Drug–Drug Interactions of Hydroxychloroquine and Chloroquine in Older Patients with COVID-19 during the First Pandemic Waves: The GeroCovid Observational Study

• 出版年: Reports
• 主要な著者: Caterina Trevisan, Andrea Cignarella, Andrea Grandieri, Giuseppe Sergi, Stefano Fumagalli, Fabio Monzani, Chukwuma Okoye, Giuseppe Bellelli, Alba Malara, Pietro Gareri, Stefano Volpato, Raffaele Antonelli Incalzi, The GeroCovid Acute Ward Working Group
• フォーマット: 論文
• 言語: 英語
• 出版事項: MDPI AG 2024-05-01
• 主題: hydroxychloroquine; chloroquine; COVID-19; drug interactions
• オンライン･アクセス: https://www.mdpi.com/2571-841X/7/2/42

Objective: Chloroquine (CQ) and hydroxychloroquine (HCQ) were used as off-label treatments for SARS-CoV-2 infection during the first pandemic waves. The urgency of combatting COVID-19 led to the dissemination of medical recommendations with a scarce awareness of possible drug–drug interactions. This issue primarily concerned people already taking multiple medications, such as older individuals. We estimated the prevalence of drug interactions with CQ or HCQ in COVID-19 inpatients during the first pandemic waves and their possible association with hospitalization-related outcomes. Methods: This study considers 487 patients aged ≥60, hospitalized for COVID-19 from March to December 2020, and treated with CQ or HCQ. Data on acute and chronic therapies and hospitalization length and outcomes were derived from medical records. The presence of drugs potentially interacting with CQ and HCQ was identified based on published literature and drug databases. Results: In our sample (mean age 77.1 years, 47.8% females), 255 (52.4%) patients presented with one drug interaction with CQ or HCQ, and 114 (23.4%) had more than two interactions. The most frequent drugs potentially interacting with CQ or HCQ were lopinavir/ritonavir (50.4%), azithromycin (47.2%), tocilizumab (15.4%), levofloxacin (8.7%), clarithromycin (6.0%), amlodipine (3.3%), and trazodone (2.4%). No substantial differences in the duration and outcomes of the hospitalization emerged as a function of the presence of drug–drug interactions. Conclusions: Many older patients prescribed with CQ or HCQ, which have lately proved ineffective against COVID-19, were exposed to the risk of drug–drug interaction. This underlines that medical recommendations should undergo careful peer review before being widely disseminated, even in emergencies like a pandemic.