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10.1016/j.sapharm.2020.04.031

http://scihub22266oqcxt.onion/10.1016/j.sapharm.2020.04.031
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suck abstract from ncbi


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pmid32409150      Res+Social+Adm+Pharm 2021 ; 17 (1): 2012-2017
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  • An evaluation of co-use of chloroquine or hydroxychloroquine plus azithromycin on cardiac outcomes: A pharmacoepidemiological study to inform use during the COVID19 pandemic #MMPMID32409150
  • Vouri SM; Thai TN; Winterstein AG
  • Res Social Adm Pharm 2021[Jan]; 17 (1): 2012-2017 PMID32409150show ga
  • BACKGROUND: Chloroquine or hydroxychloroquine (chloroquine) plus azithromycin is considered as therapy for COVID-19. With benefit evaluations underway, safety concerns due to potential additive effects on QTc prolongation should be addressed. OBJECTIVE: We compared risk of cardiac adverse events between combinations of chloroquine and azithromycin and chloroquine and amoxicillin. METHODS: We conducted a retrospective cohort study using the IBM MarketScan Commercial Claims and Medicare Supplemental Databases, 2005-2018. We included autoimmune disease patients aged >/=18 years initiating azithromycin or amoxicillin for >/=5 days during chloroquine treatment. Patients had continuous insurance coverage >/=6 months before combination use until 5 days thereafter or inpatient death. Two outcomes were sudden cardiac arrest/ventricular arrhythmias (SCA/VA) and cardiac symptoms. We followed patients for up to 5 days to estimate hazard ratios (HR). Covariates were adjusted using stabilized inverse probability treatment weighting. RESULTS: We identified two SVC/VA events among >145,000 combination users. The adjusted incidence of cardiac symptoms among azithromycin and amoxicillin users was 276 vs 254 per 10,000 person-years with an adjusted HR of 1.10 (95%CI, 0.62-1.95). CONCLUSION: Combination use of chloroquine and azithromycin at routine doses did not show pronounced increases in arrhythmias in this real-world population, though small sample size and outcome rates limit conclusions.
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Azithromycin/*administration & dosage/adverse effects[MESH]
  • |COVID-19 Drug Treatment[MESH]
  • |COVID-19/*epidemiology[MESH]
  • |Chloroquine/*administration & dosage/adverse effects[MESH]
  • |Cohort Studies[MESH]
  • |Drug Therapy, Combination/adverse effects[MESH]
  • |Female[MESH]
  • |Heart Diseases/chemically induced/*epidemiology[MESH]
  • |Humans[MESH]
  • |Hydroxychloroquine/*administration & dosage/adverse effects[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pharmacoepidemiology/*methods[MESH]
  • |Retrospective Studies[MESH]
  • |Risk Factors[MESH]


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