- •Our data reinforces the notion that chloroquine and hydroxychloroquine have a good safety profile.
- •Users of both antimalarial presented a higher risk of mild and self-limited adverse events.
- •A ten-year meta-analysis did not reveal a statistically significant higher risk of cardiovascular events in chloroquine and hydroxychloroquine users.
- •Ventricular arrhythmias and myocardial infarction were reported in hospitalized COVID-19 patients using higher than usual doses of chloroquine or hydroxychloroquine.
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to European Journal of Internal Medicine
- Reviews of anti-infective agents: role of US military research programs in the development of US food and drug administration–approved antimalarial drugs.Clin Infect Dis. 2006; 43: 67-71https://doi.org/10.1086/504873
- Activity of a new antimalarial agent, chloroquine (SN 7618).J Am Med Assoc. 1946; 130: 1069https://doi.org/10.1001/jama.1946.02870160015006
- Treatment of malaria with oral or intravenous Plaquenil.Am J Trop Med Hyg. 1953; 2: 805-807https://doi.org/10.4269/ajtmh.1953.2.805
- The history of antimalarials.Lupus. 1996; 5: 2-3https://doi.org/10.1177/0961203396005001021
- The role of anti-malarials in rheumatoid arthritis – the American experience.Lupus. 1996; 5: 41-44https://doi.org/10.1177/0961203396005001101
- Hydroxychloroquine effectiveness in reducing symptoms of hand osteoarthritis (HERO): study protocol for a randomized controlled trial.Trials. 2013; 14 (64-64)https://doi.org/10.1186/1745-6215-14-64
- The effect of hydroxychloroquine on thrombosis prevention and antiphospholipid antibody levels in primary antiphospholipid syndrome: a pilot open label randomized prospective study.Autoimmun Rev. 2020; 19 (102491–102491)https://doi.org/10.1016/j.autrev.2020.102491
- Antimalarials in rheumatology: efficacy and safety.Semin Arthritis Rheum. 1987; 16: 206-221https://doi.org/10.1016/0049-0172(87)90023-0
- Cardiac Complications attributed to chloroquine and hydroxychloroquine: a systematic review of the literature.Drug Saf. 2018; 41: 919-931https://doi.org/10.1007/s40264-018-0689-4
- Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro.Cell Res. 2020; 30: 269-271https://doi.org/10.1038/s41422-020-0282-0
- Efficacy and safety of current therapeutic options for COVID-19 - lessons to be learnt from SARS and MERS epidemic: a systematic review and meta-analysis.Pharmacol Res. 2020; 157104872https://doi.org/10.1016/j.phrs.2020.104872
- Treating COVID-19 with Chloroquine.J Mol Cell Biol. 2020; 12: 322-325https://doi.org/10.1093/jmcb/mjaa014
- Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial.Int J Antimicrob Agents. 2020; 56105949https://doi.org/10.1016/j.ijantimicag.2020.105949
- Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.Syst Rev. 2015; 4: 1https://doi.org/10.1186/2046-4053-4-1
- RoB 2: a revised tool for assessing risk of bias in randomised trials.BMJ. 2019; : l4898https://doi.org/10.1136/bmj.l4898
- How to perform a meta-analysis with R: a practical tutorial.Evid Based Ment Health. 2019; 22: 153-160https://doi.org/10.1136/ebmental-2019-300117
- Meta-analytic methods for pooling rates when follow-up duration varies: a case study.BMC Med Res Methodol. 2004; 4: 1-7https://doi.org/10.1186/1471-2288-4-17
Higgins JPT G.S. (editors). Cochrane handbook for systematic reviews of interventions 2011. www.handbook.cochrane.org.
