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HIDROXICLOROQUINA NA PREVENÇÃO E TRATAMENTO DA COVID-19

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07 Maio 2021

HIDROXICLOROQUINA NA PREVENÇÃO E TRATAMENTO DA COVID-19

A hidroxicloroquina é um fármaco utilizado no tratamento da malária e indicado também no tratamento de doenças autoimunes como a artrite reumatóide e o lúpus, em virtude dos seus efeitos imunomoduladores. A identificação de atividade antiviral in vitro contra coronavírus levou a que se equacionasse o seu reposicionamento terapêutico na prevenção e tratamento da COVID-19.

Os relatos iniciais que apontavam para eficácia da hidroxicloroquina no tratamento da COVID-19 não foram posteriormente comprovados por ensaios aleatorizados e controlados, tanto em doentes hospitalizados como nos tratados em ambulatório. De igual modo, não existe evidência que comprove o seu papel na profilaxia ou prevenção pós-exposição. Revisões sistemáticas e meta-análises entretanto realizadas reiteram a inexistência de benefício clínico. A hidroxicloroquina não é atualmente recomendada na prevenção ou tratamento da COVID-19 pelas principais normas terapêuticas.

LEITURA RECOMENDADA

Bartoszko JJ, Siemieniuk RAC, Kum E, Qasim A, Zeraatkar D, Ge L, et al. Prophylaxis against covid-19: living systematic review and network meta-analysis. BMJ. 2021 Apr 26; 373: n949. doi: 10.1136/bmj.n949.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073806/pdf/bmj.n949.pdf

Axfors C, Schmitt AM, Janiaud P, Van't Hooft J, Abd-Elsalam S, Abdo EF, et al. Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nat Commun. 2021 Apr 15; 12(1): 2349. doi: 10.1038/s41467-021-22446-z.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8050319/pdf/41467_2021_Article_22446.pdf

Johnston C, Brown ER, Stewart J, Karita HCS, Kissinger PJ, Dwyer J, et al; COVID-19 Early Treatment Study Team. Hydroxychloroquine with or without azithromycin for treatment of early SARS-CoV-2 infection among high-risk outpatient adults: A randomized clinical trial. EClinicalMedicine. 2021 Mar; 33: 100773. doi: 10.1016/j.eclinm.2021.100773.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912360/pdf/main.pdf

Schilling WH, White NJ. Does hydroxychloroquine still have any role in the COVID-19 pandemic? Expert Opin Pharmacother. 2021 Mar 16:1-10. doi: 10.1080/14656566.2021.1898589.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989952/pdf/IEOP_0_1898589.pdf

Singh B, Ryan H, Kredo T, Chaplin M, Fletcher T. Chloroquine or hydroxychloroquine for prevention and treatment of COVID‐19. Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No.: CD013587. DOI: 10.1002/14651858.CD013587.pub2. Accessed 16 February 2021.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013587.pub2/full/es?highlightAbstract=covid

Aronson JK, Ferner RE, On behalf of the Oxford COVID-19 Evidence Service Team. More about chloroquine and hydroxychloroquine. May 30, 2020; Updated 30 August 2020.
https://www.cebm.net/covid-19/chloroquine-and-hydroxychloroquine/

Mitjà O, Corbacho-Monné M, Ubals M, Alemany A, Suñer C, Tebé C, et al; BCN-PEP-CoV2 Research Group. A Cluster-Randomized Trial of Hydroxychloroquine for Prevention of Covid-19. N Engl J Med. 2021 Feb 4;384(5):417-427. doi: 10.1056/NEJMoa2021801.
https://www.nejm.org/doi/pdf/10.1056/NEJMoa2021801?articleTools=true

Abella BS, Jolkovsky EL, Biney BT, et al. Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers: A Randomized Clinical Trial. JAMA Intern Med. 2021;181(2):195–202. doi:10.1001/jamainternmed.2020.6319
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771265?guestAccessKey=a7849350-c527-4b6c-a031-118575a736b0&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_term=mostread&utm_content=olf-widget_02112021

Ebina-Shibuya R, Namkoong H, Horita N, Kato H, Hara Y, Kobayashi N, Kaneko T. Hydroxychloroquine and chloroquine for treatment of coronavirus disease 19 (COVID-19): a systematic review and meta-analysis of randomized and non-randomized controlled trials. J Thorac Dis. 2021 Jan;13(1):202-212. doi: 10.21037/jtd-20-2022.
https://jtd.amegroups.com/article/view/46921/pdf

Egeli BH, Sparks JA, Kim AHJ, Liew JW. Hydroxychloroquine for the treatment of COVID-19 and its potential cardiovascular toxicity: Hero or villain? Best Pract Res Clin Rheumatol. 2021 Jan 1:101658. doi: 10.1016/j.berh.2020.101658. Epub ahead of print.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775793/pdf/main.pdf