Hydroxychloroquine and maintenance immunosuppression use in kidney transplant recipients: Analysis of linked US registry and claims data.
Identifieur interne : 001212 ( Main/Exploration ); précédent : 001211; suivant : 001213Hydroxychloroquine and maintenance immunosuppression use in kidney transplant recipients: Analysis of linked US registry and claims data.
Auteurs : Krista L. Lentine [États-Unis] ; Ngan N. Lam [Canada] ; Yasar Caliskan [États-Unis] ; Tarek Alhamad [États-Unis] ; Huiling Xiao [États-Unis] ; Mark A. Schnitzler [États-Unis] ; Su-Hsin Chang [États-Unis] ; David Axelrod [États-Unis] ; Dorry L. Segev [États-Unis] ; Mara Mcadams-Demarco [États-Unis] ; Bertram L. Kasiske [États-Unis] ; Gregory P. Hess [États-Unis] ; Daniel C. Brennan [États-Unis]Source :
- Clinical transplantation [ 1399-0012 ] ; 2020.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Association de médicaments (MeSH), Assurance maladie (MeSH), Chimiothérapie de maintenance (méthodes), Défaillance rénale chronique (chirurgie), Défaillance rénale chronique (mortalité), Défaillance rénale chronique (étiologie), Enregistrements (MeSH), Femelle (MeSH), Humains (MeSH), Hydroxychloroquine (usage thérapeutique), Immunosuppresseurs (usage thérapeutique), Jeune adulte (MeSH), Lupus érythémateux disséminé (complications), Lupus érythémateux disséminé (mortalité), Lupus érythémateux disséminé (traitement médicamenteux), Mâle (MeSH), Mémorisation et recherche des informations (MeSH), Rejet du greffon (prévention et contrôle), Résultat thérapeutique (MeSH), Sclérodermie systémique (complications), Sclérodermie systémique (mortalité), Sclérodermie systémique (traitement médicamenteux), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Survie du greffon (MeSH), Transplantation rénale (MeSH), États-Unis (MeSH), Études rétrospectives (MeSH).
- MESH :
- chirurgie : Défaillance rénale chronique.
- mortalité : Défaillance rénale chronique, Lupus érythémateux disséminé, Sclérodermie systémique.
- méthodes : Chimiothérapie de maintenance.
- prévention et contrôle : Rejet du greffon.
- traitement médicamenteux : Lupus érythémateux disséminé, Sclérodermie systémique.
- usage thérapeutique : Hydroxychloroquine, Immunosuppresseurs, Lupus érythémateux disséminé, Sclérodermie systémique.
- étiologie : Défaillance rénale chronique.
- Adolescent, Adulte, Adulte d'âge moyen, Association de médicaments, Assurance maladie, Enregistrements, Femelle, Humains, Jeune adulte, Mâle, Mémorisation et recherche des informations, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Survie du greffon, Transplantation rénale, États-Unis, Études rétrospectives.
- Wicri :
- geographic : États-Unis.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Drug Therapy, Combination (MeSH), Female (MeSH), Graft Rejection (prevention & control), Graft Survival (MeSH), Humans (MeSH), Hydroxychloroquine (therapeutic use), Immunosuppressive Agents (therapeutic use), Information Storage and Retrieval (MeSH), Insurance, Health (MeSH), Kidney Failure, Chronic (etiology), Kidney Failure, Chronic (mortality), Kidney Failure, Chronic (surgery), Kidney Transplantation (MeSH), Lupus Erythematosus, Systemic (complications), Lupus Erythematosus, Systemic (drug therapy), Lupus Erythematosus, Systemic (mortality), Maintenance Chemotherapy (methods), Male (MeSH), Middle Aged (MeSH), Registries (MeSH), Retrospective Studies (MeSH), Scleroderma, Systemic (complications), Scleroderma, Systemic (drug therapy), Scleroderma, Systemic (mortality), Treatment Outcome (MeSH), United States (MeSH), Young Adult (MeSH).
- MESH :
- chemical , therapeutic use : Hydroxychloroquine, Immunosuppressive Agents.
- geographic : United States.
- complications : Lupus Erythematosus, Systemic, Scleroderma, Systemic.
- drug therapy : Lupus Erythematosus, Systemic, Scleroderma, Systemic.
- etiology : Kidney Failure, Chronic.
