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Hydroxychloroquine in children with interstitial (diffuse parenchymal) lung diseases

Sarah Braun1, Marion Ferner, Kai Kronfeld

  • 1Dr. von Hauner Children's University Hospital, Ludwig-Maximilians University, Munich, Germany; German Center for Lung Research (DZL), Munich, Germany.

Pediatric Pulmonology
|December 11, 2014
PubMed

Insights

Hydroxychloroquine (HCQ) may be safe for treating childhood interstitial lung disease (chILD), but more prospective studies are needed. Current evidence is based on limited case reports, highlighting the need for systematic data collection.

Area of Science:

  • Pediatric Pulmonology
  • Rheumatology
  • Clinical Pharmacology

Background:

  • Hydroxychloroquine (HCQ) is frequently used off-label for childhood interstitial lung disease (chILD).
  • Limited studies exist on the efficacy and safety of HCQ in pediatric patients.
  • A literature review was conducted to assess existing data on HCQ and chloroquine (CQ) in chILD.

Purpose of the Study:

  • To review the literature on the use of chloroquine (CQ) and hydroxychloroquine (HCQ) in children with interstitial lung disease (chILD).
  • To evaluate the reported efficacy and safety of HCQ in chILD based on available case reports and series.

Main Methods:

  • Literature search of case reports and small series from 1984 to 2013.
  • Identified 85 cases of chILD treated with CQ or HCQ, often with other medications.
  • Analyzed reported outcomes, dosages, and side effects.

Main Results:

  • A favorable response to HCQ or CQ was reported in 35 cases; outcomes were unclear or negative in others.
  • HCQ dosage ranged from 5 to 10 mg/kg/day; no pharmacokinetic data exists.
  • Gastrointestinal symptoms were common side effects; retinal changes were reported with CQ but not HCQ.

Conclusions:

  • Based on retrospective data, HCQ use in chILD appears potentially safe, though bias is likely.
  • Prospective data on HCQ efficacy and safety in chILD is lacking and urgently needed.
  • Web-based registers and controlled investigations are recommended for systematic data collection.

Keywords:
PlaquenilQuensylantimalarialschILDchloroquinediffuse parenchymal lung diseasehydroxychloroquine

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