Klorokin/Hidroksiklorokin: COVID-19 tedavisi ile gündeme gelen eski bir ilaca farmakolojik bakış

Berna Terzioğlu Bebitoğlu; Elif Oğuz; Ajla Hodzic; Nebile Hatiboğlu; Özkan Kam

doi:10.21673/anadoluklin.735826

Derleme

Chloroquine / Hydroxychloroquine: Pharmacological view of an old drug currently used in COVID-19 treatment

Yıl 2020, Sayı: Special Issue on COVID 19, 204 - 215, 20.03.2020

Berna Terzioğlu Bebitoğlu Elif Oğuz Ajla Hodzic Nebile Hatiboğlu Özkan Kam

https://doi.org/10.21673/anadoluklin.735826

Cited By: 4

Öz

Drugs that have been proven to be significantly harmless, and whose pharmacokinetics and optimal dosage are well known are subject to re-research for new indications since drug repositioning studies have been accelerated. Today, clinically proven treatment or vaccine has yet to be established against SARS-CoV-2, which caused the pandemic. In the treatment of COVID-19 disease, the treatment potential of chloroquine and hydroxychloroquine has drawn considerable attention. In this review, pharmacokinetic and pharmacodynamic properties, the information about use and safety in special populations, and particularly data on efficacy and safety in SARS-CoV-2 infection regarding recent studies of chloroquine/hydroxychloroquine, an old drug that is currently used in the treatment of COVID-19 is presented. Although chloroquine / hydroxychloroquine ranks first in the treatment algorithms of COVID-19 disease, more randomized controlled clinical trials are also required.

Anahtar Kelimeler

SARS-CoV-2, COVID-19, chloroquine, hydroxychloroquine

Kaynakça

1. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü COVID-19(SARS-CoV-2 Enfeksiyonu) Rehberi. Bilim Kurulu Çalışması. Ankara; 14 Nisan 2020. https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf
2. Zhou P, Yang XL, Wang XG et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–73.
3. Wallace DJ. The history of antimalarials. Lupus. 1996;5(1):2–3.
4. Mates M, Nesher G, Zevin S. Quinines—past and present. Harefuah. 2007;146(7): 560–62.
5. Shippey EA, Wagler VD, Collamer AN. Hydroxychloroquine: An old drug with new relevance. Cleve Clin J Med. 2018;85(6):459–67.
6. Stoughton RB. Treatment of chronic lupus erythematosus with atabrine and chloroquine. Ill Med J. 1955;107(6):299–2.
7. Ducharme, J., Farinotti, R. Clinical Pharmacokinetics and Metabolism of Chloroquine. Clin-Pharmacokinet 1996;31:257–74. https://doi.org/10.2165/00003088-199631040-00003
8. Rand JH, Wu XX, Quinn AS et al. Hydroxychloroquine directly reduces the binding of antiphospholipid antibody-beta2-glycoprotein I complexes to phospholipid bilayers. Blood. 2008;112(5):1687–95.
9. McChesney EW. Animal toxicity and pharmacokinetics of hydroxychloroquine sulfate. Am J Med. 1983;75(1A):11–18.
10. Browning DJ. Pharmacology of Chloroquine and Hydroxychloroquine. In: Hydroxychloroquine and Chloroquine Retinopathy. New York:Springer, 2014; p. 35–63.
11. Tett SE, Cutler D J, Day RO et al. Bioavailability of hydroxychloroquine tablets in healthy volunteers. Br J Clin Pharmacol. 1989;27(6):771–79.
12. Gustafsson LL, Walker D, Alván G et al. Disposition of chloroquine in man after single intravenous and oral doses. Br J Clin Pharmacol. 1983;15(4):471–79.
13. FDA Approved Drug Products: Hydroxychloroquine Oral Tablet https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/009768Orig1s051lbl.pdf
14. Collins KP, Jackson KM, Gustafson DL. Hydroxychloroquine: A Physiologically-Based Pharmacokinetic Model in the Context of Cancer-Related Autophagy Modulation. J Pharmacol Exp Ther. 2018;365(3):447–59.
15. Munster T, Gibbs JP, Shen D et al. Hydroxychloroquine concentration-response relationships in patients with rheumatoid arthritis. Arthritis Rheum. 2002;46(6):1460–69.
16. Popert AJ. Chloroquine: a review. Rheumatol Rehabil. 1976;15(3):235–38.
17. Laaksonen AL, Koskiahde V, Juva K. Dosage of antimalarial drugs for children with juvenile rheumatoid arthritis and systemic lupus erythematosus. A clinical study with determination of serum concentrations of chloroquine and hydroxychloroquine. Scand J Rheumatol. 1974;3(2):103–8.
18. Furst DE, Pharmacokinetics of hydroxychloroquine and chloroquine during treatment of rheumatic diseases. Lupus. 1996; 5(1):11–15.
19. Costedoat-Chalumeau N, Amoura Z, Hulot JS et al. Low blood concentration of hydroxychloroquine is a marker for and predictor of disease exacerbations in patients with systemic lupus erythematosus. Arthritis Rheum. 2006;54(10):3284–90.
20. Inglot AD. Comparison of the antiviral activity in vitro of some non-steroidal anti-inflammatory drugs. J Gen Virol. 1969;4(2):203–14.
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23. Ben-Zvi I, Kivity S, Langevitz P et al. Hydroxychloroquine: from malaria to autoimmunity. Clin Rev Allergy Immunol. 2012;42(2):145–53.
24. Plantone D, Koudriavtseva T. Current and Future Use of Chloroquine and Hydroxychloroquine in Infectious, Immune, Neoplastic, and Neurological Diseases: A Mini-Review. Clin Drug Investig. 2018;38(8):653–71.
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Klorokin/Hidroksiklorokin: COVID-19 tedavisi ile gündeme gelen eski bir ilaca farmakolojik bakış

