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All Studies   Meta Analysis    Recent:   

Hydroxychloroquine ineffective for COVID-19 prophylaxis in lupus and rheumatoid arthritis

Singer et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-218500
Aug 2020  
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Case -9% Improvement Relative Risk HCQ for COVID-19  Singer et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 32,758 patients in the USA No significant difference in cases c19hcq.org Singer et al., Annals of the Rheumatic.., Aug 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19hcq.org
Comparison of the percentage of SLE/RA patients on immunosuppressants that were taking HCQ, for COVID-19 diagnosis versus other infections or outpatient visits, finding a similar percentage in each case.
No mortality of severity information is provided to determine if HCQ treated patients fared better. No adjustment for concomitant medications or severity.
This study is excluded in the after exclusion results of meta analysis: not fully adjusting for the baseline risk differences within systemic autoimmune patients.
risk of case, 9.0% higher, RR 1.09, p = 0.62, treatment 55 of 10,700 (0.5%), control 104 of 22,058 (0.5%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Singer et al., 5 Aug 2020, retrospective, database analysis, USA, peer-reviewed, 3 authors.
This PaperHCQAll
Hydroxychloroquine ineffective for COVID-19 prophylaxis in lupus and rheumatoid arthritis
Prof Mendel E Singer, David C Kaelber, Maria J Antonelli
Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-218500
Table 1 Proportion of patients taking hydroxychloroquine: COVID-19 vs two control groups COVID-19 Influenza/ pneumonia/LRI CI for difference (COVID-19 vs I/P/LRI) Any outpatient visit CI for difference (COVID-19 vs OP) Age 18 and over No of patients, N 16 869 198 114 3 970 695 Lupus or RA on an immunosuppressant, N 159 2609 32 599 Hydroxychloroquine, % (N) 34.6% (55) 31.4% (819) (−4.4% to 10.8%) p=0.4290 32.7% (10 645) (−5.5% to 9.4%) p=0.6115 Age 18-64 No of patients, N 13 327 128 280 2 715 365 Lupus or RA on an immunosuppressant, N 121 1477 20 256 Hydroxychloroquine, % (N) 37.2% (45) 37.0% (547) (−8.8% to 9.1%) p=1.0000 36.9% (7473) (−8.3% to 8.9%) p=1.0000 I/P/LRI, influenza/pneumonia/other lower respiratory infection; LRI, lower respiratory infection; OP, outpatient; RA, rheumatoid arthritis.
References
Arshad, Kilgore, Chaudhry, Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19, Int J Infect Dis, doi:10.1016/j.ijid.2020.06.099
Bozzalla Cassione, Zanframundo, Biglia, COVID-19 infection in a northern-Italian cohort of systemic lupus erythematosus assessed by telemedicine, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-217717
Favalli, Lucia, Biggioggero, Role of antimalarials in COVID-19: observational data from a cohort of rheumatic patients, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-218068
Geleris, Sun, Platt, Observational study of hydroxychloroquine in hospitalized patients with Covid-19, N Engl J Med, doi:10.1056/NEJMoa2012410
Gendebien, Frenckell, Ribbens, Systematic analysis of COVID-19 infection and symptoms in a systemic lupus erythematosus population: correlation with disease characteristics, hydroxychloroquine use and immunosuppressive treatments, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-218244
Graef, Liew, Putman, Festina lente: hydroxychloroquine, COVID-19 and the role of the rheumatologist, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-217480
Magagnoli, Narendran, Pereira, Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19, medRxiv, doi:10.1016/j.medj.2020.06.001
Rosenberg, Dufort, Udo, Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York state, JAMA, doi:10.1001/jama.2020.8630
Tang, Cao, Han, Hydroxychloroquine in patients mainly with mild to moderate COVID-19: an open-label, randomized, controlled trial, BMJ
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