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

London: Nature Publishing Group UK

Erscheinungsjahr

2021

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. Hydroxychloroquine and chloroquine have been investigated as a potential treatment for Covid-19 in several clinical trials. Here the authors report a meta-analysis of published and unpublished trials, and show that treatment with hydroxychloroquine for patients with Covid-19 was associated with increased mortality, and there was no benefit from chloroquine.