Hydroxychloroquine for coronavirus: how not to repurpose a drug during a pandemic

Karunajeewa, Harin

doi:10.1111/imj.15064

Cited by 3 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings are made in the general climate of concern 26 for the reliability of publications related to Covid-19 and the continuing controversy and confusion surrounding HCQ. 27,28 This is partly fueled by a widening understanding of Covid-19 pathogenesis and the multiple mechanisms that have been proposed for HCQ. 29 It is important therefore in discussing HCQ’s putative actions to do so in relation to a specific stage in the disease.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings are made in the climate of concern [26] for the reliability of publications related to Covid-19 and the controversy surrounding HCQ. [27], [28] This is partly fueled by a widening understanding of Covid-19 pathogenesis and the multiple, sometimes stage-dependent, mechanisms proposed for HCQ. [29] In hospitalized patients, factors confounding HCQ's effectiveness are beginning to be better understood [30], with clear reports of significant HCQ-associated reductions in mortality with the use of zinc.…”

Section: Findings In the Context Of Other Covid-19 Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Effective post-exposure prophylaxis of Covid-19 is associated with use of hydroxychloroquine: Prospective re-analysis of a public dataset incorporating novel data

Wiseman

Kory

Saidi

et al. 2020

Preprint

View full text Add to dashboard Cite

BACKGROUND: A recent trial (NCT04308668) found that post-exposure prophylaxis with hydroxychloroquine (HCQ) was associated with a reduced incidence of Covid-19 by 17% overall; 36% in younger subjects, 31% in household contacts and 49% given within one day. To understand these trends, we prospectively re-analyzed the released dataset. METHODS: Our protocol conformed to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT). We compared the incidence of Covid-19 after HCQ or placebo, stratifying primarily by time to drug receipt, age and gender. RESULTS: Requesting additional data, we found that 52% of subjects received medication 1-2 days after the intended overnight delivery; 19% of them outside the intended four-day window from exposure. After re-analysis, there was a reduced incidence of Covid-19 associated with HCQ compared with placebo (9.6% vs. 16.5%) when received up to 3 days (Early) after exposure (RR 0.58, 95%CI 0.35 - 0.97; p=0.044; NNT 14.5) but not later (Late) (RR 1.22, 95%CI 0.72 - 2.04). We found a significant HCQ-associated reduction in subjects 18 to 45 years old associated with Early (RR 0.53, 95%CI 0.29-0.97; p=0.0448, NNT 11.5) but not Late (RR 1.02, 95%CI 0.55-1.89) prophylaxis, attenuated in older subjects (RR 0.75, 95%CI 0-27-2.05) and by co-morbidities. There were reductions associated with Early prophylaxis in household contacts (RR 0.35, 95%CI 0.13-0.89; p=0.025, NNT 5.7) and Health Care Workers (RR 0.74, 95%CI 0.4-1.38). We did not detect effects of gender, folate, zinc, or ascorbic acid. CONCLUSIONS: Using novel data with a prospective post hoc re-analysis, hydroxychloroquine, in an age-dependent manner, was associated with reduced illness compatible with Covid-19 or confirmed infection when supplied for post-exposure prophylaxis between 1 and 3 days after high-risk or moderate-risk exposure. This finding warrants prospective confirmation. Registered with the Open Science Framework (last revised September 27, 2020, osf.io/fqtnw).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Findings In the Context Of Other Covid-19 Studiesmentioning

confidence: 99%

Effective post-exposure prophylaxis of Covid-19 is associated with use of hydroxychloroquine: Prospective re-analysis of a public dataset incorporating novel data

Wiseman

Kory

Saidi

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Despite the promising potential of in vitro studies, RCTs, as the only true standard of truth in medicine, do not provide a rationale for repurposing of CQ/HCQ. 64 November 2020: The potential therapeutic or prophylactic effects of CQ/HCQ had not yet been elucidated. 65 In fact, the two retrospective observational studies (ROS) conducted in Italy 66 and Belgium 67 in more than 10,000 hospitalised COVID-19 patients reported a significant decrease in mortality, and no safety concerns in patients treated with HCQ compared with those who did not receive HCQ.…”

Section: Cq/hcq: Synthesis Antimalarial and Antiviral Activitymentioning

confidence: 99%

The Chloroquine Story in the First Year of the COVID-19 Pandemic

Hunić

Teparić

Kovačević

et al. 2022

Kemija U Industriji

View full text Add to dashboard Cite

The emergence of COVID-19 has caused worldwide concern due to its high infectivity and mortality. Research groups around the world have prioritised drug development against COVID-19. Repurposing of already approved drugs, including the antimalarial drug chloroquine, has attracted considerable attention. The aim of this article is to (i) provide an overview of the recent chemical methods used to synthesise chloroquine and hydroxychloroquine, and (ii) provide insight into the data collected in 2020 on their efficacy against COVID-19. Unfortunately, the promising early results have not been confirmed and a clear and unambiguous conclusion on their clinical efficacy has not yet been drawn.

show abstract

“…Observational studies of hospitalized patients with reduced mortality associated with HCQ+/-AZ had significant confounders (eg corticosteroid use)(6). RCTs using HCQ+/-AZ have not demonstrated virological or clinical benefit for prophylaxis or outpatient treatment of COVID-19(7,8). Preclinical evidence does not support use of HCQ in COVID-19.…”

mentioning

confidence: 99%