Hydroxychloroquine for the treatment of COVID-19 and its potential cardiovascular toxicity: Hero or villain?
Identifieur interne : 000452 ( Main/Corpus ); précédent : 000451; suivant : 000453Hydroxychloroquine for the treatment of COVID-19 and its potential cardiovascular toxicity: Hero or villain?
Auteurs : Bugra Han Egeli ; Jeffrey A. Sparks ; Alfred H J. Kim ; Jean W. LiewSource :
- Best practice & research. Clinical rheumatology [ 1532-1770 ] ; 2021.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Antiviral Agents, Hydroxychloroquine.
- drug therapy : COVID-19.
- Cardiotoxicity, Coronavirus Infections, Humans, SARS-CoV-2.
Abstract
A variety of treatment modalities have been investigated since the beginning of the Coronavirus Disease-19 (COVID-19) pandemic. The use of antimalarials (hydroxychloroquine and chloroquine) for COVID-19 treatment and prevention has proven to be a cautionary tale for widespread, off-label use of a medication during a crisis. The investigation of antimalarials for COVID-19 has also been a driver for a deluge of scientific output in a short amount of time. In this narrative review, we detail the evidence for and against antimalarial use in COVID-19, starting with the early small observational studies that influenced strategies worldwide. We then contrast these findings to later published larger observational studies and randomized controlled trials. We detail the emerging possible cardiovascular risks associated with antimalarial use in COVID-19 and whether COVID-19-related outcomes and cardiovascular risks may differ for antimalarials used in rheumatic diseases.
DOI: 10.1016/j.berh.2020.101658
PubMed: 33483287
PubMed Central: PMC7775793
Links to Exploration step
pubmed:33483287Le document en format XML
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<author><name sortKey="Egeli, Bugra Han" sort="Egeli, Bugra Han" uniqKey="Egeli B" first="Bugra Han" last="Egeli">Bugra Han Egeli</name>
<affiliation><nlm:affiliation>Graduate Medical Sciences, Boston University School of Medicine, 72 E Concord St L-317, Boston, MA, 02118, USA. Electronic address: bhegeli@bu.edu.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sparks, Jeffrey A" sort="Sparks, Jeffrey A" uniqKey="Sparks J" first="Jeffrey A" last="Sparks">Jeffrey A. Sparks</name>
<affiliation><nlm:affiliation>Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital and Harvard Medical School, 60 Fenwood Road, #6016U, Boston, MA, 02115, USA. Electronic address: jsparks@bwh.harvard.edu.</nlm:affiliation>
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<author><name sortKey="Kim, Alfred H J" sort="Kim, Alfred H J" uniqKey="Kim A" first="Alfred H J" last="Kim">Alfred H J. Kim</name>
<affiliation><nlm:affiliation>Division of Rheumatology, Department of Medicine, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8045, St Louis, MO, 63110, USA. Electronic address: akim@dom.wustl.edu.</nlm:affiliation>
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<author><name sortKey="Liew, Jean W" sort="Liew, Jean W" uniqKey="Liew J" first="Jean W" last="Liew">Jean W. Liew</name>
<affiliation><nlm:affiliation>Section of Rheumatology, Boston University School of Medicine, 650 Albany St, X200, Boston, MA, 02118, USA. Electronic address: jwliew@bu.edu.</nlm:affiliation>
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<author><name sortKey="Sparks, Jeffrey A" sort="Sparks, Jeffrey A" uniqKey="Sparks J" first="Jeffrey A" last="Sparks">Jeffrey A. Sparks</name>
<affiliation><nlm:affiliation>Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital and Harvard Medical School, 60 Fenwood Road, #6016U, Boston, MA, 02115, USA. Electronic address: jsparks@bwh.harvard.edu.</nlm:affiliation>
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<author><name sortKey="Kim, Alfred H J" sort="Kim, Alfred H J" uniqKey="Kim A" first="Alfred H J" last="Kim">Alfred H J. Kim</name>
<affiliation><nlm:affiliation>Division of Rheumatology, Department of Medicine, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8045, St Louis, MO, 63110, USA. Electronic address: akim@dom.wustl.edu.</nlm:affiliation>
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<author><name sortKey="Liew, Jean W" sort="Liew, Jean W" uniqKey="Liew J" first="Jean W" last="Liew">Jean W. Liew</name>
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<term>COVID-19 (drug therapy)</term>
<term>Cardiotoxicity (MeSH)</term>
<term>Coronavirus Infections (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Hydroxychloroquine (adverse effects)</term>
<term>SARS-CoV-2 (MeSH)</term>
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<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiviral Agents</term>
<term>Hydroxychloroquine</term>
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<keywords scheme="MESH" xml:lang="en"><term>Cardiotoxicity</term>
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<front><div type="abstract" xml:lang="en">A variety of treatment modalities have been investigated since the beginning of the Coronavirus Disease-19 (COVID-19) pandemic. The use of antimalarials (hydroxychloroquine and chloroquine) for COVID-19 treatment and prevention has proven to be a cautionary tale for widespread, off-label use of a medication during a crisis. The investigation of antimalarials for COVID-19 has also been a driver for a deluge of scientific output in a short amount of time. In this narrative review, we detail the evidence for and against antimalarial use in COVID-19, starting with the early small observational studies that influenced strategies worldwide. We then contrast these findings to later published larger observational studies and randomized controlled trials. We detail the emerging possible cardiovascular risks associated with antimalarial use in COVID-19 and whether COVID-19-related outcomes and cardiovascular risks may differ for antimalarials used in rheumatic diseases.</div>
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<Abstract><AbstractText>A variety of treatment modalities have been investigated since the beginning of the Coronavirus Disease-19 (COVID-19) pandemic. The use of antimalarials (hydroxychloroquine and chloroquine) for COVID-19 treatment and prevention has proven to be a cautionary tale for widespread, off-label use of a medication during a crisis. The investigation of antimalarials for COVID-19 has also been a driver for a deluge of scientific output in a short amount of time. In this narrative review, we detail the evidence for and against antimalarial use in COVID-19, starting with the early small observational studies that influenced strategies worldwide. We then contrast these findings to later published larger observational studies and randomized controlled trials. We detail the emerging possible cardiovascular risks associated with antimalarial use in COVID-19 and whether COVID-19-related outcomes and cardiovascular risks may differ for antimalarials used in rheumatic diseases.</AbstractText>
<CopyrightInformation>Copyright © 2020 Elsevier Ltd. All rights reserved.</CopyrightInformation>
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<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Egeli</LastName>
<ForeName>Bugra Han</ForeName>
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<CoiStatement>Declaration of competing interest BE has nothing to disclose. JWL has received research support from Pfizer unrelated to this work. JAS is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K23 AR069688, R03 AR075886, L30 AR066953, P30 AR070253, and P30 AR072577), the Rheumatology Research Foundation (R Bridge Award), the Brigham Research Institute, and the R. Bruce and Joan M. Mickey Research Scholar Fund. Dr. Sparks has received research support from Amgen and Bristol-Myers Squibb and performed consultancy for Bristol-Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer unrelated to this work. AHK is supported by grants from NIH/NIAMS, Rheumatology Research Foundation, and GlaxoSmithKline as well as by personal fees from Exagen Diagnostics, Inc. Annexon Biosciences, Aurinia Pharmaceuticals, and GlaxoSmithKline outside of the submitted work.</CoiStatement>
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