Ad-hoc COVID-19 Clinical Pharmacology Task Group: Statement on hydroxychloroquine

Clinical Pharmacology Task Group (CPTG) meeting date: June 12, 2020

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Policy question

The Public Health Agency of Canada (PHAC) asked the ad-hoc COVID-19 Clinical Pharmacology Task Group (CPTG) for advice on whether known and potential benefits of hydroxychloroquine outweigh known and potential risks in the treatment or prevention of COVID-19.

Recommendations

The ad-hoc Clinical Pharmacology Task Group recommends against the use of hydroxychloroquine as a treatment for patients with COVID-19 due to negligible evidence of efficacy and significant potential for harm leading to a high risk-to-benefit ratio. This guidance is not meant to replace clinical judgement or specialist consultation.

This guidance will be updated as additional peer-reviewed evidence emerges as warranted by the Clinical Pharmacology Task Group members.

This statement was approved by the Clinical Pharmacology Task Group on June 19, 2020.

Background

As of June 10, 2020, 215 clinical trials were registered worldwide to investigate hydroxychloroquine (HCQ) as a treatment or chemoprophylaxis for COVID-19, with 10 trials in CanadaFootnote 1.  A series of developments have brought into question the benefit-risk of HCQ:

Considerations

Post-hoc statement

Acknowledgments

This statement was prepared by:  N Forbes, M Patel, M Rieder, and M Salvadori, on behalf of the Clinical Pharmacology Task Group (CPTG).

CPTG Members:  M Salvadori (Co-Chair), M Rieder (Co-chair), M Lordkipanidze, R Hall, M Piquette-Miller, A Collier and S Murthy.

CPTG gratefully acknowledges the contribution of:  N Abraham, A House, M Tunis, A Killikelly, Y Chung, J Courtemanche, A Coady, B Mitchelmore, E Chong, and R Goddard.

CPTG also gratefully acknowledges the contribution from the Canadian Agency for Drugs and Technologies in Health.

Footnotes

Footnote 1

ClinicalTrials.gov. 2020  [cited 2020 June 24]; Available from: www.clinicaltrials.gov

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Footnote 2

Horby, P.W. and M.J. Landray, No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19. 2020, Nuffield Department of Population Health: www.recoverytrial.net/news

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Footnote 3

FDA, Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine. 2020, FDA.

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Footnote 4

FDA, Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine. 2020, FDA.

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Footnote 5

World Health Organization. Q&A: Hydroxychloroquine and COVID-19. 2020 June 19, 2020 [cited 2020 June 19, 2020]; Available from: https://www.who.int/news-room/q-a-detail/q-a-hydroxychloroquine-and-covid-19

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Footnote 6

Horby, P., et al., Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19. NEJM, Oct 8, 2020: DOI: 10.1056/NEJMoa2022926

Return to footnote 6 referrer

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