Key Findings There is insufficient evidence to support the routine use of HCQ or CQ for the treatment of COVID-19. Results from interim analyses of 2 large RCTs, the Recovery and the Solidarity trials, reportedly showed no clinical benefit from HCQ for hospitalized patients with COVID-19. There are 3 randomized controlled trials that investigated the efficacy and safety of HCQ compared to standard therapy. Overall quality of evidence was very low. Meta-analyses from the “COVID-19 Living Data” project suggests that the use of HCQ may increase the incidence of adverse events at day 14 to day 28 (RR 2.49, 95% confidence interval: 1.04 to 5.98, moderate quality of evidence); the most common adverse event across the two trials is diarrhea (n=8). In a statement dated June 5, 2020, the investigators of the Recovery trial announced their decision to halt further enrollment to the HCQ arm of the trial because an interim analysis showed no clinical benefit from the use of HCQ in hospitalized patients with COVID. On June 15, 2020, the US FDA revoked the emergency use authorization for HCQ and CQ as treatment for COVID-19. On June 18, 2020, the WHO announced that recruitment to the HCQ arm of the Solidarity trial has been halted.
Chloroquine ; Hydroxychloroquine ; COVID-19

OBJECTIVE: Anti-malaria drugs may modulate tumor resistance to chemotherapeutic agents, but it has not been proven effective in the treatment of malignant gliomas. The aim of this study was to determine whether adequate pre-clinical data on co-administration of chemotherapeutic agents with anti-malaria drugs on malignant cell lines could be obtained that would warrant its further potential consideration for use in a clinical trial for malignant gliomas. METHODS: Two malignant glioma cell lines (U87MG, T98G) were treated with chemotherapeutic agents alone or with anti-malaria drugs. Cells were incubated with drugs for 4 days. Following the 4-day incubation, drug sensitivity assays were performed using 3-(4, 5-dimethyl-2-thiazol-2-yl) 2, 5-diphenyltetrazolium bromide (MTT) assay following optimization of experimental conditions for each cell lines and cell viability was calculated. RESULTS: In all of four chemotherapeutic agents(doxorubicin, vincrisitne, nimustine, and cisplatin), the cell viability was found to be markedly decreased when hydroxychloroquine was co-administered on both U87MG and T98G cell lines. The two way analysis of variance(ANOVA) yielded a statistically significant two-sided p-value of 0.0033(doxorubicin), 0.0005(vincrisitne), 0.0007(nimustine), and 0.0003(cisplatin) on U87MG cell lines and 0.0006(doxorubicin), 0.0421(vincrisitne), 0.0317(nimustine), and 0.0001(cisplatin) on T98G cell lines, respectively. However, treatment with chloroquine and primaquine did not induce a decrease in cell viability on both U87MG and T98G cell lines. CONCLUSION: Our data support further consideration of the use of hydroxychloroquine prior to systemic chemotherapy to maximize its tumoricidal effect for patients with malignant gliomas.
Cell Line* ; Cell Survival ; Chloroquine ; Drug Resistance, Multiple ; Drug Therapy ; Glioma* ; Humans ; Hydroxychloroquine* ; Nimustine ; Primaquine

Animals ; Chloroquine/pharmacology* ; Longevity ; Rats

The antimalarials have been commonly described for the treatment of several connective tissue diseases. Among adverse effects of antimalarials, skin hyperpigmentation has been easily overlooked for its slow onset, but it may be a marker at risk of ocular side effects. Moreover, most cases of hyperpigmentation have been reported from chloroquine, but rarely hydroxychloroquine (HCQ). We experienced two patients who showed skin pigmentation during administration of HCQ. The first case was a 53-year-old woman presented with dark brown macules on the neck and ashy-colored patches on the buttock. The second was a 75-year-old woman presented with bluish-gray patches on both shins. Before hyperpigmentation developed, each patient had been treated with HCQ 400 mg per day for two years and five months, respectively. Two years ago after skin hyperpigmentation the first patients was found to have retinal pigmentation under the fundoscopy, so that HCQ was discontinued.
Aged ; Antimalarials ; Buttocks ; Chloroquine ; Connective Tissue Diseases ; Female ; Humans ; Hydroxychloroquine ; Hyperpigmentation ; Middle Aged ; Neck ; Pigmentation ; Retinaldehyde ; Skin ; Skin Pigmentation

No abstract available.
Chloroquine* ; Edetic Acid* ; Glycine* ; Immunoglobulin G*

