Systematic review and meta-analysis of the safety of chloroquine and hydroxychloroquine from randomized controlled trials on malarial and non-malarial conditions

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Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.contributorUniversity of Cologne-
Autor(es): dc.contributorMcMaster University-
Autor(es): dc.contributorSt Joseph’s Healthcare-Hamilton-
Autor(es): dc.contributorUniversity of Johannesburg-
Autor(es): dc.creatorSouza Botelho, Mayra-
Autor(es): dc.creatorBolfi, Fernanda-
Autor(es): dc.creatorLeite, Renata Giacomini Occhiuto Ferreira-
Autor(es): dc.creatorLeite, Mauro Salles Ferreira-
Autor(es): dc.creatorBanzato, Luisa Rocco-
Autor(es): dc.creatorSoares, Luiza Teixeira-
Autor(es): dc.creatorOlivatti, Thaina Oliveira Felicio-
Autor(es): dc.creatorMangolim, Amanda Sampaio-
Autor(es): dc.creatorOliveira, Flávia Ramos Kazan-
Autor(es): dc.creatorAbbade, Luciana Patrícia Fernandes-
Autor(es): dc.creatorAbbade, Joelcio Francisco-
Autor(es): dc.creatorde Barros Almeida, Ricardo Augusto Monteiro-
Autor(es): dc.creatorSimões Corrêa Galendi, Julia-
Autor(es): dc.creatorThabane, Lehana-
Autor(es): dc.creatordos Santos Nunes-Nogueira, Vania-
Data de aceite: dc.date.accessioned2025-08-21T20:54:20Z-
Data de disponibilização: dc.date.available2025-08-21T20:54:20Z-
Data de envio: dc.date.issued2022-04-29-
Data de envio: dc.date.issued2022-04-29-
Data de envio: dc.date.issued2021-11-30-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1186/s13643-021-01835-x-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/229850-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/229850-
Descrição: dc.descriptionBackground: Despite the expectations regarding the effectiveness of chloroquine (CQ) and hydroxychloroquine (HCQ) for coronavirus disease (COVID-19) management, concerns about their adverse events have remained. Objectives: The objective of this systematic review was to evaluate the safety of CQ and HCQ from malarial and non-malarial randomized clinical trials (RCTs). Methods: The primary outcomes were the frequencies of serious adverse events (SAEs), retinopathy, and cardiac complications. Search strategies were applied to MEDLINE, EMBASE, LILACS, CENTRAL, Scopus, and Trip databases. We used a random-effects model to pool results across studies and Peto’s one-step odds ratio (OR) for event rates below 1%. Both-armed zero-event studies were excluded from the meta-analyses. We used the Grading of Recommendations Assessment, Development, and Evaluation system to evaluate the certainty of evidence. Results: One hundred and six RCTs were included. We found no significant difference between CQ/HCQ and control (placebo or non-CQ/HCQ) in the frequency of SAEs (OR: 0.98, 95% confidence interval [CI]: 0.76–1.26, 33 trials, 15,942 participants, moderate certainty of evidence). However, there was a moderate certainty of evidence that CQ/HCQ increases the incidence of cardiac complications (RR: 1.62, 95% CI: 1.10–2.38, 16 trials, 9908 participants). No clear relationship was observed between CQ/HCQ and retinopathy (OR: 1.63, 95% CI: − 0.4–6.57, 5 trials, 344 participants, very low certainty of evidence). Conclusions: CQ and HCQ probably do not increase SAEs, with low frequency of these adverse events on malarial and non-malarial conditions. However, they may increase cardiac complications especially in patients with COVID-19. No clear effect of their use on the incidence of retinopathy was observed. Systematic review registration: PROSPERO CRD42020177818.-
Descrição: dc.descriptionDepartment of Internal Medicine São Paulo State University/UNESP Medical School-
Descrição: dc.descriptionDepartment of Infectious Diseases Dermatology Imaging Diagnosis and Radiotherapy São Paulo State University/UNESP Medical School-
Descrição: dc.descriptionDepartment of Gynecology and Obstetrics São Paulo State University/UNESP Medical School-
Descrição: dc.descriptionInstitute of Health Economics and Clinical Epidemiology Faculty of Medicine and University Hospital of Cologne University of Cologne-
Descrição: dc.descriptionDepartment of Health Research Methods Evidence and Impact McMaster University-
Descrição: dc.descriptionBiostatistics Unit St Joseph’s Healthcare-Hamilton-
Descrição: dc.descriptionFaculty of Health Sciences University of Johannesburg-
Descrição: dc.descriptionDepartment of Internal Medicine São Paulo State University/UNESP Medical School-
Descrição: dc.descriptionDepartment of Infectious Diseases Dermatology Imaging Diagnosis and Radiotherapy São Paulo State University/UNESP Medical School-
Descrição: dc.descriptionDepartment of Gynecology and Obstetrics São Paulo State University/UNESP Medical School-
Idioma: dc.languageen-
Relação: dc.relationSystematic Reviews-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectAdverse effects-
Palavras-chave: dc.subjectChloroquine-
Palavras-chave: dc.subjectCOVID-19-
Palavras-chave: dc.subjectHydroxychloroquine-
Palavras-chave: dc.subjectSafety-
Palavras-chave: dc.subjectSystematic review-
Título: dc.titleSystematic review and meta-analysis of the safety of chloroquine and hydroxychloroquine from randomized controlled trials on malarial and non-malarial conditions-
Tipo de arquivo: dc.typelivro digital-
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