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The Cardiovascular Effects of Treatment with Hydroxychloroquine and Azithromycin.
Simmering, Jacob E; Polgreen, Linnea A; Polgreen, Philip M; Teske, Rebecca E; Comellas, Alejandro P; Carter, Barry L.
  • Simmering JE; Health Ventures Signal Center for Healthcare Innovation, University of Iowa, Iowa City, Iowa, USA.
  • Polgreen LA; Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa, USA.
  • Polgreen PM; Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, USA.
  • Teske RE; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA.
  • Comellas AP; Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, USA.
  • Carter BL; Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Pharmacotherapy ; 40(9): 978-983, 2020 09.
Статья в английский | MEDLINE | ID: covidwho-648736
ABSTRACT
Hydroxychloroquine combined with azithromycin has been investigated for activity against coronavirus disease 2019 (COVID-19), but concerns about adverse cardiovascular (CV) effects have been raised. This study evaluated claims data to determine if risks for CV events were increased with hydroxychloroquine alone or combined with azithromycin. We identified data from 43,752 enrollees that qualified for analysis. The number of CV events increased by 25 (95% confidence interval [CI] 8, 42, p=0.005) per 1000 people per year of treatment with hydroxychloroquine alone compared with pretreatment levels and by 201 (95% CI 145, 256, p<0.001) events per 1000 people per year when individuals took hydroxychloroquine and azithromycin. These rates translate to an additional 0.34 (95% CI 0.11, 0.58) CV events per 1000 patients placed on a 5-day treatment with hydroxychloroquine monotherapy and 2.75 (95% CI 1.99, 3.51) per 1000 patients on a 5-day treatment with both hydroxychloroquine and azithromycin. The rate of adverse events increased with age following exposure to hydroxychloroquine alone and combined with azithromycin. For females aged 60 to 79 years prescribed hydroxychloroquine, the rate of adverse CV events was 0.92 per 1000 patients on 5 days of therapy, but it increased to 4.78 per 1000 patients when azithromycin was added. The rate of adverse CV events did not differ significantly from zero for patients 60 years of age or younger. These data suggest that hydroxychloroquine with or without azithromycin is likely safe in individuals under 60 years of age if they do not have additional CV risks. However, the combination of hydroxychloroquine and azithromycin should be used with extreme caution in older patients.
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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Azithromycin / Cardiotoxicity / COVID-19 Drug Treatment / Hydroxychloroquine Тип исследования: Экспериментальные исследования / Наблюдательное исследование / Прогностическое исследование Пределы темы: Подростки / Взрослые / Пожилые / Дети / Детский дошкольный / Женщины / Люди / Грудные дети / Мужчины / Middle aged Язык: английский Журнал: Pharmacotherapy Год: 2020 Тип: Статья Аффилированная страна: Phar.2445

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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Azithromycin / Cardiotoxicity / COVID-19 Drug Treatment / Hydroxychloroquine Тип исследования: Экспериментальные исследования / Наблюдательное исследование / Прогностическое исследование Пределы темы: Подростки / Взрослые / Пожилые / Дети / Детский дошкольный / Женщины / Люди / Грудные дети / Мужчины / Middle aged Язык: английский Журнал: Pharmacotherapy Год: 2020 Тип: Статья Аффилированная страна: Phar.2445