The widely prescribed antibiotic hydroxychloroquine and chloroquine have drawn attention as potential therapies for Covid-19 and are being widely used off-label, but a new study warns it could increase the risk of heart problems.
Hydroxychloroquine is one of several agents being evaluated in the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It’s now more important than ever to have a thorough assessment of the safety of these medications.
A recent analysis published in the British Journal of Clinical Pharmacology provides new insights.
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In the analysis of real-world data from the Food and Drug Administration Adverse Events Reporting System, a global database of post-marketing safety reports, chloroquine” hydroxychloroquine and chloroquine were associated with higher rates of various cardiovascular problems, including life-threatening heart rhythm events, heart failure, and damage to the heart muscle itself (termed cardiomyopathy).
“Moreover, we show how these adverse events carry high risks for severe outcomes including death, even with standard doses of the drugs,” said senior author Elad Maor, MD, PhD, of Sheba Medical Center and Tel-Aviv University, in Israel. “The take-home message of our work is that physicians around the world should be careful when prescribing these drugs for off-label indications, especially for patients with cardiac disorders.”
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While the short-term risks of hydroxychloroquine treatment were minimal, long-term use was associated with excess cardiovascular mortality in rheumatoid arthritis (RA), according to study results published in Lancet Rheumatology.
Researchers noted that combining hydroxychloroquine with azithromycin further increased risk for heart failure and cardiovascular mortality, even in the short term.
Hydroxychloroquine is frequently used as a first-line treatment agent in patients with autoimmune conditions, including RA.
The potential efficacy of hydroxychloroquine as an antiviral agent against coronavirus disease 2019 (Covid-19) has led to widespread publicity, much of which focuses heavily on its side effects. The present study assessed the safety profile of hydroxychloroquine alone and in combination with azithromycin in patients with RA.
