Comparative study of the adverse event profile of hydroxychloroquine
before and during the Sars-CoV2 pandemic
Abstract
Aims At the beginning of the Sars-CoV2 pandemic, there were no
clinically-tested medications for the effective treatment of coronavirus
disease. In this context, on 5 March 2020, the French Public Health
Council issued several recommendations for the therapeutic management of
this new disease, including the use of hydroxychloroquine (HCQ). An
unexpected cardiovascular safety signal was quickly identified as being
more frequent than expected thanks to the reports of adverse drug
reactions (ADRs) submitted to French regional pharmacovigilance centres
(RPVC). The objective of this study was to compare all ADRs reported
with HCQ used in its usual indication, collected before the pandemic
period (1985 to 31 December, 2019) with those reported with the COVID-19
indication (1 January to 21 July, 2020). Methods For this purpose,
reports were extracted from the French pharmacovigilance database and
analysed for these two periods. Results Our study showed a different
safety profile in COVID-19 patients with more cardiac disorders (57% of
ADRs versus 5% before the pandemic period), especially QT interval
prolongation, resulting from an interaction with azithromycin in more
than 20% of cases. Hepatobiliary disorders were also significantly more
frequent. Conclusions These observations could be associated with the
effect of the virus itself on the various organs, the profile of the
patients treated, and concomitant drug treatments.