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2020 ; 75
(4
): 363-370
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English Wikipedia
Chloroquine and hydroxychloroquine in the management of COVID-19: Much kerfuffle
but little evidence
#MMPMID32473812
Roustit M
; Guilhaumou R
; Molimard M
; Drici MD
; Laporte S
; Montastruc JL
Therapie
2020[Jul]; 75
(4
): 363-370
PMID32473812
show ga
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.