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0 0.5 1 1.5 2+ Case, PrEP 28% Improvement Relative Risk Case, PEP 9% HCQ for COVID-19  García-Albéniz et al.  META ANALYSIS Favors HCQ Favors control

Systematic review and meta-analysis of randomized trials of hydroxychloroquine for the prevention of COVID-19

García-Albéniz et al., European Journal of Epidemiology, doi:10.1007/s10654-022-00891-4 (date from preprint)
Aug 2022  
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Systematic review and meta-analysis of HCQ prophylaxis RCTs showing a statistically significant reduction in cases for pre-exposure prophylaxis.
For PEP trials there were very long treatment delays - in one trial about a third of participants were enrolled 4 days after exposure with an additional shipping delay of ~46 hours on average, and in another trial participants were enrolled up to 7 days after exposure, with an unknown additional delay before treatment, and results suggesting that exposure detection was delayed.
7 meta analyses show significant improvements with hydroxychloroquine for mortality Landsteiner de Sampaio Amêndola, Risch, Risch (B), Stricker, hospitalization Landsteiner de Sampaio Amêndola, recovery Prodromos, combined death/hospitalization/cases Ladapo, and cases García-Albéniz.
Currently there are 38 HCQ for COVID-19 early treatment studies, showing 72% lower mortality [59‑81%], 67% lower ventilation [-710‑99%], 28% lower ICU admission [-17‑55%], and 41% lower hospitalization [28‑51%].
risk of case, 28.0% lower, RR 0.72, p = 0.003, PrEP.
risk of case, 9.0% lower, RR 0.91, p = 0.45, PEP.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
García-Albéniz et al., 9 Aug 2022, peer-reviewed, 5 authors.
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Systematic review and meta-analysis of randomized trials of hydroxychloroquine for the prevention of COVID-19
Xabier García-Albéniz, Julia Del Amo, Rosa Polo, José Miguel Morales-Asencio, Miguel A Hernán
European Journal of Epidemiology, doi:10.1007/s10654-022-00891-4
Background Hydroxychloroquine (HCQ) is not an effective treatment for established coronavirus disease 2019 (COVID-19) [1, 2], but it is unclear whether HCQ can prevent symptomatic COVID-19. Early in the SARS-CoV-2 pandemic, about 30 randomized trials were designed to study HCQ as prophylaxis for COVID-19 [3] . After the findings from two of these trials were reported in the Summer of 2020 [4, 5], HCQ was generally viewed by the medical community as ineffective for COVID-19 prophylaxis. The emergence of that consensus was surprising because both trials found a lower risk of COVID-19 in the HCQ group, though they were too small to rule out either benefit or harm of HCQ. A timely completion of the remaining trials would have generated precise estimates of the potential effectiveness Xabier García-Albéniz
manuscript. All authors made substantial contributions to the design of the study, interpreted the data, revised the manuscript critically, approved the version to be published and agree to be accountable for all aspects of the work. Code is available upon request from Xabier Garcia-Albeniz ( Funding No funding was received to support the development of this manuscript. Declarations Competing Interests The authors have no relevant financial or nonfinancial interests to disclose. Author contribution XGA and MAH analysed the data and drafted the Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information The online version contains supplementary material available at
Abella, Jolkovsky, Biney, Uspal, Hyman et al., Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers: A Randomized Clinical Trial
Amrhein, Greenland, Mcshane, Scientists rise up against statistical significance, Nature
Axfors, Schmitt, Janiaud, Van't Hooft, Abd-Elsalam et al., Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials, Nat Commun
Barnabas, Brown, Bershteyn, Karita, Johnston et al., Hydroxychloroquine as Postexposure Prophylaxis to Prevent Severe Acute Respiratory Syndrome
Barnabas, Brown, Bershteyn, Miller, Wener et al., Efficacy of hydroxychloroquine for post-exposure prophylaxis to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among adults exposed to coronavirus disease (COVID-19): a structured summary of a study protocol for a randomised controlled trial, Trials
Bartoszko, Siemieniuk, Kum, Qasim, Zeraatkar et al., Prophylaxis against covid-19: living systematic review and network meta-analysis, BMJ (Clinical research ed
Bienvenu, Marty, Jones, Picot, Systematic review of registered trials of Hydroxychloroquine prophylaxis for COVID-19 health-care workers at the first third of 2020, One health
