Effect of hydroxychloroquine in hospitalized patients with Covid-19

Peter Horby (Author), Marion Mafham (Author), Martin J. Landray (Author), Mark Kačar (Research coworker)

Abstract

Background: Hydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease 2019 (Covid-19) on the basis of in vitro activity and data from uncontrolled studies and small, randomized trials. Methods: In this randomized, controlled, open-label platform trial comparing a range of possible treatments with usual care in patients hospitalized with Covid-19, we randomly assigned 1561 patients to receive hydroxychloroquine and 3155 to receive usual care. The primary outcome was 28-day mortality. Results: The enrollment of patients in the hydroxychloroquine group was closed on June 5, 2020, after an interim analysis determined that there was a lack of efficacy. Death within 28 days occurred in 421 patients (27.0%) in the hydroxychloroquine group and in 790 (25.0%) in the usual-care group (rate ratio, 1.09; 95% confidence interval [CI], 0.97 to 1.23; P = 0.15). Consistent results were seen in all prespecified subgroups of patients. The results suggest that patients in the hydroxychloroquine group were less likely to be discharged from the hospital alive within 28 days than those in the usual-care group (59.6% vs. 62.9%; rate ratio, 0.90; 95% CI, 0.83 to 0.98). Among the patients who were not undergoing mechanical ventilation at baseline, those in the hydroxychloroquine group had a higher frequency of invasive mechanical ventilation or death (30.7% vs. 26.9%; risk ratio, 1.14; 95% CI, 1.03 to 1.27). There was a small numerical excess of cardiac deaths (0.4 percentage points) but no difference in the incidence of new major cardiac arrhythmia among the patients who received hydroxychloroquine. Conclusions: Among patients hospitalized with Covid-19, those who received hydroxychloroquine did not have a lower incidence of death at 28 days than those who received usual care. (Funded by UK Research and Innovation and National Institute for Health Research and others; RECOVERY ISRCTN number, ISRCTN50189673; ClinicalTrials.gov number, NCT04381936.).

Keywords

Covid-19 -- drug therapy;hydroxychloroquine;chloroquine;

Data

Language:	English
Year of publishing:	2020
Typology:	1.01 - Original Scientific Article
Publisher:	Massachusetts Medical Society
UDC:	616.9
COBISS:	109475843
ISSN:	1533-4406
Views:	87
Downloads:	41
Average score:	0 (0 votes)
Metadata:

Other data

Secondary keywords:	Covid-19;Drug therapy;Hydroxychloroquine;Chloroquine;Terapija z zdravili;Hidroksiklorokin;Klorokin;
Source comment:	Nasl. z nasl. zaslona; Član raziskovalne skupine iz Slovenije: Mark Kačar; Opis vira z dne 27. 5. 2022;
Pages:	str. 2030-2040
Volume:	ǂVol. ǂ383
Issue:	ǂiss. ǂ21
Chronology:	Nov. 19, 2020
DOI:	10.1056/NEJMoa2022926
ID:	15468539