- methods : Maintenance Chemotherapy.
- mortality : Kidney Failure, Chronic, Lupus Erythematosus, Systemic, Scleroderma, Systemic.
- prevention & control : Graft Rejection.
- surgery : Kidney Failure, Chronic.
- Adolescent, Adult, Aged, Aged, 80 and over, Drug Therapy, Combination, Female, Graft Survival, Humans, Information Storage and Retrieval, Insurance, Health, Kidney Transplantation, Male, Middle Aged, Registries, Retrospective Studies, Treatment Outcome, Young Adult.
Abstract
Hydroxychloroquine (HCQ) is an antimalarial drug with immunomodulatory effects used to treat systemic lupus erythematosus (SLE) and scleroderma. The antiviral effects of HCQ have raised attention in the context of the COVID-19 pandemic, although safety is controversial. We examined linkages of national transplant registry data with pharmaceutical claims and Medicare billing claims to study HCQ use among Medicare-insured kidney transplant recipients with SLE or scleroderma (2008-2017; N = 1820). We compared three groups based on immunosuppression regimen 7 months-to-1 year post transplant: (a) tacrolimus (Tac) + mycophenolic acid (MPA) + prednisone (Pred) (referent group, 77.7%); (b) Tac + MPA + Pred + HCQ (16.5%); or (c) other immunosuppression + HCQ (5.7%). Compared to the referent group, recipients treated with other immunosuppression + HCQ had a 2-fold increased risk of abnormal ECG or QT prolongation (18.9% vs. 10.7%; aHR,1.12 1.963.42 , p = .02) and ventricular arrhythmias (15.2% vs. 11.4%; aHR,1.00 1.813.29 , p = .05) in the >1-to-3 years post-transplant. Tac + MPA + Pred + HCQ was associated with increased risk of ventricular arrhythmias (13.5% vs. 11.4%; aHR,1.02 1.542.31 , p = .04) and pancytopenia (35.9% vs. 31.4%; aHR,1.03 1.311.68 , p = .03) compared to triple immunosuppression without HCQ. However, HCQ-containing regimens were not associated with an increased risk of death or graft failure. HCQ may be used safely in selected kidney transplant recipients in addition to their maintenance immunosuppression, although attention to arrhythmias is warranted.
DOI: 10.1111/ctr.14118
PubMed: 33048372
Affiliations:
- Canada, États-Unis
- Alberta, Iowa, Maryland, Minnesota, Missouri (État), Pennsylvanie
- Calgary, Iowa City
- Université de Calgary, Université de l'Iowa
Links toward previous steps (curation, corpus...)
Le document en format XML
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Lentine</name><affiliation wicri:level="2"><nlm:affiliation>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Lam, Ngan N" sort="Lam, Ngan N" uniqKey="Lam N" first="Ngan N" last="Lam">Ngan N. Lam</name><affiliation wicri:level="4"><nlm:affiliation>University of Calgary, Calgary, AB, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>University of Calgary, Calgary, AB</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Caliskan, Yasar" sort="Caliskan, Yasar" uniqKey="Caliskan Y" first="Yasar" last="Caliskan">Yasar Caliskan</name><affiliation wicri:level="2"><nlm:affiliation>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Alhamad, Tarek" sort="Alhamad, Tarek" uniqKey="Alhamad T" first="Tarek" last="Alhamad">Tarek Alhamad</name><affiliation wicri:level="2"><nlm:affiliation>Washington University in Saint Louis, St. Louis, MO, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Washington University in Saint Louis, St. Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Xiao, Huiling" sort="Xiao, Huiling" uniqKey="Xiao H" first="Huiling" last="Xiao">Huiling Xiao</name><affiliation wicri:level="2"><nlm:affiliation>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Schnitzler, Mark A" sort="Schnitzler, Mark A" uniqKey="Schnitzler M" first="Mark A" last="Schnitzler">Mark A. Schnitzler</name><affiliation wicri:level="2"><nlm:affiliation>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Chang, Su Hsin" sort="Chang, Su Hsin" uniqKey="Chang S" first="Su-Hsin" last="Chang">Su-Hsin Chang</name><affiliation wicri:level="2"><nlm:affiliation>Washington University in Saint Louis, St. Louis, MO, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Washington University in Saint Louis, St. Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Axelrod, David" sort="Axelrod, David" uniqKey="Axelrod D" first="David" last="Axelrod">David Axelrod</name><affiliation wicri:level="4"><nlm:affiliation>University of Iowa, Iowa City, IA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Iowa, Iowa City, IA</wicri:regionArea><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation></author><author><name sortKey="Segev, Dorry L" sort="Segev, Dorry L" uniqKey="Segev D" first="Dorry L" last="Segev">Dorry L. Segev</name><affiliation wicri:level="2"><nlm:affiliation>Johns Hopkins University, Baltimore, MD, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins University, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Mcadams Demarco, Mara" sort="Mcadams Demarco, Mara" uniqKey="Mcadams Demarco M" first="Mara" last="Mcadams-Demarco">Mara Mcadams-Demarco</name><affiliation wicri:level="2"><nlm:affiliation>Johns Hopkins University, Baltimore, MD, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins University, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Kasiske, Bertram L" sort="Kasiske, Bertram L" uniqKey="Kasiske B" first="Bertram L" last="Kasiske">Bertram L. Kasiske</name><affiliation wicri:level="2"><nlm:affiliation>Hennepin County Med Center, Minneapolis, MN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Hennepin County Med Center, Minneapolis, MN</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Hess, Gregory P" sort="Hess, Gregory P" uniqKey="Hess G" first="Gregory P" last="Hess">Gregory P. Hess</name><affiliation wicri:level="2"><nlm:affiliation>Drexel University, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Drexel University, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Brennan, Daniel C" sort="Brennan, Daniel C" uniqKey="Brennan D" first="Daniel C" last="Brennan">Daniel C. Brennan</name><affiliation wicri:level="2"><nlm:affiliation>Johns Hopkins University, Baltimore, MD, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins University, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author></analytic><series><title level="j">Clinical transplantation</title><idno type="eISSN">1399-0012</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Drug Therapy, Combination (MeSH)</term><term>Female (MeSH)</term><term>Graft Rejection (prevention & control)</term><term>Graft Survival (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Immunosuppressive Agents (therapeutic use)</term><term>Information Storage and Retrieval (MeSH)</term><term>Insurance, Health (MeSH)</term><term>Kidney Failure, Chronic (etiology)</term><term>Kidney Failure, Chronic (mortality)</term><term>Kidney Failure, Chronic (surgery)</term><term>Kidney Transplantation (MeSH)</term><term>Lupus Erythematosus, Systemic (complications)</term><term>Lupus Erythematosus, Systemic (drug therapy)</term><term>Lupus Erythematosus, Systemic (mortality)</term><term>Maintenance Chemotherapy (methods)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Registries (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Scleroderma, Systemic (complications)</term><term>Scleroderma, Systemic (drug therapy)</term><term>Scleroderma, Systemic (mortality)</term><term>Treatment Outcome (MeSH)</term><term>United States (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Association de médicaments (MeSH)</term><term>Assurance maladie (MeSH)</term><term>Chimiothérapie de maintenance (méthodes)</term><term>Défaillance rénale chronique (chirurgie)</term><term>Défaillance rénale chronique (mortalité)</term><term>Défaillance rénale chronique (étiologie)</term><term>Enregistrements (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Hydroxychloroquine (usage thérapeutique)</term><term>Immunosuppresseurs (usage thérapeutique)</term><term>Jeune adulte (MeSH)</term><term>Lupus érythémateux disséminé (complications)</term><term>Lupus érythémateux disséminé (mortalité)</term><term>Lupus érythémateux disséminé (traitement médicamenteux)</term><term>Mâle (MeSH)</term><term>Mémorisation et recherche des informations (MeSH)</term><term>Rejet du greffon (prévention et contrôle)</term><term>Résultat thérapeutique (MeSH)</term><term>Sclérodermie systémique (complications)</term><term>Sclérodermie systémique (mortalité)</term><term>Sclérodermie systémique (traitement médicamenteux)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Survie du greffon (MeSH)</term><term>Transplantation rénale (MeSH)</term><term>États-Unis (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Hydroxychloroquine</term><term>Immunosuppressive Agents</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>United States</term></keywords><keywords scheme="MESH" qualifier="chirurgie" xml:lang="fr"><term>Défaillance rénale chronique</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Lupus Erythematosus, Systemic</term><term>Scleroderma, Systemic</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Lupus Erythematosus, Systemic</term><term>Scleroderma, Systemic</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Kidney Failure, Chronic</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Maintenance Chemotherapy</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Kidney