Combined hydroxychloroquine-azithromycin can be life-threatening: study

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Hydroxychloroquine and azithromycin, which have been proposed for the treatment of patients with COVID-19, are a life-threatening combination and can have a serious impact on the cardiovascular system, according to one study.

Researchers, including from Vanderbilt University and Stanford University in the United States, performed a retrospective observational meta-analysis of a WHO database of more than 21 million case reports adverse events.

The reports cover all classes of drugs from more than 130 countries between November 14, 1967 and March 1, 2020 – mainly before the COVID-19 pandemic.

The study, published in the journal Circulation, compared cardiovascular adverse reactions (CV-ADR) in patients who received hydroxychloroquine, azithromycin, or the combination of the two drugs with all other cardiovascular drugs in the base. of data.

Hydroxychloroquine and azithromycin, alone or in combination, have been proposed for the treatment of COVID-19 patients, the researchers said.

They said reports of potentially fatal acute cardiac proarrhythmic effects – promoting irregular heart rhythms – have been described primarily with azithromycin but also with hydroxychloroquine.

Their combination produced an even stronger signal, the scientists said. Hydroxychloroquine has also been associated with life-threatening heart failure when exposure has been prolonged for several months, the researchers said.

From more than 21 million case reports of adverse drug reactions, researchers have extracted case reports for hydroxychloroquine and azithromycin, alone or in combination.

They found that 76,822 reports of adverse events were associated with hydroxychloroquine alone and, in 28.4% of these cases (21,808), the drug was suspected of being associated with the adverse event.

The study found that 89,692 reports of adverse events were associated with azithromycin alone, and in 60.8% of these cases (54,533), the drug was suspected of being associated with adverse events.

The researchers said 607 reports of adverse events were associated with the combination of the two drugs.

Hydroxychloroquine was significantly associated with the development of conduction disorders and heart failure, they said.

The World Health Organization on Monday also suspended hydroxychloroquine testing of COVID-19 patients due to safety concerns, said WHO director-general Tedros Adhanom Ghebreyesus.

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