Yıl 2020, Sayı: Special Issue on COVID 19, 204 - 215, 20.03.2020

Berna Terzioğlu Bebitoğlu Elif Oğuz Ajla Hodzic Nebile Hatiboğlu Özkan Kam

https://doi.org/10.21673/anadoluklin.735826

Cited By: 4

Öz

Son yıllarda ilaç yeniden konumlandırma çalışmalarının hız kazanması ile özellikle zararsız olduğu kanıtlanmış, farmakokinetik ve optimal dozu iyi bilinen ilaçlar farklı endikasyonlarda kullanılmak üzere yeniden araştırmalara tabi tutulmaktadır. Günümüzde pandemiye neden olan SARS-CoV-2'ye karşı özellikle klinik olarak etkinliği kanıtlanmış tedavi ya da aşı henüz bulunmamıştır. COVID-19 hastalığının tedavisinde klorokin ve hidroksiklorokinin tedavi potansiyeli büyük ölçüde dikkat çekmiştir. Bu derlemede COVID-19'un tedavisi ile yeniden gündeme gelen eski bir ilaç olan klorokin/hidroksiklorokinin farmakokinetik, farmakodinamik özellikleri, özel popülasyonlardaki kullanımı ve güvenliği ile ilgili mevcut veriler incelenmiş ve literatürdeki güncel araştırmalar doğrultusunda SARS-CoV-2 enfeksiyonundaki etkinlik ve güvenliğine ilişkin veriler sunulmaktadır. Klorokin/Hidroksiklorokinin COVID-19 hastalığının tedavi algoritmalarında ilk sırada yer alması ile birlikte daha fazla randomize kontrollü klinik çalışmanın da gerekli olduğu görülmektedir.

