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Published on: May 10, 2016
Can HCQ Be Considered a "Safe Weapon" for COVID-19 in the Indian Population?
Pugazhenthan Thangaraju1, Nanditha Venkatesan2, Sajitha Venkatesan3
1Department of Pharmacology, All India Institute of Medical Sciences, Raipur, India.
Insights
Hydroxychloroquine (HCQ) shows a low incidence of cardiac side effects (0.6%) in India. Given its safety, cost-effectiveness, and availability, HCQ is a rational choice for COVID-19 management in India.
Area of Science:
- Pharmacology
- Infectious Diseases
- Public Health
Background:
- Hydroxychloroquine (HCQ) is widely used in India for malaria, autoimmune diseases, and recently, type 2 diabetes mellitus.
- Its use in COVID-19 management is debated due to potential life-threatening adverse effects.
- No definitive treatments or cures for COVID-19 are currently approved.
Purpose of the Study:
- To review the safety profile of hydroxychloroquine (HCQ) in the Indian subcontinent.
- To analyze the frequency of HCQ-related adverse effects in the Indian population.
- To assess the rationale for HCQ use in COVID-19 management in India.
Main Methods:
- A non-systematic critical analysis of published literature and relevant websites.
- Focus on studies concerning the Indian population and HCQ use for various indications up to April 2020.
- Noting the frequency of life-threatening and cardiac side effects associated with HCQ.
Main Results:
- PubMed database results indicated a 0.6% incidence of cardiac-related side effects among Indians on HCQ.
- Other self-limiting and minor side effects occurred in 7.42% of the Indian population using HCQ.
- HCQ demonstrated a favorable safety profile, cost-effectiveness, and availability in India.
Conclusions:
- The use of hydroxychloroquine (HCQ) for COVID-19 management in India is considered rational due to its minimal risk, safety profile, and affordability.
- A hypothesis is proposed that Indians may have a lower susceptibility to HCQ-related cardiac side effects due to genetic factors.
- Further research, including clinical trials and pharmacogenomic studies, is necessary to validate this hypothesis.
Abstract:
With no drugs currently approved for treatment and cure of COVID-19 (coronavirus disease 2019), hydroxychloroquine is one of the many first-line drugs used in the management. However, given the life-threatening adverse effects of HCQ that have been reported, its use as a prophylactic treatment remains debated. HCQ has long been used in India for the treatment of malaria, auto-immune and inflammatory diseases, and even type 2 diabetes mellitus recently. We aimed to review existing literature and relevant Web sites regarding the safety profile of HCQ in the Indian subcontinent. A non-systematic critical analysis of all published literature/studies focused on the Indian population, recording on the use of HCQ for various indications up till April 2020 was done and frequency of occurrence of HCQ related life-threatening and cardiac side effects were noted. Results from PubMed database showed an incidence of 0.6% of cardiac-related side effects and 7.42% of other self-limiting and minor side effects among the Indian population on HCQ. Considering its minimal risk and favorable safety profile, cost-effectiveness, availability, and affordability in India, the use of hydroxychloroquine in the fight against COVID-19 appears rationale. Following the results of our study, we hypothesize that Indians might be less likely to suffer from cardiac-related side effects given their genetic make-up. However, this would need further studies, clinical trials, and a pharmacogenomic understanding of the subject.
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