Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | http://hdl.handle.net/1843/59958 |
Resumo: | Objective: Because of preliminary results from in vitro studies, hydroxychloroquine (HCQ) and chloroquine (CQ) have been proposed as possible treatments for COVID-19, but the clinical evidence is discordant. This study aims to evaluate the safety and efficacy of CQ and HCQ for the treatment of COVID-19. Methods: A systematic review with meta-analysis was performed. An electronic search was conducted in four databases for randomized controlled trials that compared HCQ or CQ with standard-of-care. A complementary search was performed. A quantitative synthesis of clinical outcomes was performed using the inverse variance method adjusting for a random-effects model. Results: In total, 16 studies were included. The meta-analysis found no significant difference between intervention and control groups in terms of mortality at the most extended follow-up (RR = 1.09, CI95% = 0.99-1.19, p-value = 0.08), patients with negative PCR results (RR = 0.99, CI95% = 0.89-1.10, p-value = 0.86), or serious adverse events (RR = 2.21, CI95% = 0.89-5.47, p-value = 0.09). HCQ was associated with an increased risk of adverse events (RR = 2.28, CI95% = 1.36-2.83, p-value < 0.01). The quality of evidence varied from very low to high. Conclusion: There is no evidence that HCQ reduces the risk of death or improves cure rates in patients with COVID-19, but it might be associated with an increased risk of adverse events. |
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2023-10-24T20:16:14Z2023-10-24T20:16:14Z20211318622010.21115/JBES.v13.n2.p186-2202175-2095http://hdl.handle.net/1843/59958Objective: Because of preliminary results from in vitro studies, hydroxychloroquine (HCQ) and chloroquine (CQ) have been proposed as possible treatments for COVID-19, but the clinical evidence is discordant. This study aims to evaluate the safety and efficacy of CQ and HCQ for the treatment of COVID-19. Methods: A systematic review with meta-analysis was performed. An electronic search was conducted in four databases for randomized controlled trials that compared HCQ or CQ with standard-of-care. A complementary search was performed. A quantitative synthesis of clinical outcomes was performed using the inverse variance method adjusting for a random-effects model. Results: In total, 16 studies were included. The meta-analysis found no significant difference between intervention and control groups in terms of mortality at the most extended follow-up (RR = 1.09, CI95% = 0.99-1.19, p-value = 0.08), patients with negative PCR results (RR = 0.99, CI95% = 0.89-1.10, p-value = 0.86), or serious adverse events (RR = 2.21, CI95% = 0.89-5.47, p-value = 0.09). HCQ was associated with an increased risk of adverse events (RR = 2.28, CI95% = 1.36-2.83, p-value < 0.01). The quality of evidence varied from very low to high. Conclusion: There is no evidence that HCQ reduces the risk of death or improves cure rates in patients with COVID-19, but it might be associated with an increased risk of adverse events.Objetivo: Devido aos resultados preliminares de estudos in vitro, a hidroxicloroquina (HCQ) e a cloroquina (CQ) foram propostas como possíveis tratamentos para a COVID-19, mas as evidências clínicas são discordantes. Este estudo tem como objetivo avaliar a segurança e a eficácia da CQ eHCQ no tratamento da COVID-19. Métodos: Foi realizada uma revisão sistemática com metanálise. Uma busca eletrônica foi realizada em quatro bancos de dados por ensaios clínicos randomizados que compararam a HCQ ou CQ com o tratamento-padrão. Uma busca complementar foi realizada. Uma síntese quantitativa dos resultados foi realizada usando o método de variância inversa para um modelo de efeitos aleatórios. Resultados: No total, 16 estudos foram incluídos. A metanálise não encontrou nenhuma diferença significativa entre os grupos de intervenção e controle em termos de mortalidade no acompanhamento mais longo (RR = 1,09, IC95% = 0,99-1,19, valor-p = 0,08), pacientes com resultados de PCR negativos (RR = 0,99, IC95% = 0,89-1,10, valor-p = 0,86) ou eventos adversos graves (RR = 2,21, IC95% = 0,89-5,47, valor-p = 0,09). HCQ foi associada a um risco aumentado de eventos adversos (RR = 2,28, IC95% = 1,36-2,83, valor-p < 0,01). A qualidade da evidência variou de muito baixa a alta. Conclusão: Não há evidências de que a HCQ reduza o risco de morte ou aumente a taxa de cura em pacientes com COVID-19, mas pode estar associada a um risco aumentado de eventos adversosengUniversidade Federal de Minas GeraisUFMGBrasilFCE - DEPARTAMENTO DE CIÊNCIAS ECONÔMICASJornal brasileiro de economia da saúdeCOVID-19CloroquinaCOVID-19ChloroquineHydroxychloroquineReviewEnough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19Chega