Failure, Chronic</term><term>Lupus Erythematosus, Systemic</term><term>Scleroderma, Systemic</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Défaillance rénale chronique</term><term>Lupus érythémateux disséminé</term><term>Sclérodermie systémique</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Chimiothérapie de maintenance</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Graft Rejection</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Rejet du greffon</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Kidney Failure, Chronic</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Lupus érythémateux disséminé</term><term>Sclérodermie systémique</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Hydroxychloroquine</term><term>Immunosuppresseurs</term><term>Lupus érythémateux disséminé</term><term>Sclérodermie systémique</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Défaillance rénale chronique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Drug Therapy, Combination</term><term>Female</term><term>Graft Survival</term><term>Humans</term><term>Information Storage and Retrieval</term><term>Insurance, Health</term><term>Kidney Transplantation</term><term>Male</term><term>Middle Aged</term><term>Registries</term><term>Retrospective Studies</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Association de médicaments</term><term>Assurance maladie</term><term>Enregistrements</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Mémorisation et recherche des informations</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Survie du greffon</term><term>Transplantation rénale</term><term>États-Unis</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>États-Unis</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Hydroxychloroquine (HCQ) is an antimalarial drug with immunomodulatory effects used to treat systemic lupus erythematosus (SLE) and scleroderma. The antiviral effects of HCQ have raised attention in the context of the COVID-19 pandemic, although safety is controversial. We examined linkages of national transplant registry data with pharmaceutical claims and Medicare billing claims to study HCQ use among Medicare-insured kidney transplant recipients with SLE or scleroderma (2008-2017; N = 1820). We compared three groups based on immunosuppression regimen 7 months-to-1 year post transplant: (a) tacrolimus (Tac) + mycophenolic acid (MPA) + prednisone (Pred) (referent group, 77.7%); (b) Tac + MPA + Pred + HCQ (16.5%); or (c) other immunosuppression + HCQ (5.7%). Compared to the referent group, recipients treated with other immunosuppression + HCQ had a 2-fold increased risk of abnormal ECG or QT prolongation (18.9% vs. 10.7%; aHR,<sub>1.12</sub> 1.96<sub>3.42</sub> , p = .02) and ventricular arrhythmias (15.2% vs. 11.4%; aHR,<sub>1.00</sub> 1.81<sub>3.29</sub> , p = .05) in the >1-to-3 years post-transplant. Tac + MPA + Pred + HCQ was associated with increased risk of ventricular arrhythmias (13.5% vs. 11.4%; aHR,<sub>1.02</sub> 1.54<sub>2.31</sub> , p = .04) and pancytopenia (35.9% vs. 31.4%; aHR,<sub>1.03</sub> 1.31<sub>1.68</sub> , p = .03) compared to triple immunosuppression without HCQ. However, HCQ-containing regimens were not associated with an increased risk of death or graft failure. HCQ may be used safely in selected kidney transplant recipients in addition to their maintenance immunosuppression, although attention to arrhythmias is warranted.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33048372</PMID><DateCompleted><Year>2021</Year><Month>01</Month><Day>04</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>04</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1399-0012</ISSN><JournalIssue CitedMedium="Internet"><Volume>34</Volume><Issue>12</Issue><PubDate><Year>2020</Year><Month>12</Month></PubDate></JournalIssue><Title>Clinical transplantation</Title><ISOAbbreviation>Clin Transplant</ISOAbbreviation></Journal><ArticleTitle>Hydroxychloroquine and maintenance immunosuppression use in kidney transplant recipients: Analysis of linked US registry and claims data.