Extracorporeal Treatment for Chloroquine, Hydroxychloroquine, and Quinine Poisoning : Systematic Review and Recommendations from the EXTRIP Workgroup
Copyright © 2020 by the American Society of Nephrology..
BACKGROUND: Although chloroquine, hydroxychloroquine, and quinine are used for a range of medical conditions, recent research suggested a potential role in treating COVID-19. The resultant increase in prescribing was accompanied by an increase in adverse events, including severe toxicity and death. The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup sought to determine the effect of and indications for extracorporeal treatments in cases of poisoning with these drugs.
METHODS: We conducted systematic reviews of the literature, screened studies, extracted data, and summarized findings following published EXTRIP methods.
RESULTS: A total of 44 studies (three in vitro studies, two animal studies, 28 patient reports or patient series, and 11 pharmacokinetic studies) met inclusion criteria regarding the effect of extracorporeal treatments. Toxicokinetic or pharmacokinetic analysis was available for 61 patients (13 chloroquine, three hydroxychloroquine, and 45 quinine). Clinical data were available for analysis from 38 patients, including 12 with chloroquine toxicity, one with hydroxychloroquine toxicity, and 25 with quinine toxicity. All three drugs were classified as non-dialyzable (not amenable to clinically significant removal by extracorporeal treatments). The available data do not support using extracorporeal treatments in addition to standard care for patients severely poisoned with either chloroquine or quinine (strong recommendation, very low quality of evidence). Although hydroxychloroquine was assessed as being non-dialyzable, the clinical evidence was not sufficient to support a formal recommendation regarding the use of extracorporeal treatments for this drug.
CONCLUSIONS: On the basis of our systematic review and analysis, the EXTRIP workgroup recommends against using extracorporeal methods to enhance elimination of these drugs in patients with severe chloroquine or quinine poisoning.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
|---|---|
| Enthalten in: |
Journal of the American Society of Nephrology : JASN - 31(2020), 10 vom: 06. Okt., Seite 2475-2489 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Berling, Ingrid [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
4QWG6N8QKH |
|---|
| Anmerkungen: |
Date Completed 13.10.2020 Date Revised 07.12.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1681/ASN.2020050564 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM315342722 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM315342722 | ||
| 003 | DE-627 | ||
| 005 | 20231225154717.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1681/ASN.2020050564 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1051.xml |
| 035 | |a (DE-627)NLM315342722 | ||
| 035 | |a (NLM)32963091 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Berling, Ingrid |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Extracorporeal Treatment for Chloroquine, Hydroxychloroquine, and Quinine Poisoning |b Systematic Review and Recommendations from the EXTRIP Workgroup |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 13.10.2020 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 by the American Society of Nephrology. | ||
| 520 | |a BACKGROUND: Although chloroquine, hydroxychloroquine, and quinine are used for a range of medical conditions, recent research suggested a potential role in treating COVID-19. The resultant increase in prescribing was accompanied by an increase in adverse events, including severe toxicity and death. The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup sought to determine the effect of and indications for extracorporeal treatments in cases of poisoning with these drugs | ||
| 520 | |a METHODS: We conducted systematic reviews of the literature, screened studies, extracted data, and summarized findings following published EXTRIP methods | ||
