Emergency arising from patients' fear of taking antimalarials during these COVID-19 times: are antimalarials as unsafe for cardiovascular health as recent reports suggest?
Artículo de revista
Alianza Europea de Asociaciones de Reumatología (EULAR) y BMJ
We read with interest the paper of Graef et al recently published in your journal about the situation resulting from the massive use of antimalarials for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19), despite the fact that the evidence is controversial and there are concerns about its possible cardiotoxicity, leaving rheumatic patients who use them in a position of vulnerability due to medication shortages.1 In the past few weeks, several papers have been published about the efficacy and safety of the antimalarials chloroquine (CLQ) and hydroxychloroquine (HCLQ) for the treatment of the different phases of infection by SARS-CoV-2/COVID-19, and the data are controversial. However, it is striking that some studies report high rates of cardiovascular events (CVEs) associated mainly with cardiac arrhythmias.2 . These findings of adverse CVEs reported in the aforementioned studies have unfortunately led to the emergency in this group of patients around fear of chronic use of antimalarials, and many users are abandoning these medications, which implies great clinical risk due to relapses that may appear.3 On the other hand, the massive use of antimalarials for COVID-19 has resulted in medication shortages in some settings with potential consequences to patients users. Antimalarials have been used for several decades for the treatment of malaria and some autoimmune diseases, mainly rheumatoid arthritis (RA) and lupus, with great utility and efficacy, and also great safety at conventional doses (250mg per day of CLQ and 200–400mg per day of HCLQ).
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