Anahtar Kelimeler

SARS-CoV-2, COVID-19, klorokin, hidroksiklorokin

Kaynakça

1. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü COVID-19(SARS-CoV-2 Enfeksiyonu) Rehberi. Bilim Kurulu Çalışması. Ankara; 14 Nisan 2020. https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf
2. Zhou P, Yang XL, Wang XG et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–73.
3. Wallace DJ. The history of antimalarials. Lupus. 1996;5(1):2–3.
4. Mates M, Nesher G, Zevin S. Quinines—past and present. Harefuah. 2007;146(7): 560–62.
5. Shippey EA, Wagler VD, Collamer AN. Hydroxychloroquine: An old drug with new relevance. Cleve Clin J Med. 2018;85(6):459–67.
6. Stoughton RB. Treatment of chronic lupus erythematosus with atabrine and chloroquine. Ill Med J. 1955;107(6):299–2.
7. Ducharme, J., Farinotti, R. Clinical Pharmacokinetics and Metabolism of Chloroquine. Clin-Pharmacokinet 1996;31:257–74. https://doi.org/10.2165/00003088-199631040-00003
8. Rand JH, Wu XX, Quinn AS et al. Hydroxychloroquine directly reduces the binding of antiphospholipid antibody-beta2-glycoprotein I complexes to phospholipid bilayers. Blood. 2008;112(5):1687–95.
9. McChesney EW. Animal toxicity and pharmacokinetics of hydroxychloroquine sulfate. Am J Med. 1983;75(1A):11–18.
10. Browning DJ. Pharmacology of Chloroquine and Hydroxychloroquine. In: Hydroxychloroquine and Chloroquine Retinopathy. New York:Springer, 2014; p. 35–63.
11. Tett SE, Cutler D J, Day RO et al. Bioavailability of hydroxychloroquine tablets in healthy volunteers. Br J Clin Pharmacol. 1989;27(6):771–79.
12. Gustafsson LL, Walker D, Alván G et al. Disposition of chloroquine in man after single intravenous and oral doses. Br J Clin Pharmacol. 1983;15(4):471–79.
13. FDA Approved Drug Products: Hydroxychloroquine Oral Tablet https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/009768Orig1s051lbl.pdf
14. Collins KP, Jackson KM, Gustafson DL. Hydroxychloroquine: A Physiologically-Based Pharmacokinetic Model in the Context of Cancer-Related Autophagy Modulation. J Pharmacol Exp Ther. 2018;365(3):447–59.
15. Munster T, Gibbs JP, Shen D et al. Hydroxychloroquine concentration-response relationships in patients with rheumatoid arthritis. Arthritis Rheum. 2002;46(6):1460–69.
16. Popert AJ. Chloroquine: a review. Rheumatol Rehabil. 1976;15(3):235–38.
17. Laaksonen AL, Koskiahde V, Juva K. Dosage of antimalarial drugs for children with juvenile rheumatoid arthritis and systemic lupus erythematosus. A clinical study with determination of serum concentrations of chloroquine and hydroxychloroquine. Scand J Rheumatol. 1974;3(2):103–8.
18. Furst DE, Pharmacokinetics of hydroxychloroquine and chloroquine during treatment of rheumatic diseases. Lupus. 1996; 5(1):11–15.
19. Costedoat-Chalumeau N, Amoura Z, Hulot JS et al. Low blood concentration of hydroxychloroquine is a marker for and predictor of disease exacerbations in patients with systemic lupus erythematosus. Arthritis Rheum. 2006;54(10):3284–90.
20. Inglot AD. Comparison of the antiviral activity in vitro of some non-steroidal anti-inflammatory drugs. J Gen Virol. 1969;4(2):203–14.
21. Shimizu Y, Yamamoto S, Homma M et al. Effect of chloroquine on the growth of animal viruses. Arch Gesamte Virusforsch. 1972;36(1):93–4.
22. Schlesinger PH, Krogstad DJ, Herwaldt BL. Antimalarial agents: mechanisms of action. Antimicrob Agents Chemother. 1988;32(6):793–8. doi: 10.1128/aac.32.6.793 .
23. Ben-Zvi I, Kivity S, Langevitz P et al. Hydroxychloroquine: from malaria to autoimmunity. Clin Rev Allergy Immunol. 2012;42(2):145–53.
24. Plantone D, Koudriavtseva T. Current and Future Use of Chloroquine and Hydroxychloroquine in Infectious, Immune, Neoplastic, and Neurological Diseases: A Mini-Review. Clin Drug Investig. 2018;38(8):653–71.
25. Mauthe M, Orhon I, Rocchi C et al. Chloroquine inhibits autophagic flux by decreasing autophagosome- lysosome fusion. Autophagy. 2018;14(8),1435–55.
26. Wu SF, Chang CB, Hsu JM et al. Hydroxychloroquine inhibits CD154 expression in CD4(+) T lymphocytes of systemic lupus erythematosus through NFAT, but not STAT5, signaling. Arthritis Res Ther. 2017;19(1),183.
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28. Al-Bari MA. Chloroquine analogues in drug discovery: New directions of uses, mechanisms of actions and toxic manifestations from malaria to multifarious diseases. J Antimicrob Chemother. 2015;70:1608–21.
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Toplam 100 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Konular	Sağlık Kurumları Yönetimi
Bölüm	DERLEME
Yazarlar	Berna Terzioğlu Bebitoğlu 0000-0003-4601-7871 Elif Oğuz 0000-0002-8052-671X Ajla Hodzic Bu kişi benim 0000-0002-3850-2028 Nebile Hatiboğlu Bu kişi benim 0000-0002-7410-7842 Özkan Kam Bu kişi benim 0000-0002-0437-3053
Yayımlanma Tarihi	20 Mart 2020
Kabul Tarihi	21 Mayıs 2020
Yayımlandığı Sayı	Yıl 2020 Sayı: Special Issue on COVID 19

Kaynak Göster

Vancouver	Terzioğlu Bebitoğlu B, Oğuz E, Hodzic A, Hatiboğlu N, Kam Ö. Klorokin/Hidroksiklorokin: COVID-19 tedavisi ile gündeme gelen eski bir ilaca farmakolojik bakış. Anadolu Klin. 2020;25(Special Issue on COVID 19):204-15.