| 520 | |a RESULTS: A total of 44 studies (three in vitro studies, two animal studies, 28 patient reports or patient series, and 11 pharmacokinetic studies) met inclusion criteria regarding the effect of extracorporeal treatments. Toxicokinetic or pharmacokinetic analysis was available for 61 patients (13 chloroquine, three hydroxychloroquine, and 45 quinine). Clinical data were available for analysis from 38 patients, including 12 with chloroquine toxicity, one with hydroxychloroquine toxicity, and 25 with quinine toxicity. All three drugs were classified as non-dialyzable (not amenable to clinically significant removal by extracorporeal treatments). The available data do not support using extracorporeal treatments in addition to standard care for patients severely poisoned with either chloroquine or quinine (strong recommendation, very low quality of evidence). Although hydroxychloroquine was assessed as being non-dialyzable, the clinical evidence was not sufficient to support a formal recommendation regarding the use of extracorporeal treatments for this drug | ||
| 520 | |a CONCLUSIONS: On the basis of our systematic review and analysis, the EXTRIP workgroup recommends against using extracorporeal methods to enhance elimination of these drugs in patients with severe chloroquine or quinine poisoning | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Chloroquine | |
| 650 | 4 | |a Hydroxychloroquine | |
| 650 | 4 | |a Quinine | |
| 650 | 4 | |a hemodialysis | |
| 650 | 4 | |a hemofiltration | |
| 650 | 7 | |a Hydroxychloroquine |2 NLM | |
| 650 | 7 | |a 4QWG6N8QKH |2 NLM | |
| 650 | 7 | |a Chloroquine |2 NLM | |
| 650 | 7 | |a 886U3H6UFF |2 NLM | |
| 650 | 7 | |a Quinine |2 NLM | |
| 650 | 7 | |a A7V27PHC7A |2 NLM | |
| 700 | 1 | |a King, Joshua D |e verfasserin |4 aut | |
| 700 | 1 | |a Shepherd, Greene |e verfasserin |4 aut | |
| 700 | 1 | |a Hoffman, Robert S |e verfasserin |4 aut | |
| 700 | 1 | |a Alhatali, Badria |e verfasserin |4 aut | |
| 700 | 1 | |a Lavergne, Valery |e verfasserin |4 aut | |
| 700 | 1 | |a Roberts, Darren M |e verfasserin |4 aut | |
| 700 | 1 | |a Gosselin, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Wilson, Gabrielle |e verfasserin |4 aut | |
| 700 | 1 | |a Nolin, Thomas D |e verfasserin |4 aut | |
| 700 | 1 | |a Ghannoum, Marc |e verfasserin |4 aut | |
| 700 | 0 | |a EXTRIP workgroup |e verfasserin |4 aut | |
| 700 | 1 | |a Anseeuw, Kurt |e investigator |4 oth | |
| 700 | 1 | |a Bird, Steven |e investigator |4 oth | |
| 700 | 1 | |a Bunchman, Timothy |e investigator |4 oth | |
| 700 | 1 | |a Bouchard, Josée |e investigator |4 oth | |
| 700 | 1 | |a Calello, Diane |e investigator |4 oth | |
| 700 | 1 | |a Chin, Paul |e investigator |4 oth | |
| 700 | 1 | |a Doi, Kent |e investigator |4 oth | |
| 700 | 1 | |a Galvao, Tais |e investigator |4 oth | |
| 700 | 1 | |a Goldfarb, David |e investigator |4 oth | |
| 700 | 1 | |a Hassanian, Hossein |e investigator |4 oth | |
| 700 | 1 | |a Hoegberg, Lotte |e investigator |4 oth | |
| 700 | 1 | |a Kallab, Siba |e investigator |4 oth | |
| 700 | 1 | |a Kebede, Sofia |e investigator |4 oth | |
| 700 | 1 | |a Kielstein, Jan |e investigator |4 oth | |
| 700 | 1 | |a Lewington, Andrew |e investigator |4 oth | |
| 700 | 1 | |a Li, Yi |e investigator |4 oth | |
| 700 | 1 | |a Macedo, Etienne |e investigator |4 oth | |
| 700 | 1 | |a MacLaren, Rob |e investigator |4 oth | |
| 700 | 1 | |a Mégarbane, Bruno |e investigator |4 oth | |
| 700 | 1 | |a Mowry, James |e investigator |4 oth | |
| 700 | 1 | |a Ostermann, Marlies |e investigator |4 oth | |
| 700 | 1 | |a Peng, Ai |e investigator |4 oth | |
| 700 | 1 | |a Roy, Jean-Philippe |e investigator |4 oth | |
| 700 | 1 | |a Vijayan, Anitha |e investigator |4 oth | |
| 700 | 1 | |a Walsh, Steven |e investigator |4 oth | |
| 700 | 1 | |a Wong, Anselm |e investigator |4 oth | |
| 700 | 1 | |a Wood, David |e investigator |4 oth | |
| 700 | 1 | |a Yates, Christopher |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of the American Society of Nephrology : JASN |d 1990 |g 31(2020), 10 vom: 06. Okt., Seite 2475-2489 |w (DE-627)NLM012606502 |x 1533-3450 |7 nnns |
| 773 | 1 | 8 | |g volume:31 |g year:2020 |g number:10 |g day:06 |g month:10 |g pages:2475-2489 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1681/ASN.2020050564 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 31 |j 2020 |e 10 |b 06 |c 10 |h 2475-2489 | ||