Safety management in treatment with antimalarials in rheumatology. Interdisciplinary recommendations on the basis of a systematic literature review

Fiehn, Christoph; Neß, Thomas; Weseloh, Christiane; Specker, Christof; Hadjiski, Denitsa; Detert, J.; Krüger, Klaus; Pharmakotherapie, DGRh Kommission

doi:10.1007/s00393-020-00785-4

Cited by 41 publications

(61 citation statements)

References 38 publications

(52 reference statements)

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“…Moreover, keratopathy appears to occur more frequently in patients with CQ than with HCQ 61 . In addition, CQ exerts a number of severe side effects on fetal development, while HCQ can be safely used in patients with SLE during pregnancy and breastfeeding and provides protective effect for both mother and child 62 . The outbreak of SARS-CoV-2 has placed many pregnant women at high risk of infection (several infected cases have been reported).…”

Section: Could Hcq and Cq Have Protective Vascular Effects In Covid-1mentioning

confidence: 99%

Is hydroxychloroquine beneficial for COVID-19 patients?

et al. 2020

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The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in December 2019. As similar cases rapidly emerged around the world1–3, the World Health Organization (WHO) declared a public health emergency of international concern on January 30, 2020 and pronounced the rapidly spreading coronavirus outbreak as a pandemic on March 11, 20204. The virus has reached almost all countries of the globe. As of June 3, 2020, the accumulated confirmed cases reached 6,479,405 with more than 383,013 deaths worldwide. The urgent and emergency care of COVID-19 patients calls for effective drugs, in addition to the beneficial effects of remdesivir5, to control the disease and halt the pandemic.

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Section: Could Hcq and Cq Have Protective Vascular Effects In Covid-1mentioning

confidence: 99%

Is hydroxychloroquine beneficial for COVID-19 patients?

et al. 2020

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“…Patients with psoriasis, porphyria and alcoholism may be more susceptible to adverse skin events, usually without severity. In rare cases, hemolysis may occur in patients with glucose-6-phosphate dehydrogenase deficiency [63]. Besides G6PD deficiency, the concomitant use of HCQ with dapsone may enhance the risk of hemolytic reactions [64].…”

Section: Safetymentioning

confidence: 99%

“…Patients with myopathy have proximal muscle weakness without myalgia or muscle enzymes changes (or slightly elevated more rarely). Patients can improve with medication discontinuation [63].…”

Section: Myotoxicitymentioning

confidence: 99%

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Revisiting hydroxychloroquine and chloroquine for patients with chronic immunity-mediated inflammatory rheumatic diseases

et al. 2020

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Hydroxychloroquine and chloroquine, also known as antimalarial drugs, are widely used in the treatment of rheumatic diseases and have recently become the focus of attention because of the ongoing COVID-19 pandemic. Rheumatologists have been using antimalarials to manage patients with chronic immune-mediated inflammatory rheumatic diseases for decades. It is an appropriate time to review their immunomodulatory and anti-inflammatory mechanisms impact on disease activity and survival of systemic lupus erythematosus patient, including antiplatelet effect, metabolic and lipid benefits. We also discuss possible adverse effects, adding a practical and comprehensive approach to monitoring rheumatic patients during treatment with these drugs.

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“…Diese Aussage findet sich auch in den neuen deutschen Sicherheitsempfehlungen zum Sicherheitsmanagement der AM-Therapie. [8]. AM stellen somit künftig die primäre Therapie für jeden Patienten dar.…”

Section: Antimalariamittelunclassified

Therapie des SLE 2020: aktueller Stand nach den EULAR-Empfehlungen 2019

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ZusammenfassungDie Veröffentlichung der neuen ACR/EULAR Klassifikationskriterien für den systemischen Lupus erythematodes (SLE) und die Überarbeitung der EULAR-Empfehlungen zum Management des SLE im vergangenen Jahr beinhalten viele wichtige Neuerungen, die die Klassifikation und Versorgung von Lupus-Patienten verändern werden. Dies bezieht sich sowohl auf generelle Grundprinzipien der Versorgung sowie auf konkrete Therapieempfehlungen. So kann ein SLE erst als solcher klassifiziert werden, wenn antinukleäre Antikörper (ANA) unabhängig von Titer-Höhe und Fluoreszenzmuster nachgewiesen werden können. Sind ANA nachgewiesen, erhalten Lupus-spezifische Symptome und serologische Auffälligkeiten einen Punktwert. Ab einem Wert von 10 kann ein SLE-Patient als solcher klassifiziert werden. Im Hinblick auf die Versorgung von SLE-Patienten sollte jede Therapie ganz im Sinne eines treat-to-target Ansatzes mit dem Ziel der Remission verfolgt werden. Dies dient der Sicherung des Langzeitüberlebens, der Reduktion von Schaden sowie der Verbesserung von Lebensqualität. Erreicht werden diese Ziele durch konsequente Therapie und regelmäßige Evaluation der Krankheitsaktivität. So sollen alle Patienten bei Abwesenheit von Kontraindikationen Antimalariamittel erhalten. Bei unzureichendem Ansprechen werden Steroidpulse über wenige Tage sowie der frühzeitige Einsatz von Immunsuppressiva (IM) empfohlen. Die einzelnen IM und ihre jeweiligen Indikationen sind im Text aufgeführt. Mit dem Einbezug von Biologika, insbesondere Belimumab und Rituximab, haben außerdem nun ganz neue Substanzklassen Einzug in die Empfehlungen gefunden.

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Safety management in treatment with antimalarials in rheumatology. Interdisciplinary recommendations on the basis of a systematic literature review

Abstract: contains further information on systematic literature searches. Article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field, the supplementary material can be found under "Supplementary contents".

Cited by 41 publications

References 38 publications

Is hydroxychloroquine beneficial for COVID-19 patients?

Is hydroxychloroquine beneficial for COVID-19 patients?

Revisiting hydroxychloroquine and chloroquine for patients with chronic immunity-mediated inflammatory rheumatic diseases

Therapie des SLE 2020: aktueller Stand nach den EULAR-Empfehlungen 2019

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