Τίτλος:
Optimization of hydroxychloroquine dosing scheme based on COVID-19 patients’ characteristics: a review of the literature and simulations
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
During the recent COVID-19 outbreak hydroxychloroquine (HCQ) has been proposed as a safe and effective therapeutic option. However, a wide variety of dosing schemes has been applied in the clinical practice and tested in clinical studies. An extended literature survey was performed investigating the pharmacokinetics, the efficacy and safety of HCQ in COVID-19 treatment. Population pharmacokinetic models were retrieved from the literature and after evaluation and assessment one was selected in order to perform simulations. The most commonly applied dosing schemes were explored for patients with different weights and different levels of HCQ clearance impairment. Model-based simulations of HCQ concentrations revealed that high initial doses followed by low and sparse doses may offer significant benefits to patients by decreasing the viral load without reaching levels considered to produce adverse effects. For instance, the dosing scheme proposed for a 70 kg adult with moderate COVID-19 symptoms would be 600 mg upon diagnosis, 400 mg after 12 h, 300 mg after 24 h, 200 mg after 36 h, followed by 200 mg BID for 4 d, followed by 200 mg OD for 5 d. Based on the results from simulations performed and the currently published knowledge regarding HCQ in COVID-19 treatment, this study provides evidence that a high loading dose followed by sparse doses could offer significant benefits to the patients. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
Συγγραφείς:
Karatza, E.
Ismailos, G.
Marangos, M.
Karalis, V.
Εκδότης:
Taylor and Francis Ltd.
Λέξεις-κλειδιά:
albumin; azithromycin; ceftriaxone; chloroquine; glycophorin A; hydroxychloroquine; immunosuppressive agent; quinolone derivative; antivirus agent; hydroxychloroquine, adult; Article; body weight; cardiotoxicity; clinical practice; controlled study; coronavirus disease 2019; drug absorption; drug bioavailability; drug clearance; drug efficacy; drug half life; drug safety; drug tolerability; female; gastrointestinal toxicity; hepatic clearance; human; maximum plasma concentration; maximum tolerated dose; observational study; Plasmodium vivax malaria; single drug dose; time to maximum plasma concentration; World Health Organization; computer simulation; drug therapy, Antiviral Agents; Computer Simulation; COVID-19; Humans; Hydroxychloroquine
DOI:
10.1080/00498254.2020.1824301
