dc.date.accessioned | 2022-02-14T18:42:53Z | |
dc.date.available | 2022-02-14T18:42:53Z | |
dc.date.created | 2022-01-06T09:08:15Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Axfors, Cathrine Schmitt, Andreas Janiaud, Perrine Hooft, Janneke Abd-Elsalam, Sherief Abdo, Ehab Abella, Benjamin Akram, Javed Amaravadi, Ravi Angus, Derek Lyngbakken, Magnus Nakrem Røsjø, Helge Rørvik Dalgard, Olav . Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nature Communications. 2021 | |
dc.identifier.uri | http://hdl.handle.net/10852/90893 | |
dc.description.abstract | Substantial COVID-19 research investment has been allocated to randomized clinical trials (RCTs) on hydroxychloroquine/chloroquine, which currently face recruitment challenges or early discontinuation. We aim to estimate the effects of hydroxychloroquine and chloroquine on survival in COVID-19 from all currently available RCT evidence, published and unpublished. We present a rapid meta-analysis of ongoing, completed, or discontinued RCTs on hydroxychloroquine or chloroquine treatment for any COVID-19 patients (protocol: https://osf.io/QESV4/). We systematically identified unpublished RCTs (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Cochrane COVID-registry up to June 11, 2020), and published RCTs (PubMed, medRxiv and bioRxiv up to October 16, 2020). All-cause mortality has been extracted (publications/preprints) or requested from investigators and combined in random-effects meta-analyses, calculating odds ratios (ORs) with 95% confidence intervals (CIs), separately for hydroxychloroquine and chloroquine. Prespecified subgroup analyses include patient setting, diagnostic confirmation, control type, and publication status. Sixty-three trials were potentially eligible. We included 14 unpublished trials (1308 patients) and 14 publications/preprints (9011 patients). Results for hydroxychloroquine are dominated by RECOVERY and WHO SOLIDARITY, two highly pragmatic trials, which employed relatively high doses and included 4716 and 1853 patients, respectively (67% of the total sample size). The combined OR on all-cause mortality for hydroxychloroquine is 1.11 (95% CI: 1.02, 1.20; I² = 0%; 26 trials; 10,012 patients) and for chloroquine 1.77 (95%CI: 0.15, 21.13, I² = 0%; 4 trials; 307 patients). We identified no subgroup effects. We found that treatment with hydroxychloroquine is associated with increased mortality in COVID-19 patients, and there is no benefit of chloroquine. Findings have unclear generalizability to outpatients, children, pregnant women, and people with comorbidities. | |
dc.language | EN | |
dc.publisher | Nature Portfolio | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | |
dc.title | Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials | |
dc.type | Journal article | |
dc.creator.author | Axfors, Cathrine | |
dc.creator.author | Schmitt, Andreas | |
dc.creator.author | Janiaud, Perrine | |
dc.creator.author | Hooft, Janneke | |
dc.creator.author | Abd-Elsalam, Sherief | |
dc.creator.author | Abdo, Ehab | |
dc.creator.author | Abella, Benjamin | |
dc.creator.author | Akram, Javed | |
dc.creator.author | Amaravadi, Ravi | |
dc.creator.author | Angus, Derek | |
dc.creator.author | Lyngbakken, Magnus Nakrem | |
dc.creator.author | Røsjø, Helge Rørvik | |
dc.creator.author | Dalgard, Olav | |
cristin.unitcode | 185,53,82,0 | |
cristin.unitname | Klinikk for indremedisin og lab fag | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 2 | |
dc.identifier.cristin | 1975607 | |
dc.identifier.bibliographiccitation | info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Nature Communications&rft.volume=&rft.spage=&rft.date=2021 | |
dc.identifier.jtitle | Nature Communications | |
dc.identifier.volume | 12 | |
dc.identifier.issue | 1 | |
dc.identifier.doi | https://doi.org/10.1038/s41467-021-22446-z | |
dc.identifier.urn | URN:NBN:no-93529 | |
dc.type.document | Tidsskriftartikkel | |
dc.type.peerreviewed | Peer reviewed | |
dc.source.issn | 2041-1723 | |
dc.identifier.fulltext | Fulltext https://www.duo.uio.no/bitstream/handle/10852/90893/4/s41467-021-22446-z.pdf | |
dc.type.version | PublishedVersion | |
cristin.articleid | 2349 | |