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Abstract
Hydroxychloroquine has recently received attention as a treatment for COVID-19. However, it may prolong the QTc interval. Furthermore, when hydroxychloroquine is administered concomitantly with other drugs, it can exacerbate the risk of QT prolongation. Nevertheless, the risk of QT prolongation due to drug-drug interactions (DDIs) between hydroxychloroquine and concomitant medications has not yet been identified. To evaluate the risk of QT prolongation due to DDIs between hydroxychloroquine and 118 concurrent drugs frequently used in real-world practice, we analyzed the electrocardiogram results obtained for 447,632 patients and their relevant electronic health records in a tertiary teaching hospital in Korea from 1996 to 2018. We repeated the case–control analysis for each drug. In each analysis, we performed multiple logistic regression and calculated the odds ratio (OR) for each target drug, hydroxychloroquine, and the interaction terms between those two drugs. The DDIs were observed in 12 drugs (trimebutine, tacrolimus, tramadol, rosuvastatin, cyclosporin, sulfasalazine, rofecoxib, diltiazem, piperacillin/tazobactam, isoniazid, clarithromycin, and furosemide), all with a p value of < 0.05 (OR 1.70–17.85). In conclusion, we found 12 drugs that showed DDIs with hydroxychloroquine in the direction of increasing QT prolongation.
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1 Ajou University School of Medicine, Department of Biomedical Informatics, Suwon, Republic of Korea (GRID:grid.251916.8) (ISNI:0000 0004 0532 3933)
2 Ajou University School of Medicine, Department of Pulmonology and Critical Care Medicine, Suwon, Republic of Korea (GRID:grid.251916.8) (ISNI:0000 0004 0532 3933)
3 Ajou University School of Medicine, Department of Cardiology, Suwon, Republic of Korea (GRID:grid.251916.8) (ISNI:0000 0004 0532 3933)
4 Ajou University School of Medicine, Department of Biomedical Informatics, Suwon, Republic of Korea (GRID:grid.251916.8) (ISNI:0000 0004 0532 3933); Ajou University Medical Center, Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Suwon, Republic of Korea (GRID:grid.411261.1) (ISNI:0000 0004 0648 1036)
5 Ajou University School of Medicine, Department of Biomedical Informatics, Suwon, Republic of Korea (GRID:grid.251916.8) (ISNI:0000 0004 0532 3933); Yonsei University College of Medicine, Department of Biomedical Systems Informatics, Yongin, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)