</ArticleTitle><Pagination><MedlinePgn>e14118</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/ctr.14118</ELocationID><Abstract><AbstractText>Hydroxychloroquine (HCQ) is an antimalarial drug with immunomodulatory effects used to treat systemic lupus erythematosus (SLE) and scleroderma. The antiviral effects of HCQ have raised attention in the context of the COVID-19 pandemic, although safety is controversial. We examined linkages of national transplant registry data with pharmaceutical claims and Medicare billing claims to study HCQ use among Medicare-insured kidney transplant recipients with SLE or scleroderma (2008-2017; N = 1820). We compared three groups based on immunosuppression regimen 7 months-to-1 year post transplant: (a) tacrolimus (Tac) + mycophenolic acid (MPA) + prednisone (Pred) (referent group, 77.7%); (b) Tac + MPA + Pred + HCQ (16.5%); or (c) other immunosuppression + HCQ (5.7%). Compared to the referent group, recipients treated with other immunosuppression + HCQ had a 2-fold increased risk of abnormal ECG or QT prolongation (18.9% vs. 10.7%; aHR,<sub>1.12</sub> 1.96<sub>3.42</sub> , p = .02) and ventricular arrhythmias (15.2% vs. 11.4%; aHR,<sub>1.00</sub> 1.81<sub>3.29</sub> , p = .05) in the >1-to-3 years post-transplant. Tac + MPA + Pred + HCQ was associated with increased risk of ventricular arrhythmias (13.5% vs. 11.4%; aHR,<sub>1.02</sub> 1.54<sub>2.31</sub> , p = .04) and pancytopenia (35.9% vs. 31.4%; aHR,<sub>1.03</sub> 1.31<sub>1.68</sub> , p = .03) compared to triple immunosuppression without HCQ. However, HCQ-containing regimens were not associated with an increased risk of death or graft failure. HCQ may be used safely in selected kidney transplant recipients in addition to their maintenance immunosuppression, although attention to arrhythmias is warranted.</AbstractText><CopyrightInformation>© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lentine</LastName><ForeName>Krista L</ForeName><Initials>KL</Initials><Identifier Source="ORCID">0000-0002-9423-4849</Identifier><AffiliationInfo><Affiliation>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lam</LastName><ForeName>Ngan N</ForeName><Initials>NN</Initials><Identifier Source="ORCID">0000-0002-0129-7091</Identifier><AffiliationInfo><Affiliation>University of Calgary, Calgary, AB, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Caliskan</LastName><ForeName>Yasar</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alhamad</LastName><ForeName>Tarek</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Washington University in Saint Louis, St. Louis, MO, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xiao</LastName><ForeName>Huiling</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schnitzler</LastName><ForeName>Mark A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chang</LastName><ForeName>Su-Hsin</ForeName><Initials>SH</Initials><AffiliationInfo><Affiliation>Washington University in Saint Louis, St. Louis, MO, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Axelrod</LastName><ForeName>David</ForeName><Initials>D</Initials><Identifier Source="ORCID">0000-0001-5684-0613</Identifier><AffiliationInfo><Affiliation>University of Iowa, Iowa City, IA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Segev</LastName><ForeName>Dorry L</ForeName><Initials>DL</Initials><AffiliationInfo><Affiliation>Johns Hopkins University, Baltimore, MD, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McAdams-DeMarco</LastName><ForeName>Mara</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0003-3013-925X</Identifier><AffiliationInfo><Affiliation>Johns Hopkins University, Baltimore, MD, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kasiske</LastName><ForeName>Bertram L</ForeName><Initials>BL</Initials><AffiliationInfo><Affiliation>Hennepin County Med Center, Minneapolis, MN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hess</LastName><ForeName>Gregory P</ForeName><Initials>GP</Initials><AffiliationInfo><Affiliation>Drexel University, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brennan</LastName><ForeName>Daniel C</ForeName><Initials>DC</Initials><AffiliationInfo><Affiliation>Johns Hopkins University, Baltimore, MD, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>R01-DK120518</GrantID><Acronym>DK</Acronym><Agency>NIDDK NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>HHSH250201000018C</GrantID><Acronym>HRSA</Acronym><Agency>HRSA HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01-DK120518</GrantID><Acronym>DK</Acronym><Agency>NIDDK NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>HHSH250201000018C</GrantID><Acronym>HRSA</Acronym><Agency>HRSA HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>22</Day></ArticleDate></Article><MedlineJournalInfo><Country>Denmark</Country><MedlineTA>Clin Transplant</MedlineTA><NlmUniqueID>8710240</NlmUniqueID><ISSNLinking>0902-0063</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007166">Immunosuppressive Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004359" MajorTopicYN="N">Drug Therapy, Combination</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006084" MajorTopicYN="N">Graft Rejection</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006085" MajorTopicYN="N">Graft