects, it would be a reasonable thing to do.”

Trump would appear be part of the cohort most at risk of taking the drug in this manner. The president has a common heart disease, with a buildup of plaque in his blood vessels, according to records the White House released after his 2018 physical exam.

Monday's disclosure mixed the defiance Trump has displayed since the early days of the pandemic with a heightened sense of vulnerability. The president has insisted the country can reopen for business as the virus continues to spread, questioned death tolls and dismissed some assertions by his health advisers. And yet he appears willing to take an unproven drug he insists is effective as the virus spreads to his inner circle.

Trump’s doctor, Sean Conley, said he and the president had “numerous discussions” about the evidence surrounding hydroxychloroquine, according to a newly released White House memo that didn't specify a treatment regimen.

“We concluded the potential benefit from treatment outweighed the relative risks,” Conley wrote.

Experts also worried that Trump’s latest comments would spark another dash to scoop up hydroxychloroquine, which has been on FDA’s shortage list since late March after the president began hyping the drug as a potential treatment. State pharmacy boards last month cracked down on dispensing the drug after Trump's boosterism prompted a surge in demand.

Even before Trump's comments, the head of the FDA’s drug office earlier Monday expressed concern for vulnerable patients who depend on the drug.

“It's a necessary drug for them and not having access would have terrible consequences," tweeted Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research.

Trump's former secretary of Veterans Affairs, David Shulkin, expressed worry on Twitter that Trump's touting of the drug would influence the public to take hydroxychloroquine without data to support its use.

Other health experts worried that patients would gravitate toward hydroxychloroquine, even as another experimental drug — Gilead's remdesivir — has shown promise in hospitalized patients.

Aneesh Mehta, an infectious disease doctor at Emory University, said that some patients didn’t enroll in a trial of remdesivir he helped run because they wanted to take hydroxychloroquine after seeing media reports.