“Stop Prescribing Hydroxychloroquine for COVID-19”

In 2021, there were more than 560,000 prescriptions for hydroxychloroquine in the US alone. Last year, the 890,000 prescriptions were nine times larger than in previous years.

In 2021, there were more than 560,000 prescriptions of hydroxychloroquine for the prevention, post-exposure and treatment of COVID-19 in the United States alone. Since its beginnings in February 2020, the US has been the epicenter of the pandemic and continues to be the world leader in cases and deaths. Last year, the 890,000 prescriptions for hydroxychloroquine were nine times higher than in previous years, leading to large shortages in the approved indications of autoimmune disease, mainly in younger women.

In a commentary published in The American Journal of Medicine, researchers from Florida Atlantic University’s Schmidt College of Medicine and collaborators review the recent large randomized, double-blind, placebo-controlled studies and present an updated meta-analysis of hydroxychloroquine in post-exposure prophylaxis as well as in hospitalized patients. patients. Last year, the same researchers called for a moratorium on prescribing hydroxychloroquine in prevention or treatment pending the outcome of ongoing randomized trials.

“The updated randomized evidence provides even stronger support for discontinuing the prescription of hydroxychloroquine in the prevention or treatment of COVID-19,” said Charles H. Hennekens, MD, Dr.PH, senior author, first Sir Richard Doll professor and senior academic advisor at the FAU’s Schmidt College of Medicine.

The authors say that in addition to a lack of significant benefit, the new randomized evidence shows some suggestion of harm. They explain that the previously reassuring safety profile of hydroxychloroquine applies to patients with lupus and rheumatoid arthritis, both of which are more common in younger and middle-aged women, whose risk of fatal heart outcomes from hydroxychloroquine is reassuringly very low.

In contrast, the risks of hydroxychloroquine for patients with COVID-19 are significantly higher because fatal cardiovascular complications resulting from these drugs are so much higher in elderly patients and in patients with pre-existing heart disease or its risk factors, both of which are more predominant in males.

“Premature and preventable deaths will continue to occur if people take hydroxychloroquine and avoid public health strategies with proven benefits, including vaccinations and masking,” Hennekens added.

Reference: “Updates on Hydroxychloroquine in Prevention and Treatment of COVID-19” by Charles H. Hennekens, MD, DrPH; Manas Rane, MD; Joshua Solano, MD; Scott Alter, MD; Heather Johnson, MD, FACC, FAHA, FASPC; Shiv Krishnaswamy, B.S.; Richard Shih, MD; Dennis Maki, MD and David L. DeMets, PhD, Aug. 23, 2021, The American Journal of Medicine.
DOI: 10.116/j.amjmed.2021.07.035

Co-authors are Manas Rane, MD, a preventive cardiology fellow at Harvard Medical School and Boston VA System and a former FAU resident of internal medicine; Joshua J. Solano, MD, an assistant professor of emergency medicine; Scott M. Alter, MD, MBA, an associate professor of emergency medicine; and Richard D. Shih, MD, a professor of emergency medicine; all within the Schmidt College of Medicine; Dennis G. Maki, MD, Ovid O. Meyer Professor of Medicine, and David L. DeMets, Ph.D., Max Halperin Professor of Biostatistics, Emeritus and Past Chair of the Department of Biostatistics and Medical Informatics, both with the University of Wisconsin School of Medicine and Public Health; Heather Johnson, MD, preventive cardiologist at Lynn Women’s Health and Wellness Institute, Boca Raton Regional Hospital/Baptist Health South Florida and adjunct professor at the University of Wisconsin School of Medicine and Public Health; and Shiv Krishnaswamy, a fourth-year medical student, FAU Schmidt College of Medicine.

Hennekens and Maki have been working together since 1969, when they served as lieutenant commanders in the US Public Health Service as epidemic intelligence officers at the US Centers for Disease Control and Prevention. Hennekens, Maki and Johnson also collaborated on a recently published commentary highlighting the already alarming racial disparities in mortality from COVID-19, which are likely to only increase further until vaccines are distributed fairly.