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Risk of QT prolongation through drug interactions between hydroxychloroquine and concomitant drugs prescribed in real world practice

Authors
 Byung Jin Choi  ;  Yeryung Koo  ;  Tae Young Kim  ;  Wou Young Chung  ;  Yun Jung Jung  ;  Ji Eun Park  ;  Hong-Seok Lim  ;  Bumhee Park  ;  Dukyong Yoon 
Citation
 SCIENTIFIC REPORTS, Vol.11(1) : 6918, 2021-03 
Journal Title
SCIENTIFIC REPORTS
Issue Date
2021-03
MeSH
COVID-19 / drug therapy* ; COVID-19 / virology ; Case-Control Studies ; Drug Interactions ; Electrocardiography ; Humans ; Hydroxychloroquine / administration & dosage ; Hydroxychloroquine / adverse effects* ; Long QT Syndrome / chemically induced* ; Long QT Syndrome / physiopathology ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 / isolation & purification
Abstract
Hydroxychloroquine has recently received attention as a treatment for COVID-19. However, it may prolong the QTc interval. Furthermore, when hydroxychloroquine is administered concomitantly with other drugs, it can exacerbate the risk of QT prolongation. Nevertheless, the risk of QT prolongation due to drug-drug interactions (DDIs) between hydroxychloroquine and concomitant medications has not yet been identified. To evaluate the risk of QT prolongation due to DDIs between hydroxychloroquine and 118 concurrent drugs frequently used in real-world practice, we analyzed the electrocardiogram results obtained for 447,632 patients and their relevant electronic health records in a tertiary teaching hospital in Korea from 1996 to 2018. We repeated the case-control analysis for each drug. In each analysis, we performed multiple logistic regression and calculated the odds ratio (OR) for each target drug, hydroxychloroquine, and the interaction terms between those two drugs. The DDIs were observed in 12 drugs (trimebutine, tacrolimus, tramadol, rosuvastatin, cyclosporin, sulfasalazine, rofecoxib, diltiazem, piperacillin/tazobactam, isoniazid, clarithromycin, and furosemide), all with a p value of < 0.05 (OR 1.70-17.85). In conclusion, we found 12 drugs that showed DDIs with hydroxychloroquine in the direction of increasing QT prolongation.
Files in This Item:
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DOI
10.1038/s41598-021-86321-z
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Yoon, Dukyong(윤덕용)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182311
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