A combination of the drugs hydroxychloroquine (HCQ) and azithromycin is currently in use for the treatment of COVID-19 patients.
According to a Firstpost report, a new multinational retrospective study suggests that the combination of hydroxychloroquine (HCQ) and azithromycin can have severe consequences on heart health. This study has been conducted by a group of researchers from the Columbia University Irving Medical Center, and has been published in the journal Lancet Rheumatology.
Findings of this study have been used twice by the European Medicine Agency (EMA), in April and in July, to warn against the risks and side effects of HCQ and chloroquine.
What do HCQ and Azithromycin Do?
Hydroxychloroquine, primarily used in the treatment of malaria, belongs to a category of drugs called disease-modifying anti-arthritic drugs or DMARDs. It is also used to treat rheumatoid arthritis and systemic lupus erythematosus. The drug targets the body’s immune system to reduce inflammation.
On the other hand, azithromycin is an antibiotic drug that is used to treat bacterial diseases such as pneumonia and bronchitis. It comes in both tablet and liquid form.
Medical experts have recommended the use of a combination of these drugs to treat COVID-19, as inflammation and pneumonia are two prominent features of the viral infection.
Various studies conducted over the past few months have investigated the benefits as well as the potential side effects of HCQ and chloroquine alone, and in combination with azithromycin.
However, scientists are still to come to a conclusion on the effectiveness and safety of these drugs.
What Was The Study?
This latest study was led by Observational Health Data Sciences and Informatics (OHDSI), an international collaboration of academics, healthcare workers, regulators and industry scientists. The organisation collects and provides data on the history of an illness, and on the healthcare delivery and effects of interventions used to treat the disease, so that reliable healthcare decisions can be made.
In the study, the researchers looked at various groups of patients of age 18 years or older. These patients had a history of rheumatoid arthritis or other conditions, and had been taking HCQ with azithromycin, HCQ with amoxicillin and HCQ with sulfasalazine. While amoxicillin is an antibiotic, sulfasalazine is also a DMARD like HCQ.
The study collected its data from electronic health records and administrative claims spanning over a period of 20 years. 9,56,374 HCQ users, 3,10,350 sulfasalazine users, 3,23,122 users of HCQ and azithromycin and 3,51,956 users of HCQ with amoxicillin were included in the study. Patients from Japan, Germany, Spain, Netherlands, the UK, and the US were included in the study.
What Did They Find?
The research found that HCQ does not lead to any adverse effects when used for a short term, extending up to a period of about 30 days. However, patients using HCQ in the long term were found to have a 65 percent increased risk of death from cardiovascular conditions than those who had used sulfasalazine.
The risk was found to be even greater for the patients who had taken a combination of HCQ and azithromycin, even in the short term. The combination also increased the occurrence of chest pain and heart failure by about 15-20 per cent.
“Hydroxychloroquine, both alone and in combination with azithromycin, gained strong consideration as a potential COVID treatment without a large-scale study of its overall safety profile... We had access to an unprecedented amount of data on this drug, and we were relieved to find no worrying side effects in the short-term use of hydroxychloroquine. However, when prescribed in combination with azithromycin, it may induce heart failure and cardiovascular mortality and we would urge caution in using the two together.”Dr Daniel Prieto-Alhambra, Co-Senior Author of the Study
(With inputs from Firstpost)
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