Hydroxychloroquine- and chloroquine-related cardiovascular events
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Hydroxychloroquine- and chloroquine-related cardiovascular events Use of hydroxychloroquine (HCQ) and chloroquine (CQ) appears to increase the rate of cardiovascular events, according to findings of an analysis of data from the US Food and Drug Administration Adverse Events Reporting System (FAERS) published in the British Journal of Clinical Pharmacology. Disproportionality analysis was used to assess reporting odds ratios (RORs) for HCQ/CQ-associated cardiovascular adverse events (CVAEs) reported to the FAERS database between July 2014 and September 2019, prior to the COVID-19 pandemic. Of the 6 667 225 reports to the FAERS during the study period, 4895 reports were of HCQ/CQ-related adverse events and included 696 CVAEs. HCQ/CQ use was associated with higher reporting rates of major CVAEs compared with the full database, including cardiomyopathy (ROR 29.0; 95% CI 5 23.3, 35.9), QT-interval prolongation/torsades de pointes (ROR 4.5; 95% CI 3.3, 6.1), arrhythmias (ROR 2.2; 95% CI 1.8, 2.7) and heart failure (ROR 2.2; 95% CI 1.9, 2.7). HCQ/CQ was associated with significantly increased RORs for bradyarrhythmias, ventricular arrhythmias and supraventricular arrhythmias, and HCQ was also associated with endocardial disorders, myocarditis, pericardial disease, pulmonary hypertension and vasculitis. HCQ/CQ-related CVAEs resulted in hospitalisation and death in 39% and 8% of cases, respectively. Overdose was associated with an increased frequency of QT-interval prolongation (35%) and ventricular arrhythmias (25%). "In a real-world setting, a wide array of CVAEs are associated with HCQ/CQ treatment of non-COVID-19 patients . . . These AEs carry a high risk for severe outcomes, including death, even with standard doses. HCQ/CQ treatment should be carefully considered as an off-label indication while taking into account potential drug interactions and cardiac comorbidities," said the authors. Goldman A, et al. Cardiovascular adverse events associated with hydroxychloroquine and chloroquine: A comprehensive pharmacovigilance analysis of pre-COVID-19 803505515 reports. British Journal of Clinical Pharmacology : 22 Sep 2020. Available from: URL: http://doi.org/10.1111/bcp.14546
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Reactions 3 Oct 2020 No. 1824
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