Abstract
Introduction : The 4-aminoquinolines, chloroquine, and hydroxychloroquine have been used for over 70 years for malaria and rheumatological conditions, respectively. Their broad-spectrum antiviral activity, excellent safety profile, tolerability, low cost, and ready availability made them prime repurposing therapeutic candidates at the beginning of the COVID-19 pandemic. Areas covered : Here, the authors discuss the history of hydroxychloroquine and chloroquine, the in vitro data which led to their widespread repurposing and adoption in COVID-19 and their complex pharmacokinetics. The evidence for the use of these drugs is assessed through in vivo animal experiments and the wealth of conflicting data and interpretations published during COVID-19, including the more informative results from randomized controlled trials (RCTs). The safety aspects of these drugs, in particular cardiotoxicity, are then reviewed. Expert opinion : The evidence from clinical trials in COVID-19 supports the well-established safety record of the 4-aminoquinolines at currently recommended dosage. In hospitalized patients with severe COVID-19 RCTs show clearly that the 4-aminoquinolines are not beneficial. The only treatments with proven benefit at this stage of infection are immunomodulators (dexamethasone, IL-6 receptor antagonists). No antiviral drugs have proven life-saving in late-stage COVID-19.
Keywords: COVID-19; Chloroquine; SARS-CoV-2; antiviral; hydroxychloroquine; pharmacokinetics; prevention.
【저자키워드】 COVID-19, SARS-CoV-2, Chloroquine, Hydroxychloroquine, Antiviral, pharmacokinetics, prevention, 【초록키워드】 Dexamethasone, Randomized controlled trial, Treatment, clinical trial, Chloroquine, Hydroxychloroquine, severe COVID-19, Antiviral, IL-6, COVID-19 pandemic, antiviral drugs, Infection, drugs, clinical trials, pharmacokinetics, drug, antiviral activity, hospitalized patients, RCT, antiviral drug, immunomodulator, malaria, immunomodulators, controlled trials, therapeutic, Interpretation, experiment, adoption, in vivo, safety profile, RCTs, Evidence, Cardiotoxicity, IL-6 receptor antagonists, Support, Tolerability, dosage, complex, candidate, in vitro data, widespread, expert, benefit, rheumatological, hospitalized patient, conditions, Area, 【제목키워드】 Hydroxychloroquine,