Circulation:羟氯喹和阿奇霉素心律失常风险高!世卫组织分析

2020-05-25 岱西 中国循环杂志

近日一项发表在Circulation杂志的研究表示,这非常不靠谱,两药本身会增加心律失常风险,而组合起来更是“要命”。

美国总统特朗普曾发推吹捧过羟氯喹和阿奇霉素来对抗新冠病毒,并多次“带货”羟氯喹,而据相关研究显示,在经如此“带货”,美国人购买羟氯喹和搜索量分别增加了442%和1389%。

但近日一项发表在Circulation杂志的研究表示,这非常不靠谱,两药本身会增加心律失常风险,而组合起来更是“要命”。

这项研究根据世卫组织药物不良反应数据库进行分析。这一药物不良数据库,涵盖了1967年11月至2020年3月130个国家2100万例药物不良事件报告。

数据库显示,报告的76822例羟氯喹不良事件,有28.4%怀疑与羟氯喹相关;报告的89692例阿奇霉素不良事件,有60.8%怀疑与阿奇霉素相关;两药联合有607例不良事件报告。

经过分析发现,与其他药物相比,羟氯喹与阿奇霉素两种药都与QT间期延长和(或)室性心动过速(包括尖端扭转型室性心动过速)报告更多,差异具有显着统计学意义。

此外,羟氯喹还与传导障碍(房室阻滞和束支阻滞)和心力衰竭的发展密切相关。

与单用羟氯喹相比,单用阿奇霉素相关QT间期延长和(或)尖端扭转型室性心动过速报告更多(0.8% vs 0.3%);而两药联合,则QT间期延长和(或)尖端扭转型室性心动过速更多见。

单用羟氯喹相关尖端扭转型室性心动过速所致死亡比例为8.4%(7/83),阿奇霉素为20.2%(52/257);单用羟氯喹或阿奇霉素相关的无尖端扭转型室性心动过速仅QT间期延长,死亡比例分别为0%(0/53)和5.4%(12/223)。

研究者指出,鉴于两药的促心律失常作用,对于伴有QT间期延长或尖端扭转型室性心动过速高危因素的患者,比如白介素6升高、低钾血症、多种药物相互作用等,更要多加注意。

美国心脏协会相关专家强调,羟氯喹和阿奇霉素增加心血管毒性,对于新冠病毒患者,不应在临床试验之外给药。

原始出处:Nguyen LS, Dolladille C, Drici MD, et al. Cardiovascular Toxicities Associated with Hydroxychloroquine and Azithromycin: An Analysis of the World Health Organization Pharmacovigilance Database. Circulation. 2020 May 22.

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    2020-09-01 14818eb4m67暂无昵称

    学习

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    2020-05-25 ms20000019

    不错

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    2020-05-25 thm112988

    0

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    2020-05-25 njwbhuang

    感谢分享,学习了

    0

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