In a new study, researchers confirm the combination of hydroxychloroquine and azithromycin is linked to strong heart disease risks, including mortality.
This the largest safety study ever performed comparing hydroxychloroquine treatment to hydroxychloroquine and azithromycin treatment for rheumatoid arthritis patients.
The research was conducted by a team at the Observational Health Data Sciences and Informatics (OHDSI) and elsewhere.
Hydroxychloroquine is commonly used to treat rheumatoid arthritis, while azithromycin is a frequently-prescribed antibiotic to treat infections such as pneumonia, chest and sinus infections, etc.
The team examined more than 950,000 hydroxychloroquine users.
They found in patients with rheumatoid arthritis, hydroxychloroquine treatment in the short term (30 days) was found to not carry excess side effects, but hydroxychloroquine treatment in the long term had a 65% relative increase in heart-related mortality, compared to sulfasalazine, a similar rheumatoid arthritis drug.
Hydroxychloroquine and azithromycin together had a heart mortality risk that was more than twice as high as the comparative treatment even in the short term based on findings from more than 320,000 users of that combination therapy.
This treatment also produced a 15-20% increased rate of angina/chest pain and heart failure.
Hydroxychloroquine, a drug commonly used in the treatment of malaria and lupus in addition to rheumatoid arthritis, gained early attention during the pandemic as a potential COVID-19 treatment.
The team says hydroxychloroquine, both alone and in combination with azithromycin, gained strong consideration as a potential COVID-19 treatment without a large-scale study of its overall safety profile.
They were relieved to find no worrying side effects in the short-term use of hydroxychloroquine.
However, when prescribed in combination with azithromycin, it may induce heart failure and cardiovascular mortality and we would urge caution in using the two together.
The team says the standardizing data for nearly 1,000,000 patients on hydroxychloroquine provides confidence in these findings, and they hope this study can help make a positive clinical impact as treatment options continue to be evaluated.
One author of the study is Daniel Prieto-Alhambra.
The study is published in The Lancet Rheumatology.
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