The changes of susceptibility to chloroquine associated with mutations at 76 point of transporter membrane gene (P.fcrt) and at 86 point of multi-drug resistant 1 gene (P.fmdr-1) of P.falciparum were investigated by nested PCR. Analysis of 113 P.falciparum blood samples collected from the malaria patients in the Farm No11 of Phu Rieng Rubber Company in Binh Phuoc province in October 2002. The results showed that: at76 point of P.fcrt gene, 58 samples (51%) were wild type, 24 samples (21%) were mutated type and 31 samples (28%) were mixture of wild and mutated type. At 86 point of P.fmdr-1 gene, 3 samples of mixed wild and mutated type (2.7%), 110 samples of wild type (97.3%) and non of mutated type samples
malaria ; malaria, falciparum ; Chloroquine ; diagnosis ; mutation ; genes

Plasmodium vivax malaria, which used to be endemic in the past, re-emerged in 1993 and the number of cases has increased annually. Though there has been no proven endemic drug-resistant malaria case reported, widespread use of anti-malarial chemoprophylaxis for the military personnel could cause emergence of resistance. We herein report a case of tertian malaria, which recurred three times despite the standard chloroquine-primaquine therapy. The patient is 40-year-old male, lives in Dongducheon city, Gyeonggy province, and has never been abroad. He visited hospital in September 2000, because of fever. His blood smear revealed ring forms and trophozoites of P. vivax. He took hydroxychloroquine for 3 days and primaquine for 14 days. His symptoms disappeared then. After 7 months he got fever for 2 days and his blood smear revealed schizonts of P. vivax. He took the same medicines and got well next day. Fever recurred 4 month later, and trophozoites were observed on the blood smear. Hydroxychloroquine and primaquine were prescribed in the same way and fever disappeared. Forty three days later, he had fever and positive blood smear of P. vivax trophozoite. Fever disappeared on the day drug was administered and no malaria was detected in follow up smear of 7 and 14 days. He was free of fever in follow up at 3 months later.
Adult ; Chemoprevention ; Chloroquine ; Fever ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Hydroxychloroquine ; Malaria* ; Malaria, Vivax ; Male ; Military Personnel ; Plasmodium vivax ; Primaquine ; Recurrence ; Schizonts ; Trophozoites

Bartonella henselae causes cat-scratch disease, bacteremia, and various focal infections. Despite the worldwide occurrence of B. henselae infections, reports in humans are rare in Korea. The clinical manifestation of all 5 previously reported cases was lymphadenopathy. Herein, we report a case of bacteremia in a woman who presented with prolonged fever. B. henselae was isolated from a blood specimen by cell culture. Conventional polymerase chain reaction amplification and sequencing of the 16S-23S rRNA intergenic space region confirmed the isolate to be B. henselae. The patient had no underlying immunocompromising conditions and no recent exposure to animals. She was successfully managed with a combination of doxycycline and hydroxychloroquine.
Animals ; Bacteremia* ; Bartonella henselae* ; Bartonella* ; Cat-Scratch Disease ; Cell Culture Techniques ; Chloroquine ; Doxycycline ; Female ; Fever ; Fever of Unknown Origin ; Focal Infection ; Humans ; Hydroxychloroquine ; Korea* ; Lymphatic Diseases ; Polymerase Chain Reaction

Plasmodium vivax has many stages in the life cycle, and shows different susceptibilities to anti-malarial drugs at each stage. Of these drugs, primaquine is only drug that has anti-malarial activity to hypnozoite. Generally, primaquine is administered for the prevention of relapse by hypnozoite following the treatment with chloroquine in tertian malaria, at the dosage of 15mg/ day for 14 days. But Plasmodium vivax has different susceptibility to primaquine in different areas (so as to strains), and the resistance to primaquine is increasing in endemic areas. We recently experienced a case of imported tertian malaria that relapsed two times after the completions of chloroquine-primaquine therapy. The patient was treated with 22.5 mg of primaquine for 2 weeks at the first relapse, and 3 weeks course of 30 mg of primaquine in the second relapsing episode. Therefore we report this primaquine-resistant tertian malaria with review.
Chloroquine ; Humans ; Life Cycle Stages ; Malaria* ; Plasmodium vivax ; Primaquine ; Recurrence

We describe herein four cases of childhood dermatomysitis of Brunsting type. The ages of these patients were between 7 to 10 years at the time of the disease. All four patients had pathognomOnic cutaneous changes, such as heliotrope erythema and Gottron's papules, which are not seen frequently in adult type dermatomyositis. These patients did not show any marked serologic abnormalities suggestive of having other connective tissue diseases or autoimmune diseases. All patients were initially treated with prednisolone and chloroquine, and have been under control with low dose prednisolone, or chloroquine alone.
Autoimmune Diseases ; Chloroquine ; Connective Tissue Diseases ; Dermatomyositis* ; Erythema ; Humans ; Prednisolone