The Rise and Fall of Hydroxychloroquine for the Treatment and Prevention of COVID-19.
Identifieur interne : 000774 ( Main/Corpus ); précédent : 000773; suivant : 000775The Rise and Fall of Hydroxychloroquine for the Treatment and Prevention of COVID-19.
Auteurs : Zelyn Lee ; Craig R. Rayner ; Jamie I. Forrest ; Jean B. Nachega ; Esha Senchaudhuri ; Edward J. MillsSource :
- The American journal of tropical medicine and hygiene [ 1476-1645 ] ; 2021.
English descriptors
- KwdEn :
- Antimalarials (adverse effects), Antimalarials (therapeutic use), Antiviral Agents (adverse effects), Antiviral Agents (therapeutic use), COVID-19 (drug therapy), COVID-19 (prevention & control), Cardiovascular Diseases (chemically induced), Humans (MeSH), Hydroxychloroquine (adverse effects), Hydroxychloroquine (therapeutic use), Politics (MeSH), SARS-CoV-2 (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , adverse effects : Antimalarials, Antiviral Agents, Hydroxychloroquine.
- chemical , therapeutic use : Antimalarials, Antiviral Agents, Hydroxychloroquine.
- chemically induced : Cardiovascular Diseases.
- drug therapy : COVID-19.
- prevention & control : COVID-19.
- Humans, Politics, SARS-CoV-2, Treatment Outcome.
Abstract
The efficacy and safety of hydroxychloroquine (HCQ) for the prevention and treatment of COVID-19 has received great attention, and most notably, the enthusiasm for HCQ has been one of politicization rather than science. Laboratory studies and case series published early in the pandemic supported its efficacy. The scientific community raced to conduct observational and randomized evaluations of the drug in all stages of the disease, including prophylaxis, early treatment, and advanced disease. Yet a divisive media response affected recruitment, funding, and subsequent enthusiasm for continuing scientific investigations. Of the more than 300 HCQ trials registered, fewer than 50% report having recruited any patients, and most trials might fail to achieve any useful portions of their intended sample size. Multiple observational studies and two large randomized trials have demonstrated HCQ does not offer efficacy against COVID-19 in hospitalized patients. Prophylaxis studies and early treatment studies provided heterogeneous results and are plagued by low event rates and poor study outcome monitoring. Emerging high-quality evaluations of prophylaxis and early treatment do not support a role for HCQ in these populations. The story of HCQ for COVID-19 has followed a pattern of initial enthusiasm supported by poor quality evidence, followed by disappointment based on more rigorous evaluations. The experience of HCQ in the COVID-19 era calls for the depoliticization of science away from media glare.
DOI: 10.4269/ajtmh.20-1320
PubMed: 33236703
PubMed Central: PMC7790108
Links to Exploration step
pubmed:33236703Le document en format XML
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Forrest</name><affiliation><nlm:affiliation>4Cytel Inc., Vancouver, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>5School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Nachega, Jean B" sort="Nachega, Jean B" uniqKey="Nachega J" first="Jean B" last="Nachega">Jean B. 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Rayner</name><affiliation><nlm:affiliation>2Certara Inc, Princeton, New Jersey.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>3Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Forrest, Jamie I" sort="Forrest, Jamie I" uniqKey="Forrest J" first="Jamie I" last="Forrest">Jamie I. Forrest</name><affiliation><nlm:affiliation>4Cytel Inc., Vancouver, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>5School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Nachega, Jean B" sort="Nachega, Jean B" uniqKey="Nachega J" first="Jean B" last="Nachega">Jean B. Nachega</name><affiliation><nlm:affiliation>6Department of Medicine, Stellenbosch University, Cape Town, South Africa.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>7Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>8Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>9Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>11Department of Health Research Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Senchaudhuri, Esha" sort="Senchaudhuri, Esha" uniqKey="Senchaudhuri E" first="Esha" last="Senchaudhuri">Esha Senchaudhuri</name><affiliation><nlm:affiliation>4Cytel Inc., Vancouver, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mills, Edward J" sort="Mills, Edward J" uniqKey="Mills E" first="Edward J" last="Mills">Edward J. Mills</name><affiliation><nlm:affiliation>4Cytel Inc., Vancouver, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>11Department of Health Research Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The American journal of tropical medicine and hygiene</title><idno type="eISSN">1476-1645</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antimalarials (adverse effects)</term><term>Antimalarials (therapeutic use)</term><term>Antiviral Agents (adverse effects)</term><term>Antiviral Agents (therapeutic use)</term><term>COVID-19 (drug therapy)</term><term>COVID-19 (prevention & control)</term><term>Cardiovascular Diseases (chemically induced)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (adverse effects)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Politics (MeSH)</term><term>SARS-CoV-2 (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antimalarials</term><term>Antiviral Agents</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antimalarials</term><term>Antiviral Agents</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Cardiovascular Diseases</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Politics</term><term>SARS-CoV-2</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The