Survival</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007166" MajorTopicYN="N">Immunosuppressive Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016247" MajorTopicYN="N">Information Storage and Retrieval</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007348" MajorTopicYN="N">Insurance, Health</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007676" MajorTopicYN="N">Kidney Failure, Chronic</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016030" MajorTopicYN="Y">Kidney Transplantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008180" MajorTopicYN="N">Lupus Erythematosus, Systemic</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D060046" MajorTopicYN="N">Maintenance Chemotherapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012042" MajorTopicYN="N">Registries</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012595" MajorTopicYN="N">Scleroderma, Systemic</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014481" MajorTopicYN="N" Type="Geographic">United States</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">hydroxychloroquine</Keyword><Keyword MajorTopicYN="Y">immunosuppression</Keyword><Keyword MajorTopicYN="Y">kidney transplantation</Keyword><Keyword MajorTopicYN="Y">outcomes</Keyword><Keyword MajorTopicYN="Y">pharmacy claims</Keyword><Keyword MajorTopicYN="Y">registries</Keyword><Keyword MajorTopicYN="Y">scleroderma</Keyword><Keyword MajorTopicYN="Y">systemic lupus erythematosus</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>07</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>09</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>10</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>10</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>1</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>10</Month><Day>13</Day><Hour>12</Hour><Minute>14</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33048372</ArticleId><ArticleId 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Ann Noninvasive Electrocardiol. 2015;20(5):426-432.</Citation></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Alberta</li><li>Iowa</li><li>Maryland</li><li>Minnesota</li><li>Missouri (État)</li><li>Pennsylvanie</li></region><settlement><li>Calgary</li><li>Iowa City</li></settlement><orgName><li>Université de Calgary</li><li>Université de l'Iowa</li></orgName></list><tree><country name="États-Unis"><region name="Missouri (État)"><name sortKey="Lentine, Krista L" sort="Lentine, Krista L" uniqKey="Lentine K" first="Krista L" last="Lentine">Krista L. Lentine</name></region><name sortKey="Alhamad, Tarek" sort="Alhamad, Tarek" uniqKey="Alhamad T" first="Tarek" last="Alhamad">Tarek Alhamad</name><name sortKey="Axelrod, David" sort="Axelrod, David" uniqKey="Axelrod D" first="David" last="Axelrod">David Axelrod</name><name sortKey="Brennan, Daniel C" sort="Brennan, Daniel C" uniqKey="Brennan D" first="Daniel C" last="Brennan">Daniel C. Brennan</name><name sortKey="Caliskan, Yasar" sort="Caliskan, Yasar" uniqKey="Caliskan Y" first="Yasar" last="Caliskan">Yasar Caliskan</name><name sortKey="Chang, Su Hsin" sort="Chang, Su Hsin" uniqKey="Chang S" first="Su-Hsin" last="Chang">Su-Hsin Chang</name><name sortKey="Hess, Gregory P" sort="Hess, Gregory P" uniqKey="Hess G" first="Gregory P" last="Hess">Gregory P. Hess</name><name sortKey="Kasiske, Bertram L" sort="Kasiske, Bertram L" uniqKey="Kasiske B" first="Bertram L" last="Kasiske">Bertram L. Kasiske</name><name sortKey="Mcadams Demarco, Mara" sort="Mcadams Demarco, Mara" uniqKey="Mcadams Demarco M" first="Mara" last="Mcadams-Demarco">Mara Mcadams-Demarco</name><name sortKey="Schnitzler, Mark A" sort="Schnitzler, Mark A" uniqKey="Schnitzler M" first="Mark A" last="Schnitzler">Mark A. Schnitzler</name><name sortKey="Segev, Dorry L" sort="Segev, Dorry L" uniqKey="Segev D" first="Dorry L" last="Segev">Dorry L. Segev</name><name sortKey="Xiao, Huiling" sort="Xiao, Huiling" uniqKey="Xiao H" first="Huiling" last="Xiao">Huiling Xiao</name></country><country name="Canada"><region name="Alberta"><name sortKey="Lam, Ngan N" sort="Lam, Ngan N" uniqKey="Lam N" first="Ngan N" last="Lam">Ngan N. Lam</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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|wiki= Sante
|area= CovidChloroV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= pubmed:33048372
|texte= Hydroxychloroquine and maintenance immunosuppression use in kidney transplant recipients: Analysis of linked US registry and claims data.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:33048372" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a CovidChloroV1
| This area was generated with Dilib version V0.6.38. |  |