Indonesian Journal of Pharmacology and Therapy
Vol 4 No 1 (2023)

Safety monitoring of chloroquine and hydroxychloroquine in COVID-19 patients in Indonesia on QT prolongation: hospital based monitoring study

Jarir At Thobari (Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta)
Togi Junice Hutadjulu (Badan Pengawasan Obat dan Makanan Republik Indonesia, Jakarta)
Tri Asti Isnariani (Badan Pengawasan Obat dan Makanan Republik Indonesia, Jakarta)
Umi Sa'adatun Nikmah (Clinical Epidemiology and Biostatistics Unit, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta)
Lukman Ade Chandra (Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta)
Pompini Agustina Sitompul (Rumah Sakit Penyakit Infeksi Prof. Dr. Sulianti Saroso, Jakarta)
Anggoro Budi Hartopo (Unknown)
Rizki Amalia Gumilang (Rumah Sakit Akademik Universitas Gadjah Mada, Yogyakarta)
Luhur Pribadi (Rumah Sakit Pusat Angkatan Udara (RSPAU) dr. S. Hardjolukito, Yogyakarta)
Deva Bachtiar (Rumah Sakit Yarsi, Jakarta)
Anwar Santoso (Department of Cardiology and Vascular Medicine, National Cardiovascular Centre Harapan Kita, Faculty of Medicine Universitas Indonesia, Jakarta)



Article Info

Publish Date
31 Mar 2023

Abstract

Chloroquine (CQ) and Hydroxychloroquine (HCQ) are the challenging drugs used for COVID-19. Several studies show its beneficial, however, both medications can prolong the QTc interval and increase the risk of patients for torsades de pointes and death. The Tisdale score is identified to have successfully predicted the at-risk population of side effects of these drugs. This study aim to evaluate the QT prolongation caused by the administration of chloroquine and hydroxychloroquine in COVID-19 patients and the association with the treatment outcomes based on their Tisdale score. We conducted an observational study on 213 hospitalized patients with confirmed or suspect COVID-19 in 6 referral hospitals in Indonesia. All baseline demographic such as age and gender, RT-PCR test result, severity of disease, history of cardiovascular disease (myocardial infarction, heart failure, hypertension), serum kalium level at baseline, and the use of medication associated with risk QTc interval prolongation were collected. The Tisdale risk score was used for predicting high-risk patients for QT corrected (QTc) interval prolongation. Out of 213 patients who were treated with CQ/HCQ, there were 60 (28.2%) patients had QTc interval prolongation, included 43 patients (20.2%) who had normal QTc interval at baseline and at the end of treatment had prolong interval; or 17 patients (8.0%) who had QTc interval more than 470 msec at baseline and QTc interval prolongation was worsen at the end of treatment. Several factors, including age more than 50 years, COVID-19 confirm PCR, and had comorbidity heart failure, were statistically significant associated with QTc interval prolongation. The high-risk score of Tisdale score have increased risk significantly on QTc interval prolongation (RR: 2.15, 95%CI 1.07-4.32) and associated with risk of death (RR: 3.50, 95%CI 1.34-9.13) compared to low-risk score. Our findings showed that the treatment of CQ/HCQ in COVID-19 patients is associated with QTc prolongation. The Tisdale score can be used as a valuable tool to predict the COVID-19 patients’ outcome after treatment of these QTc-prolonging drugs.

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Journal Info

Abbrev

JPT

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Immunology & microbiology Neuroscience

Description

Indonesian Journal of Pharmacology and Therapy (IJPTher ) is a scientific journal which managed by Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFI) and Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada. IJPTher is an open-access, and double-blind ...