2020
DOI: 10.1101/2020.04.08.20054551
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Abstract: Background Hydroxychloroquine has recently received Emergency Use Authorization by the FDA and is currently prescribed in combination with azithromycin for COVID-19 pneumonia. We studied the safety of hydroxychloroquine, alone and in combination with azithromycin.Methods New user cohort studies were conducted including 16 severe adverse events (SAEs).Rheumatoid arthritis patients aged 18+ and initiating hydroxychloroquine were compared to those initiating sulfasalazine and followed up over 30 days. Self-contro… Show more

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Cited by 88 publications
(79 citation statements)
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“…This has occurred despite limited data supporting its efficacy in COVID-19 as well as considerable concern about its safety when used at high doses (>400 mg daily) and in combination with other QT interval prolonging drugs. [1][2][3][4] An inaccurate narrative has emerged in recent weeks that patients with systemic lupus erythematosus (SLE) who are taking HCQ as a baseline therapy are less affected by or do not develop COVID-19. [5][6][7] This assumption has been challenged by Monti and Montecucco, 8 referencing data from the COVID-19 Global Rheumatology Alliance registry on patients with rheumatic disease that previously identified 19/110 (17%) patients with SLE.…”
mentioning
confidence: 99%
“…This has occurred despite limited data supporting its efficacy in COVID-19 as well as considerable concern about its safety when used at high doses (>400 mg daily) and in combination with other QT interval prolonging drugs. [1][2][3][4] An inaccurate narrative has emerged in recent weeks that patients with systemic lupus erythematosus (SLE) who are taking HCQ as a baseline therapy are less affected by or do not develop COVID-19. [5][6][7] This assumption has been challenged by Monti and Montecucco, 8 referencing data from the COVID-19 Global Rheumatology Alliance registry on patients with rheumatic disease that previously identified 19/110 (17%) patients with SLE.…”
mentioning
confidence: 99%
“…No studies were found assessing the safety of azithromycin treatment in the context of COVID-19, but a multi-centre self-controlled case series study was identified, which assessed primary and secondary care medical record data between 2000 and 2020 for 956 374 patients in six countries. 21 The authors of that study identified a significantly increased risk in cardiovascular mortality, chest pain, and heart failure in patients who were treated with azithromycin and hydroxychloroquine compared to hydroxychloroquine alone. While the findings are not specific to the context of COVID-19 disease, these results indicate that adverse cardiovascular events are more likely to occur when hydroxychloroquine and azithromycin are combined.…”
Section: Comparison With Other Literaturementioning
confidence: 99%
“…Even in the short-term as proposed for COVID-19 management, there was an observed 5% to 20% increased risk of angina or chest pain and heart failure, and a 2-fold risk of cardiovascular mortality in the fi rst month of treatment. 14…”
Section: ■ Relevant Issues To Keep In Mindmentioning
confidence: 99%