Does hydroxychloroquine still have any role in the COVID-19 pandemic?
Identifieur interne : 000231 ( Main/Corpus ); précédent : 000230; suivant : 000232Does hydroxychloroquine still have any role in the COVID-19 pandemic?
Auteurs : William Hk Schilling ; Nicholas J. WhiteSource :
- Expert opinion on pharmacotherapy [ 1744-7666 ] ; 2021.
Abstract
Introduction: The 4-aminoquinolines, chloroquine, and hydroxychloroquine have been used for over 70 years for malaria and rheumatological conditions, respectively. Their broad-spectrum antiviral activity, excellent safety profile, tolerability, low cost, and ready availability made them prime repurposing therapeutic candidates at the beginning of the COVID-19 pandemic.Areas covered: Here, the authors discuss the history of hydroxychloroquine and chloroquine, the in vitro data which led to their widespread repurposing and adoption in COVID-19 and their complex pharmacokinetics. The evidence for the use of these drugs is assessed through in vivo animal experiments and the wealth of conflicting data and interpretations published during COVID-19, including the more informative results from randomized controlled trials (RCTs). The safety aspects of these drugs, in particular cardiotoxicity, are then reviewed.Expert opinion: The evidence from clinical trials in COVID-19 supports the well-established safety record of the 4-aminoquinolines at currently recommended dosage. In hospitalized patients with severe COVID-19 RCTs show clearly that the 4-aminoquinolines are not beneficial. The only treatments with proven benefit at this stage of infection are immunomodulators (dexamethasone, IL-6 receptor antagonists). No antiviral drugs have proven life-saving in late-stage COVID-19.
DOI: 10.1080/14656566.2021.1898589
PubMed: 33724123
PubMed Central: PMC7989952
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Does hydroxychloroquine still have any role in the COVID-19 pandemic?</title><author><name sortKey="Schilling, William Hk" sort="Schilling, William Hk" uniqKey="Schilling W" first="William Hk" last="Schilling">William Hk Schilling</name><affiliation><nlm:affiliation>Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J" last="White">Nicholas J. White</name><affiliation><nlm:affiliation>Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33724123</idno><idno type="pmid">33724123</idno><idno type="doi">10.1080/14656566.2021.1898589</idno><idno type="pmc">PMC7989952</idno><idno type="wicri:Area/Main/Corpus">000231</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000231</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Does hydroxychloroquine still have any role in the COVID-19 pandemic?</title><author><name sortKey="Schilling, William Hk" sort="Schilling, William Hk" uniqKey="Schilling W" first="William Hk" last="Schilling">William Hk Schilling</name><affiliation><nlm:affiliation>Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J" last="White">Nicholas J. White</name><affiliation><nlm:affiliation>Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Expert opinion on pharmacotherapy</title><idno type="eISSN">1744-7666</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><b>Introduction</b>: The 4-aminoquinolines, chloroquine, and hydroxychloroquine have been used for over 70 years for malaria and rheumatological conditions, respectively. Their broad-spectrum antiviral activity, excellent safety profile, tolerability, low cost, and ready availability made them prime repurposing therapeutic candidates at the beginning of the COVID-19 pandemic.<b>Areas covered</b>: Here, the authors discuss the history of hydroxychloroquine and chloroquine, the <i>in vitro</i> data which led to their widespread repurposing and adoption in COVID-19 and their complex pharmacokinetics. The evidence for the use of these drugs is assessed through <i>in vivo</i> animal experiments and the wealth of conflicting data and interpretations published during COVID-19, including the more informative results from randomized controlled trials (RCTs). The safety aspects of these drugs, in particular cardiotoxicity, are then reviewed.<b>Expert opinion</b>: The evidence from clinical trials in COVID-19 supports the well-established safety record of the 4-aminoquinolines at currently recommended dosage. In hospitalized patients with severe COVID-19 RCTs show clearly that the 4-aminoquinolines are not beneficial. The only treatments with proven benefit at this stage of infection are immunomodulators (dexamethasone, IL-6 receptor antagonists). No antiviral drugs have proven life-saving in late-stage COVID-19.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33724123</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1744-7666</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Mar</Month><Day>16</Day></PubDate></JournalIssue><Title>Expert opinion on pharmacotherapy</Title><ISOAbbreviation>Expert Opin Pharmacother</ISOAbbreviation></Journal><ArticleTitle>Does hydroxychloroquine still have any role in the COVID-19 pandemic?</ArticleTitle><Pagination><MedlinePgn>1-10</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1080/14656566.2021.1898589</ELocationID><Abstract><AbstractText><b>Introduction</b>: The 4-aminoquinolines, chloroquine, and hydroxychloroquine have been used for over 70 years for malaria and rheumatological conditions, respectively. Their broad-spectrum antiviral activity, excellent safety profile, tolerability, low cost, and ready availability made them prime repurposing therapeutic candidates at the beginning of the COVID-19 pandemic.<b>Areas covered</b>: Here, the authors discuss the history of hydroxychloroquine and chloroquine, the <i>in vitro</i> data which led to their widespread repurposing and adoption in COVID-19 and their complex pharmacokinetics. The evidence for the use of these drugs is assessed through <i>in vivo</i> animal experiments and the wealth of conflicting data and interpretations published during COVID-19, including the more informative results from randomized controlled trials (RCTs). The safety aspects of these drugs, in particular cardiotoxicity, are then reviewed.<b>Expert opinion</b>: The evidence from clinical trials in COVID-19 supports the well-established safety record of the 4-aminoquinolines at currently recommended dosage. In hospitalized patients with severe COVID-19 RCTs show clearly that the 4-aminoquinolines are not beneficial. The only treatments with proven benefit at this stage of infection are immunomodulators (dexamethasone, IL-6 receptor antagonists). No antiviral drugs have proven life-saving in late-stage COVID-19.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Schilling</LastName><ForeName>William Hk</ForeName><Initials>WH</Initials><AffiliationInfo><Affiliation>Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>White</LastName><ForeName>Nicholas J</ForeName><Initials>NJ</Initials><AffiliationInfo><Affiliation>Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, 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