Use este identificador para citar ou linkar para este item: http://repositorio.ufla.br/jspui/handle/1/41253
Título : “Off-label” use of hydroxychloroquine, azithromycin, lopinavir-ritonavir and chloroquine in COVID-19: a survey of cardiac adverse drug reactions by the French Network of Pharmacovigilance Centers
Autor: Gérard, Alexandre
Romani, Serena
Fresse, Audrey
Viard, Delphine
Parassol, Nadège
Granvuillemin, Aurélie
Chouchana, Laurent
Rocher, Fanny
Drici, Milou-Daniel
Palavras-chave: Hydroxychloroquine
Azithromycin
Lopinavir
Cardiac adverse effects
QTc prolongation
Arrhythmia
COVID-19
Publicador: Elsevier
Data da publicação: 2020
Referência: GÉRARD, A. et al. “Off-label” use of hydroxychloroquine, azithromycin, lopinavir-ritonavir and chloroquine in COVID-19: a survey of cardiac adverse drug reactions by the French Network of Pharmacovigilance Centers. Therapies, [S.l.], 2020. No prelo.
Abstract: Introduction COVID-19 is an unprecedented challenge for physicians and scientists. Several publicized drugs are being used with not much evidence of their efficacy such as hydroxychloroquine, azithromycin or lopinavir-ritonavir. Yet, the cardiac safety of these drugs in COVID-19 deserves scrutiny as they are known to foster cardiac adverse ADRs, notably QTc interval prolongation on the electrocardiogram and its arrhythmogenic consequences. Methods Since March 27th, 2020, the French Pharmacovigilance Network directed all cardiac adverse drug reactions associated with “off-label” use of hydroxychloroquine, azithromycin and lopinavir-ritonavir in COVID-19 to the Nice Regional Center of Pharmacovigilance. Each Regional Center of Pharmacovigilance first assessed causality of drugs. We performed a specific analysis of these cardiac adverse drug reactions amidst an array of risk factors, reassessed the electrocardiograms and estimated their incidence in coronavirus disease 2019. Results In one month, 120 reports of cardiac adverse drug reactions have been notified, 103 of which associated with hydroxychloroquine alone (86%), or associated with azithromycin (60%). Their estimated incidence is 0.77% to 1.54% of all patients, notwithstanding strong underreporting. Lopinavir-ritonavir came third with 17 reports (14%) and chloroquine fourth with 3 reports (2.5%). There were 8 sudden, unexplained or aborted deaths (7%), 8 ventricular arrhythmias (7%), 90 reports of prolonged QTc (75%) most of them “serious” (64%), 48 of which proved ≥ 500ms, 20 reports of severe conduction disorders (17%) and 5 reports of other cardiac causes (4%). Six reports derived from automedication. Discussion and conclusion “Off-label” use of treatments in COVID-19 increases the risk of cardiac ADRs, some of them avoidable. Even if these drugs are perceived as familiar, they are used in patients with added risk factors caused by infection. Precautions should be taken to mitigate the risk, even if they will be proven efficacious.
URI: http://www.sciencedirect.com/science/article/pii/S0040595720300913
http://repositorio.ufla.br/jspui/handle/1/41253
Idioma: en_US
Aparece nas coleções:FCS - Artigos sobre Coronavirus Disease 2019 (COVID-19)

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