Details

Autor(en) / Beteiligte

• Axfors, Cathrine
• Schmitt, Andreas M
• Janiaud, Perrine
• Van't Hooft, Janneke
• Abd-Elsalam, Sherief
• Abdo, Ehab F
• Abella, Benjamin S
• Akram, Javed
• Amaravadi, Ravi K
• Angus, Derek C
• Arabi, Yaseen M
• Azhar, Shehnoor
• Baden, Lindsey R
• Baker, Arthur W
• Belkhir, Leila
• Benfield, Thomas
• Berrevoets, Marvin A H
• Chen, Cheng-Pin
• Chen, Tsung-Chia
• Cheng, Shu-Hsing
• Cheng, Chien-Yu
• Chung, Wei-Sheng
• Cohen, Yehuda Z
• Cowan, Lisa N
• Dalgard, Olav
• de Almeida E Val, Fernando F
• de Lacerda, Marcus V G
• de Melo, Gisely C
• Derde, Lennie
• Dubee, Vincent
• Elfakir, Anissa
• Gordon, Anthony C
• Hernandez-Cardenas, Carmen M
• Hills, Thomas
• Hoepelman, Andy I M
• Huang, Yi-Wen
• Igau, Bruno
• Jin, Ronghua
• Jurado-Camacho, Felipe
• Khan, Khalid S
• Kremsner, Peter G
• Kreuels, Benno
• Kuo, Cheng-Yu
• Le, Thuy
• Lin, Yi-Chun
• Lin, Wu-Pu
• Lin, Tse-Hung
• Lyngbakken, Magnus Nakrem
• McArthur, Colin
• McVerry, Bryan J
• Meza-Meneses, Patricia
• Monteiro, Wuelton M
• Morpeth, Susan C
• Mourad, Ahmad
• Mulligan, Mark J
• Murthy, Srinivas
• Naggie, Susanna
• Narayanasamy, Shanti
• Nichol, Alistair
• Novack, Lewis A
• O'Brien, Sean M
• Okeke, Nwora Lance
• Perez, Léna
• Perez-Padilla, Rogelio
• Perrin, Laurent
• Remigio-Luna, Arantxa
• Rivera-Martinez, Norma E
• Rockhold, Frank W
• Rodriguez-Llamazares, Sebastian
• Rolfe, Robert
• Rosa, Rossana
• Røsjø, Helge
• Sampaio, Vanderson S
• Seto, Todd B
• Shahzad, Muhammad
• Soliman, Shaimaa
• Stout, Jason E
• Thirion-Romero, Ireri
• Troxel, Andrea B
• Tseng, Ting-Yu
• Turner, Nicholas A
• Ulrich, Robert J
• Walsh, Stephen R
• Webb, Steve A
• Weehuizen, Jesper M
• Velinova, Maria
• Wong, Hon-Lai
• Wrenn, Rebekah
• Zampieri, Fernando G
• Zhong, Wu
• Moher, David
• Goodman, Steven N
• Ioannidis, John P A
• Hemkens, Lars G

Titel

Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials

Ist Teil von

• Nature communications, 2021-04, Vol.12 (1), p.2349-13, Article 2349

Ort / Verlag

England: Nature Publishing Group

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Substantial COVID-19 research investment has been allocated to randomized clinical trials (RCTs) on hydroxychloroquine/chloroquine, which currently face recruitment challenges or early discontinuation. We aim to estimate the effects of hydroxychloroquine and chloroquine on survival in COVID-19 from all currently available RCT evidence, published and unpublished. We present a rapid meta-analysis of ongoing, completed, or discontinued RCTs on hydroxychloroquine or chloroquine treatment for any COVID-19 patients (protocol: https://osf.io/QESV4/ ). We systematically identified unpublished RCTs (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Cochrane COVID-registry up to June 11, 2020), and published RCTs (PubMed, medRxiv and bioRxiv up to October 16, 2020). All-cause mortality has been extracted (publications/preprints) or requested from investigators and combined in random-effects meta-analyses, calculating odds ratios (ORs) with 95% confidence intervals (CIs), separately for hydroxychloroquine and chloroquine. Prespecified subgroup analyses include patient setting, diagnostic confirmation, control type, and publication status. Sixty-three trials were potentially eligible. We included 14 unpublished trials (1308 patients) and 14 publications/preprints (9011 patients). Results for hydroxychloroquine are dominated by RECOVERY and WHO SOLIDARITY, two highly pragmatic trials, which employed relatively high doses and included 4716 and 1853 patients, respectively (67% of the total sample size). The combined OR on all-cause mortality for hydroxychloroquine is 1.11 (95% CI: 1.02, 1.20; I² = 0%; 26 trials; 10,012 patients) and for chloroquine 1.77 (95%CI: 0.15, 21.13, I² = 0%; 4 trials; 307 patients). We identified no subgroup effects. We found that treatment with hydroxychloroquine is associated with increased mortality in COVID-19 patients, and there is no benefit of chloroquine. Findings have unclear generalizability to outpatients, children, pregnant women, and people with comorbidities.