Gendelman: Continuous Hydroxychloroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From a Large Healthcare Database Analysis [HCQ]

Continuous Hydroxychloroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From a Large Healthcare Database Analysis

Gendelman et al., Autoimmunity Reviews, 19:7, July 2020, doi:10.1016/j.autrev.2020.102566

Gendelman et al., Continuous Hydroxychloroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From.., Autoimmunity Reviews, 19:7, July 2020, doi:10.1016/j.autrev.2020.102566

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Very small study of rheumatic disease/autoimmune disorder patients showing no significant difference but with only 3 chronic HCQ patient cases. Only considers people tested at a time when primarily symptomatic cases were tested.

Other research shows that the risk of COVID-19 for systemic autoimmune disease patients is much higher overall, Ferri et al. show OR 4.42, p<0.001 [Ferri], which is the observed real-world risk, taking into account factors such as these patients potentially being more careful to avoid exposure.

Adjusting for the difference in baseline risk using the result in Ferri et al. shows substantial benefit for HCQ, RR 0.211, but with only 3 HCQ cases the result is inconclusive. More recent studies with rheumatic disease/autoimmune condition patients provide higher confidence. This study is excluded in the after exclusion results of meta analysis: not fully adjusting for the different baseline risk of systemic autoimmune patients.

1. Ferri at al., Clinical Rheumatology, doi:0.1007/s10067-020-05334-7, COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series, https://link.springer.com/article/10.1007/s10067-020-05334-7.

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risk of case, 8.1% lower, RR 0.92, p = 0.88, treatment 3 of 36 (8.3%), control 1,314 of 14,484 (9.1%), NNT 135.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Gendelman et al., 5 May 2020, retrospective, database analysis, Israel, peer-reviewed, 5 authors.

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Abstract: Autoimmunity Reviews 19 (2020) 102566 Contents lists available at ScienceDirect Autoimmunity Reviews journal homepage: www.elsevier.com/locate/autrev Continuous hydroxychloroquine or colchicine therapy does not prevent infection with SARS-CoV-2: Insights from a large healthcare database analysis T Omer Gendelmana,b,1, Howard Amitala,b,1,⁎, Nicola Luigi Bragazzic, Abdulla Watada,b, Gabriel Chodickb,d a Department of Medicine ‘B', Sheba Medical Center, Tel-Hashomer, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, ON M3J 1P3, Canada d Maccabitech, Maccabi Healthcare Services, Tel Aviv, Israel b c ARTICLE INFO ABSTRACT Keywords: COVID-19 SARS-CoV-2 Colchicine Hydroxychloroquine Rheumatic disease Autoimmunity Background: Some disease-modifying agents commonly used to treat patients with rheumatic diseases/autoimmune disorders, such as hydroxychloroquine and colchicine, are under investigation as potential therapies for the “coronavirus disease 2019” (COVID-19). However, the role of such agents as prophylactic tools is still not clear. Methods: This is a retrospective study based on a large healthcare computerized database including all patients that were screened for the “Severe Acute Respiratory Syndrome Coronavirus type 2” (SARS-CoV-2) in the study period from February 23rd 2020 to March 31st 2020. A comparison was conducted between subjects tested positive for SARS-CoV-2 and those found negative in terms of rate of administration of hydroxychloroquine/ colchicine therapy. Results: An overall sample of 14,520 subjects were screened for SARS-CoV-2 infection and 1317 resulted positive. No significant difference was found in terms of rates of usage of hydroxychloroquine or colchicine between those who were found positive for SARS-CoV-2 and those who were found negative (0.23% versus 0.25% for hydroxychloroquine, and 0.53% versus 0.48% for colchicine, respectively). Conclusion: These findings raise doubts regarding the protective role of these medications in the battle against SARS-CoV-2 infection.

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