Boulware, Pullen, Bangdiwala, Pastick, Lofgren et al., A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19, N Engl J Med
Dahabreh, Petito, Robertson, Hernán, Steingrimsson, Toward Causally Interpretable Meta-analysis: Transporting Inferences from Multiple Randomized Trials to a New Target Population, Epidemiology
Dersimonian, Laird, Meta-analysis in clinical trials, Control Clin Trials
García-Albéniz, Jd, Polo, Morales-Asencio, Hernán, Systematic review and meta-analysis of randomized trials of hydroxychloroquine for the prevention of COVID-19, medRxiv
Goldman, Hydroxychloroquine for Prevention of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: Challenges to Trial Conduct During the Global Pandemic, Infect Dis Soc Am
Grau-Pujol, Camprubí-Ferrer, Marti-Soler, Fernández-Pardos, Carreras-Abad et al., Pre-exposure prophylaxis with hydroxychloroquine for COVID-19: a double-blind, placebo-controlled randomized clinical trial, Trials
Greenland, Senn, Rothman, Carlin, Poole et al., Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations, Eur J Epidemiol
Hartung, Knapp, A refined method for the meta-analysis of controlled clinical trials with binary outcome, Stat Med
Hernan, Robins, Per-protocol analyses of pragmatic trials, N Engl J Med
Higgins, Thompson, Spiegelhalter, A re-evaluation of random-effects meta-analysis, J R Stat Soc Ser A Stat Soc
Horby, Mafham, Linsell, Bell, Staplin et al., Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19, N Engl J Med
Inthout, Ioannidis, Borm, The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method, BMC Med Res Methodol
Jackson, Law, Rücker, Schwarzer, The Hartung-Knapp modification for random-effects meta-analysis: A useful refinement but are there any residual concerns?, Ann Intern Med
Kuhar, Henderson, Struble, Heneine, Thomas et al., Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis
Liu, Ezekowitz, Columbo, Khan, Martin et al., Testing the feasibility of operationalizing a prospective, randomized trial with remote cardiac safety EKG monitoring during a pandemic, J Interv Card Electrophysiol
Mckinnon, Wang, Zervos, Saval, Marshall-Nightengale et al., Safety and tolerability of hydroxychloroquine in health care workers and first responders for the prevention of COVID-19: WHIP COVID-19 Study, Int J Infect Dis
Mitjà, Corbacho-Monné, Ubals, Alemany, Suñer et al., A Cluster-Randomized Trial of Hydroxychloroquine for Prevention of Covid-19, New England Journal of Medicine
Naggie, Milstone, Castro, Collins, Seetha et al., Hydroxychloroquine for pre-exposure prophylaxis of COVID-19 in health care workers: a randomized, multicenter, placebo-controlled trial (HERO-HCQ), medRxiv
Niburski, Niburski, Impact of Trump's Promotion of Unproven COVID-19 Treatments and Subsequent Internet Trends: Observational Study, J Med Internet Res
Pan, Peto, Karim, Alejandria, Henao-Restrepo et al., Repurposed antiviral drugs for COVID-19 -interim WHO SOLIDARITY trial results, medRxiv
Partlett, Riley, Random effects meta-analysis: Coverage performance of 95% confidence and prediction intervals following REML estimation, Stat Med
Polo, García-Albéniz, Terán, Morales, Rial-Crestelo et al., Daily tenofovir disoproxil fumarate/emtricitabine and hydroxychloroquine for pre-exposure prophylaxis of COVID-19: a double-blind placebo controlled randomized trial in healthcare workers, medRxiv
Rajasingham, Bangdiwala, Nicol, Skipper, Pastick et al., Hydroxychloroquine as pre-exposure prophylaxis for COVID-19 in healthcare workers: a randomized trial
Rojas-Serrano, Portillo-Vásquez, Thirion-Romero, Vázquez-Pérez, Mejía-Nepomuceno et al., Hydroxychloroquine for prophylaxis of COVID-19 in health workers: A randomized clinical trial, PLoS ONE
Röver, Knapp, Friede, Hartung-Knapp-Sidik-Jonkman approach and its modification for random-effects meta-analysis with few studies, BMC Med Res Methodol
Seet, Quek, Ooi, Sengupta, Lakshminarasappa et al., Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: An open-label randomized trial, Int J Infect Dis
Sterne, Savović, Page, Elbers, Blencowe et al., RoB 2: a revised tool for assessing risk of bias in randomised trials, BMJ
Syed, Arif, Niazi, Baqar, Hashmi et al., Pre-Exposure Prophylaxis with Various Doses of Hdroxychloroquine among high-risk COVID 19 Healthcare Personnel: CHEER randomized controlled trial, medRxiv
Wiksten, Rücker, Schwarzer, Hartung-Knapp method is not always conservative compared with fixed-effect meta-analysis, Stat Med
Yao, Ye, Zhang, Cui, Huang et al., Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Infect Dis Soc Am
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