No abstract available.
Hydroxychloroquine ; Hyperpigmentation

OBJECTIVES: Hydroxychloroquine (HCQ) 400 mg is approved by the Drug Controller General of India (DCGI) and recommended by the Research Society for the Study of Diabetes in India (RSSDI) clinical practice recommendations 2017 as add-on therapy after metformin and sulfonylurea in Type 2 Diabetes (T2DM) patients. The aim of this observational study is to compare the efficacy and safety of hydroxychloroquine 400 mg and teneligliptin 20 mg when used as add-on therapy in Indian Type 2 DM patients who were inadequately controlled (HbA1c ?7.5%) with metformin 1000 mg and glimepiride 2 mg combination.

METHODOLOGY: This study is a prospective observational study to be conducted in 2 diabetic centres of Patna city between October 2017 and May 2018 involving 180 patients followed up for 6 months. One group (N=90) of patients received hydroxychloroquine 400 mg + metformin 1000 mg + glimepiride 2 mg, the other group (N=90) received teneligliptin 20 mg + metformin 1000 mg + glimepiride 2 mg. Efficacy was assessed by fasting blood glucose (FBG), post prandial blood glucose (PPBG) and glycated haemoglobin (HbA1c) reduction. Safety was evaluated by the number of hypoglycaemic events and changes in serum creatinine levels. Home based glucose monitoring was used to detect the hypoglycaemic events. Patients who had any type of retinopathy/maculopathy were excluded.

RESULTS: Mean age of entire population was 66 ± 8 years with mean 6 ± 2 years of DM with 102 males. Mean body weight was 71 ± 12 kg. Baseline HbA1c was 8.1 ± 0.3 in the hydroxychloroquine group and 8.2 ± 0.2 in the teneligliptin group.

At 24 weeks there were statistically significant reductions in mean HbA1c in the hydroxychloroquine group (1.1 ± 0.3) as compared to the teneligliptin group (0.82 ± 0.3) (P?0.001). The mean FBG and PPBG was 169 ± 18 mg/dl and 232 ± 18 mg/dl respectively in hydroxychloroquine group which was reduced to 121 ± 15 mg/dl and 161 ± 19 mg/dl at the end of 24 weeks. In the teneligliptin group, FBG and PPBG was 171 ± 16 mg/dl and 239 ± 21 mg/dl at baseline, which was reduced to 121 ± 15 mg/dl and 161 ± 19 mg/dl respectively in same period of time (P? 0.005). There were 4 incidences of hypoglycaemic events in the hydroxychloroquine group (4.4%) and 6 in the teneligliptin group (6.67%). No patients required medical assistance for hypoglycaemic events. There was no statistically significant change in body weight in both the groups. No marked changes in creatinine levels were found in patients in both the groups.

CONCLUSION: In conclusion, treatment with hydroxychloroquine 400 mg for 24 weeks reduces glycaemic parameters more aggressively than teneligliptin 20 mg in Indian type 2 diabetes patients.

No abstract available.
Erythema* ; Hydroxychloroquine* ; Sjogren's Syndrome*

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

No abstract available.
Alopecia Areata ; Alopecia ; Humans ; Hydroxychloroquine

Pemphigus erythematosus (PE) is a superficial type of pemphigus, which can be aggravated by sunlight (espicially UV light). Because of the known side effects of corticosteroids, we evaluated the efficacy of hydroxychloroquine as a corticosteroid-sparing agent and/or the effect of a single-drug regimen in two patients with PE with photosensitivity. We obtained a good therapeutic response with hydroxychloroquine in these two patients with PE. This drug could be used in selected patients with pemphigus who are prednisolone/ immunosuppressive-resistant or who have certain degrees of photosensitivity.
Adrenal Cortex Hormones ; Humans ; Hydroxychloroquine* ; Pemphigus* ; Sunlight

Acute generalized exanthematous pustulosis (AGEP) is a cutaneous reaction principally induced by drugs. Spontaneous resolution is observed in most patients. However, severe cases required systemic corticosteroid administration. Hydroxychloroquine, which is used to treat some dermatologic and rheumatologic diseases because of its anti-inflammatory and immunosuppressive effects, is an uncommon cause of AGEP. A 67-year-old female patient presented with severe AGEP due to hydroxychloroquine treatment. She was recalcitrant to supportive care and systemic corticosteroid treatment butwas successfully treated with cyclosporine. Hydroxychloroquine-induced AGEP occurs in women with underlying rheumatologic diseases, has a longer latent period, and has a severe course usually requiring systemic treatment.
Acute Generalized Exanthematous Pustulosis* ; Aged ; Cyclosporine* ; Female ; Humans ; Hydroxychloroquine

There are two stages in the life circle of Plasmodium spp in humans: exoerythrocytic and erythrocytic stages. Hydroxychloroquine is the major chemotherapeutic agent against malarial parasites in their erythrocytic stage. The recurrence of Plasmodium vivax malaria, which is usually caused by an inadequate treatment or the presence of drug resistant parasites, has been reported frequently in the world, but rarely in Korea. We experienced two patients who recurred with P. vivax malaria after hydroxychloroquine therapy, and treating with insufficient doses of the drug was suspected as the cause of the recurrence.
Humans ; Hydroxychloroquine ; Korea ; Malaria, Vivax* ; Parasites ; Plasmodium ; Plasmodium vivax ; Recurrence

Childhood dermatomyositis seems to differ from the adult form by the presence of vasculitis and the late development of calcinosis. We report two patients with childhood dermatomyositis who were clinically characteristic and successfully treated with the followings. The first patient improved with intravenous gammaglobulin. The second patient improved with oral prednisone, methotrexate, and hydroxychloroquine.
Adult ; Calcinosis ; Dermatomyositis* ; Humans ; Hydroxychloroquine ; Methotrexate ; Prednisone ; Vasculitis

Hydroxychloroquine (HCQ) has been widely used for treatment of various rheumatic and dermatologic diseases. However, under a high cumulative dose, HCQ may cause retinal toxicity. In this review, we summarize the underlying mechanisms, prevalence, risk factors, clinical characteristics, screening tests, treatments, and prognosis of HCQ retinopathy. Because HCQ retinopathy is rarely reversible, screening tests to determine the retinal toxicity prior to its development are important. The American Academy of Ophthalmology screening protocols for early detection were updated in 2013. However, as a different clinical type is found in Asian patients, predominantly the pericentral type of photoreceptor damage, rather than the traditional parafoveal type, we propose a modified screening protocol for detection of HCQ retinopathy in Korean and other Asian patients.
Asian Continental Ancestry Group ; Humans ; Hydroxychloroquine* ; Mass Screening ; Ophthalmology ; Prevalence ; Prognosis ; Retina ; Retinaldehyde ; Risk Factors