Chloroquine and hydroxychloroquine in the management of COVID-19: Much kerfuffle but little evidence.
COVID-19
Chloroquine
Coronavirus
Hydroxychloroquine
SARS-Cov-2
Journal
Therapie
ISSN: 1958-5578
Titre abrégé: Therapie
Pays: France
ID NLM: 0420544
Informations de publication
Date de publication:
Historique:
received:
03
05
2020
accepted:
18
05
2020
pubmed:
1
6
2020
medline:
2
9
2020
entrez:
1
6
2020
Statut:
ppublish
Résumé
Chloroquine and hydroxychloroquine are drugs that have shown in vitro activity on the replication of certain coronaviruses. In the context of the SARS-Cov-2 epidemic, the virus responsible for the novel coronavirus disease (COVID-19), these two drugs have been proposed as possible treatments. The results of the first clinical studies evaluating the effect of hydroxychloroquine do not support any efficacy of this drug in patients with COVID-19, due to major methodological weaknesses. Yet, these preliminary studies have aroused considerable media interest, raising fears of massive and uncontrolled use. In the absence of evidence of clinical benefits, the main risk is of exposing patients unnecessarily to the well-known adverse effects of hydroxychloroquine, with a possibly increased risk in the specific setting of COVID-19. In addition, widespread use outside of any recommendation risks compromising the completion of good quality clinical trials. The chloroquine hype, fueled by low-quality studies and media announcements, has yielded to the implementation of more than 150 studies worldwide. This represents a waste of resources and a loss of opportunity for other drugs to be properly evaluated. In the context of emergency, rigorous trials are more than ever needed in order to have, as soon as possible, reliable data on drugs that are possibly effective against the disease. Meanwhile, serious adverse drug reactions have been reported in patients with COVID-19 receiving hydroxychloroquine, justifying to limit its prescription, and to perform suitable cardiac and therapeutic drug monitoring.
Identifiants
pubmed: 32473812
pii: S0040-5957(20)30100-1
doi: 10.1016/j.therap.2020.05.010
pmc: PMC7244425
pii:
doi:
Substances chimiques
Hydroxychloroquine
4QWG6N8QKH
Chloroquine
886U3H6UFF
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
363-370Informations de copyright
Copyright © 2020 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.
Références
J Virol. 2020 Oct 14;94(21):
pubmed: 32817221
BMJ. 2020 May 14;369:m1849
pubmed: 32409561
PLoS Negl Trop Dis. 2010 Aug 10;4(8):e785
pubmed: 20706626
Biosci Trends. 2020 Mar 16;14(1):72-73
pubmed: 32074550
Can J Physiol Pharmacol. 2016 Jun;94(6):613-9
pubmed: 26998724
Therapie. 2020 Jul - Aug;75(4):371-379
pubmed: 32418730
Ann Rheum Dis. 2017 May;76(5):891-897
pubmed: 27903507
Expert Rev Clin Immunol. 2017 Jan;13(1):35-41
pubmed: 27417340
Virol J. 2005 Aug 22;2:69
pubmed: 16115318
Therapie. 2020 Jul - Aug;75(4):385-387
pubmed: 32402475
Therapie. 2000 Jan-Feb;55(1):185-93
pubmed: 10860023
Lancet Infect Dis. 2006 Feb;6(2):67-9
pubmed: 16439323
J Interferon Cytokine Res. 2015 Mar;35(3):143-56
pubmed: 25321315
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):215-219
pubmed: 32391667
Cell Res. 2020 Mar;30(3):269-271
pubmed: 32020029
Virol J. 2006 May 29;3:39
pubmed: 16729896
Antiviral Res. 2020 May;177:104762
pubmed: 32147496
JAMA. 2012 Jul 25;308(4):353-61
pubmed: 22820788
Clin Infect Dis. 2020 Jul 28;71(15):732-739
pubmed: 32150618
JAMA Cardiol. 2020 Sep 01;5(9):1036-1041
pubmed: 32936252
BMJ. 2020 May 14;369:m1844
pubmed: 32409486
Proc Natl Acad Sci U S A. 1981 Jun;78(6):3605-9
pubmed: 6115382
Cell Discov. 2020 Mar 18;6:16
pubmed: 32194981
J Gastroenterol. 2010 Feb;45(2):195-203
pubmed: 19760134
Vector Borne Zoonotic Dis. 2008 Dec;8(6):837-9
pubmed: 18620511
JAMA Cardiol. 2020 Sep 1;5(9):1067-1069
pubmed: 32936266
Drug Saf. 2001;24(8):575-85
pubmed: 11480490
JAMA. 2020 Jun 23;323(24):2493-2502
pubmed: 32392282
Med. 2020 Dec 18;1(1):114-127.e3
pubmed: 32838355
Nature. 2020 Apr;580(7805):573
pubmed: 32332911
Science. 2020 Jul 10;369(6500):208-211
pubmed: 32404476
Nat Rev Rheumatol. 2018 Dec;14(12):693-703
pubmed: 30401979
N Engl J Med. 2016 Oct 13;375(15):1448-1456
pubmed: 27732819
Travel Med Infect Dis. 2020 May - Jun;35:101738
pubmed: 32387409
N Engl J Med. 1984 May 24;310(21):1404-8
pubmed: 6717522
N Engl J Med. 1979 May 31;300(22):1242-5
pubmed: 431682
Crit Care. 2019 Mar 29;23(1):104
pubmed: 30925922
Curr Pharm Des. 2004;10(21):2643-8
pubmed: 15320751
Clin Pharmacol Ther. 2020 Oct;108(4):766-769
pubmed: 32344449
Lancet Infect Dis. 2011 Sep;11(9):677-83
pubmed: 21550310
N Engl J Med. 2020 Jun 18;382(25):2411-2418
pubmed: 32379955
Fundam Clin Pharmacol. 2020 Jun;34(3):389-396
pubmed: 32394481
Antimicrob Agents Chemother. 2014 Aug;58(8):4875-84
pubmed: 24841269
J Immunol. 2000 Aug 1;165(3):1534-40
pubmed: 10903761
Heart Rhythm. 2015 Oct;12(10):2186-94
pubmed: 26025323
J Crit Care. 2020 Jun;57:279-283
pubmed: 32173110
Biochem Biophys Res Commun. 2004 Oct 8;323(1):264-8
pubmed: 15351731
Viruses. 2018 May 17;10(5):
pubmed: 29772762
J Clin Epidemiol. 2020 Jul;123:120-126
pubmed: 32330521
Lancet Infect Dis. 2003 Nov;3(11):722-7
pubmed: 14592603
Int J Antimicrob Agents. 2020 Jul;56(1):105949
pubmed: 32205204
Antimicrob Agents Chemother. 2012 Jun;56(6):3261-70
pubmed: 22391528