de loucura: uma revisão sistemática e metanálise de hidroxicloroquina para COVID-19info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://jbes.com.br/images/v13n2/186.pdfMônica Viegas AndradeAndre Soares SantosÉrica Sandy Dias GonçalvesAnanda Jessyla Felix OliveiraKenya Micaela de Souza Noronhainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/59958/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALEnough with the madness.pdfEnough with the madness.pdfapplication/pdf3982099https://repositorio.ufmg.br/bitstream/1843/59958/2/Enough%20with%20the%20madness.pdfc62cc93ae2b5da2d28cf4baafbda1e1fMD521843/599582023-10-24 17:23:46.392oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-10-24T20:23:46Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19 |
dc.title.alternative.pt_BR.fl_str_mv |
Chega de loucura: uma revisão sistemática e metanálise de hidroxicloroquina para COVID-19 |
title |
Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19 |
spellingShingle |
Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19 Mônica Viegas Andrade COVID-19 Chloroquine Hydroxychloroquine Review COVID-19 Cloroquina |
title_short |
Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19 |
title_full |
Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19 |
title_fullStr |
Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19 |
title_full_unstemmed |
Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19 |
title_sort |
Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19 |
author |
Mônica Viegas Andrade |
author_facet |
Mônica Viegas Andrade Andre Soares Santos Érica Sandy Dias Gonçalves Ananda Jessyla Felix Oliveira Kenya Micaela de Souza Noronha |
author_role |
author |
author2 |
Andre Soares Santos Érica Sandy Dias Gonçalves Ananda Jessyla Felix Oliveira Kenya Micaela de Souza Noronha |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Mônica Viegas Andrade Andre Soares Santos Érica Sandy Dias Gonçalves Ananda Jessyla Felix Oliveira Kenya Micaela de Souza Noronha |
dc.subject.por.fl_str_mv |
COVID-19 Chloroquine Hydroxychloroquine Review |
topic |
COVID-19 Chloroquine Hydroxychloroquine Review COVID-19 Cloroquina |
dc.subject.other.pt_BR.fl_str_mv |
COVID-19 Cloroquina |
description |
Objective: Because of preliminary results from in vitro studies, hydroxychloroquine (HCQ) and chloroquine (CQ) have been proposed as possible treatments for COVID-19, but the clinical evidence is discordant. This study aims to evaluate the safety and efficacy of CQ and HCQ for the treatment of COVID-19. Methods: A systematic review with meta-analysis was performed. An electronic search was conducted in four databases for randomized controlled trials that compared HCQ or CQ with standard-of-care. A complementary search was performed. A quantitative synthesis of clinical outcomes was performed using the inverse variance method adjusting for a random-effects model. Results: In total, 16 studies were included. The meta-analysis found no significant difference between intervention and control groups in terms of mortality at the most extended follow-up (RR = 1.09, CI95% = 0.99-1.19, p-value = 0.08), patients with negative PCR results (RR = 0.99, CI95% = 0.89-1.10, p-value = 0.86), or serious adverse events (RR = 2.21, CI95% = 0.89-5.47, p-value = 0.09). HCQ was associated with an increased risk of adverse events (RR = 2.28, CI95% = 1.36-2.83, p-value < 0.01). The quality of evidence varied from very low to high. Conclusion: There is no evidence that HCQ reduces the risk of death or improves cure rates in patients with COVID-19, but it might be associated with an increased risk of adverse events. |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021 |
dc.date.accessioned.fl_str_mv |
2023-10-24T20:16:14Z |
dc.date.available.fl_str_mv |
2023-10-24T20:16:14Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/59958 |
dc.identifier.doi.pt_BR.fl_str_mv |
10.21115/JBES.v13.n2.p186-220 |
dc.identifier.issn.pt_BR.fl_str_mv |
2175-2095 |
identifier_str_mv |
10.21115/JBES.v13.n2.p186-220 2175-2095 |
url |
http://hdl.handle.net/1843/59958 |
dc.language.iso.fl_str_mv |
eng |
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eng |
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Jornal brasileiro de economia da saúde |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
dc.publisher.department.fl_str_mv |
FCE - DEPARTAMENTO DE CIÊNCIAS ECONÔMICAS |
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Universidade Federal de Minas Gerais |
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reponame:Repositório Institucional da UFMG instname:Universidade Federal de Minas Gerais (UFMG) instacron:UFMG |
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