efficacy and safety of hydroxychloroquine (HCQ) for the prevention and treatment of COVID-19 has received great attention, and most notably, the enthusiasm for HCQ has been one of politicization rather than science. Laboratory studies and case series published early in the pandemic supported its efficacy. The scientific community raced to conduct observational and randomized evaluations of the drug in all stages of the disease, including prophylaxis, early treatment, and advanced disease. Yet a divisive media response affected recruitment, funding, and subsequent enthusiasm for continuing scientific investigations. Of the more than 300 HCQ trials registered, fewer than 50% report having recruited any patients, and most trials might fail to achieve any useful portions of their intended sample size. Multiple observational studies and two large randomized trials have demonstrated HCQ does not offer efficacy against COVID-19 in hospitalized patients. Prophylaxis studies and early treatment studies provided heterogeneous results and are plagued by low event rates and poor study outcome monitoring. Emerging high-quality evaluations of prophylaxis and early treatment do not support a role for HCQ in these populations. The story of HCQ for COVID-19 has followed a pattern of initial enthusiasm supported by poor quality evidence, followed by disappointment based on more rigorous evaluations. The experience of HCQ in the COVID-19 era calls for the depoliticization of science away from media glare.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33236703</PMID><DateCompleted><Year>2021</Year><Month>01</Month><Day>25</Day></DateCompleted><DateRevised><Year>2021</Year><Month>02</Month><Day>03</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1476-1645</ISSN><JournalIssue CitedMedium="Internet"><Volume>104</Volume><Issue>1</Issue><PubDate><Year>2021</Year><Month>Jan</Month></PubDate></JournalIssue><Title>The American journal of tropical medicine and hygiene</Title><ISOAbbreviation>Am J Trop Med Hyg</ISOAbbreviation></Journal><ArticleTitle>The Rise and Fall of Hydroxychloroquine for the Treatment and Prevention of COVID-19.</ArticleTitle><Pagination><MedlinePgn>35-38</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.4269/ajtmh.20-1320</ELocationID><ELocationID EIdType="pii" ValidYN="Y">tpmd201320</ELocationID><Abstract><AbstractText>The efficacy and safety of hydroxychloroquine (HCQ) for the prevention and treatment of COVID-19 has received great attention, and most notably, the enthusiasm for HCQ has been one of politicization rather than science. Laboratory studies and case series published early in the pandemic supported its efficacy. The scientific community raced to conduct observational and randomized evaluations of the drug in all stages of the disease, including prophylaxis, early treatment, and advanced disease. Yet a divisive media response affected recruitment, funding, and subsequent enthusiasm for continuing scientific investigations. Of the more than 300 HCQ trials registered, fewer than 50% report having recruited any patients, and most trials might fail to achieve any useful portions of their intended sample size. Multiple observational studies and two large randomized trials have demonstrated HCQ does not offer efficacy against COVID-19 in hospitalized patients. Prophylaxis studies and early treatment studies provided heterogeneous results and are plagued by low event rates and poor study outcome monitoring. Emerging high-quality evaluations of prophylaxis and early treatment do not support a role for HCQ in these populations. The story of HCQ for COVID-19 has followed a pattern of initial enthusiasm supported by poor quality evidence, followed by disappointment based on more rigorous evaluations. The experience of HCQ in the COVID-19 era calls for the depoliticization of science away from media glare.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Zelyn</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>1University of Toronto, Toronto, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rayner</LastName><ForeName>Craig R</ForeName><Initials>CR</Initials><AffiliationInfo><Affiliation>2Certara Inc, Princeton, New Jersey.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>3Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Forrest</LastName><ForeName>Jamie I</ForeName><Initials>JI</Initials><AffiliationInfo><Affiliation>4Cytel Inc., Vancouver, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>5School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nachega</LastName><ForeName>Jean B</ForeName><Initials>JB</Initials><AffiliationInfo><Affiliation>6Department of Medicine, Stellenbosch University, Cape Town, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>7Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>8Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>9Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>11Department of Health Research Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Senchaudhuri</LastName><ForeName>Esha</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>4Cytel Inc., Vancouver, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mills</LastName><ForeName>Edward J</ForeName><Initials>EJ</Initials><AffiliationInfo><Affiliation>4Cytel Inc., Vancouver, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>11Department of Health Research Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Trop Med 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UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002318" MajorTopicYN="N">Cardiovascular Diseases</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="N">chemically induced</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic 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