Journal article
The Cardiovascular Effects of Treatment with Hydroxychloroquine and Azithromycin
Pharmacotherapy, Vol.40(9), pp.978-983
09/2020
DOI: 10.1002/phar.2445
PMCID: PMC7404845
PMID: 32677113
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.
Details
- Title: Subtitle
- The Cardiovascular Effects of Treatment with Hydroxychloroquine and Azithromycin
- Creators
- Jacob E Simmering - University of IowaLinnea A Polgreen - University of IowaPhilip M Polgreen - University of IowaRebecca E Teske - University of IowaAlejandro P Comellas - University of IowaBarry L Carter - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Pharmacotherapy, Vol.40(9), pp.978-983
- DOI
- 10.1002/phar.2445
- PMID
- 32677113
- PMCID
- PMC7404845
- NLM abbreviation
- Pharmacotherapy
- ISSN
- 0277-0008
- eISSN
- 1875-9114
- Grant note
- P30 ES005605 / NIEHS NIH HHS UL1 TR002537 / NCATS NIH HHS
- Language
- English
- Date published
- 09/2020
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Infectious Diseases; Health Management and Policy; ICTS; Epidemiology; Economics; Pharmacy Practice and Science; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984359585102771
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