Combination of hydroxychloroquine and azithromycin can induce CV mortality, heart failure
Treating patients with the combination of hydroxychloroquine and azithromycin is associated with an increased risk of cardiovascular mortality and heart failure, according to a new meta-analysis of more than 950,000 patients.
The study, published in full in Lancet Rheumatology, may gain considerable attention throughout the world in the weeks ahead. After all, the potential use of hydroxychloroquine—on its own or along with azithromycin—as a COVID-19 treatment has been one of the biggest stories of the ongoing pandemic.
The study’s authors tracked data from patients who received care over a 20-year period in the United States, the United Kingdom, the Netherlands, Germany, Japan or Spain. All patients were 18 years old or older and seeking treatment for rheumatoid arthritis.
In the short term—30 days after treatment—treatment with hydroxychloroquine alone was not associated with any complications. Adding azithromycin to the mix, however, led to an increased risk of cardiovascular mortality, angina/heart pain and heart failure.
“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,” co-senior author Daniel Prieto-Alhambra, PhD, University of Oxford in the U.K., said in a statement. “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.”
“We are looking at patients from the general population, which is why it is so important to look at data from multiple countries,” co-lead author Jennifer Lane, MD, also of the University of Oxford, said in the same statement. “There are reasons why you may get bias from one data source, but if we find a signal in the Netherlands, and we find it in Spain, and we find it in the U.S., then we know we have something.”
The full Lancet Rheumatology study is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.