Hydroxychloroquine administered for eight weeks as pre-exposure prophylaxis has no clinical benefit in hospital-based health care workers (HCWs) exposed to patients with COVID-19, research published online in JAMA Internal Medicine has shown.
Benjamin S. Abella, M.D., M.Phil., from the University of Pennsylvania in Philadelphia, and colleagues examined the efficacy of hydroxychloroquine to prevent transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in hospital-based HCWs with exposure to COVID-19 patients.
A total of 132 full-time, hospital-based HCWs, 125 of whom were initially asymptomatic and had negative results for SARS-CoV-2, were randomly assigned to either hydroxychloroquine or size-matched placebo for eight weeks as pre-exposure prophylaxis.
The trial was terminated early for futility.
The researchers found that infection rates did not differ significantly among participants randomly assigned to hydroxychloroquine or placebo (6.3 versus 6.6 percent). Participants taking hydroxychloroquine more often had mild adverse events compared with those taking placebo (45 versus 26 percent); the groups had similar rates of treatment discontinuation (19 versus 16 percent).
There was no between-group difference in the median change in QTc (baseline to four-week evaluation; 4 versus 3 milliseconds for hydroxychloroquine versus placebo).
“We cannot recommend the routine use of hydroxychloroquine among HCWs to prevent COVID-19,” the authors added.
REFERENCE: Abella et al: Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers – A Randomized Clinical Trial; https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771265