Evidence map›Paper›PMID 32677113›Full record

ArticlePharmacotherapy2020

The Cardiovascular Effects of Treatment with Hydroxychloroquine and Azithromycin.

Jacob E Simmering, Linnea A Polgreen, Philip M Polgreen, Rebecca E Teske, Alejandro P Comellas, Barry L Carter

Open access · greenAbstract read
In one paragraph

Article in Pharmacotherapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Jacob E SimmeringHealth Ventures Signal Center for Healthcare Innovation, University of Iowa, Iowa City, Iowa, USA.
Linnea A PolgreenDepartment of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa, USA.
Philip M PolgreenDepartment of Internal Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Rebecca E TeskeDepartment of Internal Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Alejandro P ComellasDepartment of Internal Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Barry L CarterDepartment of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa, USA.ORCID https://orcid.org/0000-0002-0466-343X
University of Iowa · US

Funding

Pulmonary Toxicology Facility CoreP30ES005605 · NIEHS · UNIVERSITY OF IOWA · PI Brandi Janssen · 1990 to 2026
$40.5M
The University of Iowa Clinical and Translational Science AwardUL1TR002537 · NCATS · UNIVERSITY OF IOWA · PI HANSEN, MARLAN R, WINOKUR, PATRICIA · 2018 to 2022
$20.0M
NCATS NIH HHS UL1 TR002537NIEHS NIH HHS P30 ES005605
6 · The paper itself

Abstract

Hydroxychloroquine combined with azithromycin has been investigated for activity against coronavirus disease 2019 (COVID-19), but concerns about adverse cardiovascular (CV) effects have been raised. This study evaluated claims data to determine if risks for CV events were increased with hydroxychloroquine alone or combined with azithromycin. We identified data from 43,752 enrollees that qualified for analysis. The number of CV events increased by 25 (95% confidence interval [CI]: 8, 42, p=0.005) per 1000 people per year of treatment with hydroxychloroquine alone compared with pretreatment levels and by 201 (95% CI: 145, 256, p<0.001) events per 1000 people per year when individuals took hydroxychloroquine and azithromycin. These rates translate to an additional 0.34 (95% CI: 0.11, 0.58) CV events per 1000 patients placed on a 5-day treatment with hydroxychloroquine monotherapy and 2.75 (95% CI: 1.99, 3.51) per 1000 patients on a 5-day treatment with both hydroxychloroquine and azithromycin. The rate of adverse events increased with age following exposure to hydroxychloroquine alone and combined with azithromycin. For females aged 60 to 79 years prescribed hydroxychloroquine, the rate of adverse CV events was 0.92 per 1000 patients on 5 days of therapy, but it increased to 4.78 per 1000 patients when azithromycin was added. The rate of adverse CV events did not differ significantly from zero for patients 60 years of age or younger. These data suggest that hydroxychloroquine with or without azithromycin is likely safe in individuals under 60 years of age if they do not have additional CV risks. However, the combination of hydroxychloroquine and azithromycin should be used with extreme caution in older patients.

Indexed as

COVID-19 Drug TreatmentAdolescentAdultAgedAged, 80 and overAge FactorsAzithromycinCardiotoxicityCardiovascular DiseasesChildChild, PreschoolDatabases, FactualDrug Therapy, CombinationFemaleHumansHydroxychloroquineAzithromycinHydroxychloroquineazithromycincoronavirus infectionshydroxychloroquine

Identifiers

PMID32677113
PMCPMC7404845
OpenAlexW3043393667

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.