TY  - JOUR
PY  - 2020//
TI  - Extracorporeal treatment for chloroquine, hydroxychloroquine, and quinine poisoning: systematic review and recommendations from the EXTRIP Workgroup
JO  - Journal of the American Society of Nephrology
A1  - Berling, Ingrid
A1  - King, Joshua D.
A1  - Shepherd, Greene
A1  - Hoffman, Robert S.
A1  - Alhatali, Badria
A1  - Lavergne, Valery
A1  - Roberts, Darren M.
A1  - Gosselin, Sophie
A1  - Wilson, Gabrielle
A1  - Nolin, Thomas D.
A1  - Ghannoum, Marc
A1  - EXTRIP workgroup, 
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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.<p />  <p>Language: en</p>
LA  - en
SN  - 1046-6673
UR  - http://dx.doi.org/10.1681/ASN.2020050564
ID  - ref1
ER  -