HMHs Observational Study Demonstrates Lack of Efficacy of Hydroxychloroquine Among Hospitalized COVID19 Patients But Finds First Treatment tocilizumab to Improve Survival

What you need to know

Hackensack Meridian Health has utilized its large observational database of more than 3,000 hospitalized COVID-19 patients to show that the touted malaria treatment, hydroxychloroquine, does not improve survival for hospitalized patients.

Another drug, tocilizumab, appears to improve survival among critically ill intensive care unit (ICU) patients.  If confirmed, tocilizumab would become the first medication improving survival from COVID-19. 

These major findings were released today on the online platform medRxiv, which allow researchers to share critical scientific information rapidly prior to publication in peer-reviewed journals.  Given the potential lifesaving findings of tocilizumab the Hackensack Meridian Health researchers believe that sharing this information rapidly is important.  The results are based on the new data analysis platform - the HMH Universal Observational Database for COVID-19, or RECOVERY, which compiles outcomes from 13 Hackensack Meridian Health hospitals throughout New Jersey. This database enhances the understanding of this disease and helps rapidly identify effective therapies.

Results

Results from the study include the following:

• Among 2,512 hospitalized patients with COVID-19, 76 percent received at least one dose of hydroxychloroquine and 59 percent received hydroxychloroquine with azithromycin.
• After adjusting for imbalances via propensity modeling, compared to receiving no hydroxychloroquine, there was no significant differences in associated mortality for patients receiving any hydroxychloroquine during the hospital stay.
• Among 547 ICU patients, including 134 receiving tocilizumab in the ICU, an exploratory analysis found a trend towards an improved survival rate: 56 percent who received the drug compared to 46 percent who did not receive the therapy, and a propensity adjusted hazard ratio 0.76.

Analyzing data

Using a national leader in real-world evidence analysis to assist, COTA, Inc., the Hackensack Meridian John Theurer Cancer Center team conducted propensity modeling to assess for potential effective therapeutic interventions. The data and statistical analysis were enhanced by Donald A. Berry, Ph.D., professor, Department of Biostatistics, The University of Texas MD Anderson Cancer Center and his statistical team at Berry Consultants.

Researchers established an observational database through Epic – Hackensack Meridian’s electronic health records (EHR) system – and collected a random sampling of COVID-19 patients who received treatment at one of 13 hospitals across the network.