The Pharmacokinetic and Pharmacodynamic Properties of Hydroxychloroquine and Dose Selection for COVID-19: Putting the Cart Before the Horse.

Morrisette, Taylor; Lodise, Thomas P; Scheetz, Marc H; Goswami, Srijib; Pogue, Jason M; Rybak, Michael J

The Pharmacokinetic and Pharmacodynamic Properties of Hydroxychloroquine and Dose Selection for COVID-19: Putting the Cart Before the Horse.

Issue Date

2020-09

Authors

Morrisette, Taylor

Lodise, Thomas P

Scheetz, Marc H

Goswami, Srijib

Pogue, Jason M

Rybak, Michael J

Abstract

Coronavirus disease 2019 (COVID-19), caused by the 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently responsible for a global pandemic. To date, only remdesivir and dexamethasone have demonstrated a positive response in a prospective, randomized trial for the treatment of patients with COVID-19. Hydroxychloroquine (HCQ) is an agent available in an oral formulation with in vitro activity against SARS-CoV-2 that has been suggested as a potential agent. Unfortunately, results of randomized trials evaluating HCQ as treatment against a control group are lacking, and little is known about its pharmacokinetic/pharmacodynamic (PK/PD) profile against SARS-CoV-2. The objective of this review was to describe the current understanding of the PK/PD and dose selection of HCQ against SARS-CoV-2, discuss knowledge gaps, and identify future studies that are needed to optimize the efficacy and safety of treatments against COVID-19.

Citation

Morrisette T, Lodise TP, Scheetz MH, Goswami S, Pogue JM, Rybak MJ. The Pharmacokinetic and Pharmacodynamic Properties of Hydroxychloroquine and Dose Selection for COVID-19: Putting the Cart Before the Horse. Infect Dis Ther. 2020 Sep;9(3):561-572. doi: 10.1007/s40121-020-00325-2. Epub 2020 Aug 1. PMID: 32740858; PMCID: PMC7395206.