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Current Allergy and Asthma Reports

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01-01-2021 | Chloroquin | Invited Commentary

Hydroxychloroquine and COVID-19: a Rheumatologist’s Take on the Lessons Learned

Authors: Akrithi Udupa, David Leverenz, Stephen J. Balevic, Rebecca E. Sadun, Teresa K. Tarrant, Jennifer L. Rogers

Published in: Current Allergy and Asthma Reports | Issue 1/2021

Abstract

Purpose of Review

Told from the viewpoint of rheumatologists, this review tells the story of hydroxychloroquine and its swift ascent to become a household name as a therapeutic strategy against the novel SARS-CoV-2 virus. This review describes the history, mechanisms, pharmacokinetics, therapeutic applications, and safety profile of hydroxychloroquine as an immunomodulatory and antiviral agent. It also summarizes the major studies that launched and assessed the use of hydroxychloroquine against COVID-19 infection.

Recent Findings

More recent literature calls into question the long-held dogma that endolysosomal alkalinization is the primary mode of action of hydroxychloroquine. Ongoing uncertainty about the multiple potential mechanisms contributing to the therapeutic effect of hydroxychloroquine in rheumatic and viral disease led to a natural avenue for exploration in the treatment of COVID-19. Taken as a whole, the literature does not support utilizing hydroxychloroquine to treat or prevent infection from the SARS-CoV-2 virus. This is, at least in part, due to the wide variability in hydroxychloroquine pharmacokinetics between patients and difficulty achieving adequate target tissue concentrations of hydroxychloroquine without encountering unacceptable toxicities.

Summary

Hydroxychloroquine continues to be a routinely prescribed, well-tolerated, effective, and low-cost treatment for rheumatic disease. Its therapeutic versatility has led to frequent repurposing for other conditions, most recently as an investigative treatment against the SARS-CoV-2 virus. Despite overall negative findings, the intense study of hydroxychloroquine against COVID-19 infection has enhanced our overall understanding of how hydroxychloroquine operates in autoimmune disease and beyond.

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Title: Hydroxychloroquine and COVID-19: a Rheumatologist’s Take on the Lessons Learned
Authors: Akrithi Udupa
David Leverenz
Stephen J. Balevic
Rebecca E. Sadun
Teresa K. Tarrant
Jennifer L. Rogers
Publication date: 01-01-2021
Publisher: Springer US
Keywords: Chloroquin
Chloroquin
SARS-CoV-2
COVID-19
Hydroxychloroquine
Published in: Current Allergy and Asthma Reports / Issue 1/2021
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI: https://doi.org/10.1007/s11882-020-00983-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Hydroxychloroquine and COVID-19: a Rheumatologist’s Take on the Lessons Learned

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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