Publication: Does hydroxychloroquine still have any role in the COVID-19 pandemic?
Issued Date
2021-01-01
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ISSN
17447666
14656566
14656566
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2-s2.0-85102786897
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Mahidol University
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SCOPUS
Bibliographic Citation
Expert Opinion on Pharmacotherapy. Vol.22, No.10 (2021), 1257-1266
Suggested Citation
William H.K. Schilling, Nicholas J. White Does hydroxychloroquine still have any role in the COVID-19 pandemic?. Expert Opinion on Pharmacotherapy. Vol.22, No.10 (2021), 1257-1266. doi:10.1080/14656566.2021.1898589 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78793
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Title
Does hydroxychloroquine still have any role in the COVID-19 pandemic?
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Abstract
Introduction: The 4-aminoquinolines, chloroquine, and hydroxychloroquine have been used for over 70 years for malaria and rheumatological conditions, respectively. Their broad-spectrum antiviral activity, excellent safety profile, tolerability, low cost, and ready availability made them prime repurposing therapeutic candidates at the beginning of the COVID-19 pandemic. Areas covered: Here, the authors discuss the history of hydroxychloroquine and chloroquine, the in vitro data which led to their widespread repurposing and adoption in COVID-19 and their complex pharmacokinetics. The evidence for the use of these drugs is assessed through in vivo animal experiments and the wealth of conflicting data and interpretations published during COVID-19, including the more informative results from randomized controlled trials (RCTs). The safety aspects of these drugs, in particular cardiotoxicity, are then reviewed. Expert opinion: The evidence from clinical trials in COVID-19 supports the well-established safety record of the 4-aminoquinolines at currently recommended dosage. In hospitalized patients with severe COVID-19 RCTs show clearly that the 4-aminoquinolines are not beneficial. The only treatments with proven benefit at this stage of infection are immunomodulators (dexamethasone, IL-6 receptor antagonists). No antiviral drugs have proven life-saving in late-stage COVID-19.