- Inclusion of zero total event trials in meta-analyses maintains analytic consistency and incorporates all available data.BMC Med Res Methodol. 2007; 7: 5https://doi.org/10.1186/1471-2288-7-5
- Quantifying heterogeneity in a meta-analysis.Stat Med. 2002; 21: 1539-1558https://doi.org/10.1002/sim.1186
- Bias in meta-analysis detected by a simple, graphical test.BMJ. 1997; 315: 629-634https://doi.org/10.1136/bmj.315.7109.629
- Effect of hydroxychloroquine in hospitalized patients with Covid-19.N Engl J Med. 2020; 383: 2030-2040https://doi.org/10.1056/NEJMoa2022926
- Hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19.N Engl J Med. 2020; (NEJMoa2019014)https://doi.org/10.1056/NEJMoa2019014
- Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis.Biometrics. 2000; 56: 455-463https://doi.org/10.1111/j.0006-341X.2000.00455.x
- Outlier and influence diagnostics for meta-analysis.Res Synth Methods. 2010; 1: 112-125https://doi.org/10.1002/jrsm.11
- Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis.Lancet Gastroenterol Hepatol. 2020; 5: 667-678https://doi.org/10.1016/S2468-1253(20)30126-6
- Lupus erythematosus treated with chloroquine.Lancet. 1953; 262: 201-202https://doi.org/10.1016/S0140-6736(53)90138-X
- The treatment of lupus erythematosus with chloroquine sulphate1.J Invest Dermatol. 1954; 22: 89-91https://doi.org/10.1038/jid.1954.12
- Dramatic response to chloroquine and mirtazapine for recalcitrant atopic dermatitis.Dermatitis. 2006; 17: 208-209https://doi.org/10.2310/6620.2006.06013
- Assessment of hypokalemia and clinical characteristics in patients with coronavirus disease 2019.JAMA Netw Open. 2020; 3 (e2011122)https://doi.org/10.1001/jamanetworkopen.2020.11122
- Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China.JAMA Cardiol. 2020; 5: 802https://doi.org/10.1001/jamacardio.2020.0950
- Chloroquine and hydroxychloroquine in the treatment of cardiac arrhythmias.N Engl J Med. 1958; 258: 798-800https://doi.org/10.1056/NEJM195804172581608
- Evidence for cardiac safety and antiarrhythmic potential of chloroquine in systemic lupus erythematosus.Europace. 2014; 16: 887-892https://doi.org/10.1093/europace/eut290
- Pitfalls in meta-analyses on adverse events reported from clinical trials: PITFALLS IN META-ANALYSES ON ADVERSE EVENTS.Pharmacoepidemiol Drug Saf. 2011; 20: 1014-1020https://doi.org/10.1002/pds.2208
- A Randomized comparison of chloroquine versus dihydroartemisinin–piperaquine for the treatment of Plasmodium vivax infection in Vietnam.Am J Trop Med Hyg. 2016; 94: 879-885https://doi.org/10.4269/ajtmh.15-0740
- Therapeutic and transmission-blocking efficacy of dihydroartemisinin/piperaquine and chloroquine against Plasmodium vivax Malaria, Cambodia.Emerg Infect Dis. 2018; 24: 1516-1519https://doi.org/10.3201/eid2408.170768
- Two-year results of disease activity score (DAS)-remission-steered treatment strategies aiming at drug-free remission in early arthritis patients (the IMPROVED-study).Arthritis Res Ther. 2016; 18: 23https://doi.org/10.1186/s13075-015-0912-y
- Randomised comparison of initial triple DMARD therapy with methotrexate monotherapy in combination with low-dose glucocorticoid bridging therapy; 1-year data of the tREACH trial.Ann Rheum Dis. 2014; 73: 1331-1339https://doi.org/10.1136/annrheumdis-2013-204788
- Therapies for active rheumatoid arthritis after methotrexate failure.N Engl J Med. 2013; 369: 307-318https://doi.org/10.1056/NEJMoa1303006
- A randomized comparative effectiveness study of oral triple therapy versus etanercept plus methotrexate in early aggressive rheumatoid arthritis: the treatment of early aggressive rheumatoid arthritis trial.Arthritis Rheum. 2012; 64: 2824-2835https://doi.org/10.1002/art.34498
- Conventional combination treatment versus biological treatment in methotrexate-refractory early rheumatoid arthritis: 2 year follow-up of the randomised, non-blinded, parallel-group Swefot trial.Lancet. 2012; 379: 1712-1720https://doi.org/10.1016/S0140-6736(12)60027-0