Systemic toxicity of chloroquine and hydroxychloroquine : prevalence, mechanisms, risk factors, prognostic and screening possibilities

Chloroquine (CQ) and its hydroxylated analog, hydroxychloroquine (HCQ), are 4-aminoquinoline initially used as an antimalarial treatment. CQ and HCQ (4-aminoquinoline, 4-AQ) are today used in rheumatology, especially to treat rheumatoid arthritis and systemic lupus erythematosus. Their mechanism of action revolves around a singular triptych: 4-AQ acts as alkalizing agents, ionized amphiphilic molecules, and by binding to numerous targets. 4-AQ have so pleiotropic and original mechanisms of action, providing them an effect at the heart of the regulation of several physiological functions. However, this broad spectrum of action is also at the origin of various and original side effects, notably a remarkable chronic systemic toxicity. We describe here the 4-AQ-induced lesions on the eye, the heart, muscle, the nerves, the inner ear, and the kidney. We also describe their prevalence, their pathophysiological mechanisms, their risk factors, their potential severity, and the means to detect them early. Most of these side effects are reversible if treatment is stopped promptly. This 4-AQ-induced toxicity must be known to prescribing physicians, to closely monitor its appearance and stop treatment in time if necessary.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:41

Enthalten in:

Rheumatology international - 41(2021), 7 vom: 23. Juli, Seite 1189-1202

Sprache:

Englisch

Beteiligte Personen:

Muller, Romain [VerfasserIn]

Links:

Volltext

Themen:

4QWG6N8QKH
886U3H6UFF
Antirheumatic Agents
Chloroquine
Hydroxychloroquine
Iatrogenesis
Journal Article
Review

Anmerkungen:

Date Completed 11.01.2022

Date Revised 18.02.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00296-021-04868-6

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM324474334