Department of Rheumatology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland.
Department of Clinical Auxology and Pediatric Nursing, Poznan University of Medical Sciences, Poznań, Poland.
Ann Agric Environ Med. 2021 Mar 18;28(1):122-126. doi: 10.26444/aaem/127766. Epub 2020 Oct 8.
The COVID-19 pandemic causes vital concerns due to the lack of proved, effective, and safe therapy. Chloroquine and hydroxychloroquine seem to be useful, but recently serious concerns regarding their adverse events have risen. The aim of the study was to broaden the general perspective of chloroquine and hydroxychloroquine use in COVID-19 treatment, based on an analysis of their current safety profile among patients with rheumatic diseases.
The study was based on a group of 152 patients with rheumatic diseases, aged 20-78 years, treated either with chloroquine or hydroxychloroquine. Analyzed data included age, gender, comorbidities, type of drug, dosage, treatment duration, and reported adverse events. Cases of drug withdrawal related to adverse events were also recorded.
The dosage was consistent in both groups: 250 mg of chloroquine or 200 mg of hydroxychloroquine daily. 77.6% of patients did not experience any adverse reactions to the treatment. Hydroxychloroquine showed better safety profile, with 10.9% of patients reporting side-ffects, compared to 28.9% in patients treated with chloroquine. The overall incidence of ophthalmic complications was 6.6%. For both drugs, no statistically significant correlation between adverse events and age, chronic heart or liver disease, or hypertension was found.
Chloroquine and hydroxychloroquine at lower doses, as used in rheumatic diseases, prove to be relatively safe. Data from the literature show that high dosage as recommended in COVID-19 treatment may pose a risk of toxicity and require precise management, but prophylactic, long-term use of lower, safe doses might be a promising solution.
由于缺乏已证实、有效且安全的治疗方法，COVID-19 大流行引起了人们的高度关注。氯喹和羟氯喹似乎具有一定的疗效，但最近人们对其不良事件的担忧日益增加。本研究旨在通过分析风湿性疾病患者中氯喹和羟氯喹的当前安全性概况，拓宽其在 COVID-19 治疗中的应用。
本研究基于一组 152 例年龄在 20-78 岁之间的风湿性疾病患者，他们接受氯喹或羟氯喹治疗。分析的数据包括年龄、性别、合并症、药物类型、剂量、治疗持续时间和报告的不良事件。还记录了与不良事件相关的药物停药病例。
两组的剂量均一致：氯喹每日 250mg，羟氯喹每日 200mg。77.6%的患者在治疗过程中未出现任何不良反应。羟氯喹的安全性更好，10.9%的患者出现副作用，而氯喹组则为 28.9%。总体眼部并发症发生率为 6.6%。对于这两种药物，未发现不良事件与年龄、慢性心脏病或肝病或高血压之间存在统计学显著相关性。
在风湿性疾病中使用较低剂量的氯喹和羟氯喹被证明相对安全。文献数据表明，COVID-19 治疗中推荐的高剂量可能存在毒性风险，需要精确管理，但预防性、长期使用较低、安全剂量可能是一个有前途的解决方案。
