Cor Vasa 2021, 63(5):564-571 | DOI: 10.33678/cor.2021.053

Comparison of hydroxychloroquine plus moxifloxacin versus hydroxychloroquine alone on corrected QT interval prolongation in COVID-19 patients

Veysel Yavuza, Ferhat Ozyurtlub, Nurullah Cetinc
a Department of Cardiology, Akhisar Mustafa Kirazoglu State Hospital, Manisa, Turkey
b Department of Cardiology, Grandmedical Hospital, Manisa, Turkey
c Department of Cardiology, Celal Bayar University, Manisa, Turkey

Background: Hydroxychloroquine (HCQ) alone or with some antibiotic and antiviral agents is used off label in the treatment of Coronavirus Disease 2019 (COVID-19). It seems that the most important safety problem about these medications are their cardiac side effects. Although there are data on arrhythmogenic events associated with the use of HCQ alone, such as corrected QT (QTc) prolongation, Torsade de pointes (TdP) or bradycardia, there are insufficient data on its combination with moxifloxacin (MOX).

Keywords: Corrected QT interval, Hydroxychloroquine, Moxifloxacin

Received: March 22, 2021; Revised: April 15, 2021; Accepted: April 17, 2021; Published: October 20, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Yavuz V, Ozyurtlu F, Cetin N. Comparison of hydroxychloroquine plus moxifloxacin versus hydroxychloroquine alone on corrected QT interval prolongation in COVID-19 patients. Cor Vasa. 2021;63(5):564-571. doi: 10.33678/cor.2021.053.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Chen L, Liu W, Zhang Q, et al. RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia cases in 2019 Wuhan outbreak. Emerg Microbes Infect 2020;9:313-319. Go to original source... Go to PubMed...
    2. Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020;382:727-733. Go to original source... Go to PubMed...
    3. Chen CY, Wang FL, Lin CC. Chronic hydroxychloroquine use associated with QT prolongation and refractory ventricular arrhythmia. Clin Toxicol (Phila) 2006;44:173-175. Go to original source... Go to PubMed...
    4. Soumya RS, Unni TG, Raghu KG. Impact of COVID-19 on the Cardiovascular System: A Review of Available Reports. Cardiovasc Drugs Ther 2021;35:411-425. Go to original source... Go to PubMed...
    5. Garcia-Cremades M, Solans BP, Hughes E, et al. Optimizing Hydroxychloroquine Dosing for Patients With COVID-19: An Integrative Modeling Approach for Effective Drug Repurposing. Clin Pharmacol Ther 2020;108:253-263. Go to original source... Go to PubMed...
    6. Briasoulis A, Agarwal V, Pierce WJ. QT prolongation and torsade de pointes induced by fluoroquinolones: infrequent side effects from commonly used medications. Cardiology 2011;120:103-110. Go to original source... Go to PubMed...
    7. Ministry of Health (2019). Ulusal Pandemi Hazirlik Plani [online].Website: https://hsgm.saglik.gov.tr/tr/bulasicihastaliklar-haberler/ulusal-pandemi-hazirlik-plani.html [accessed 17. April 2020]
    8. Anderson ME, Al-Khatib SM, Roden DM, Califf RM. Cardiac repolarization: Current knowledge, critical gaps, and new approaches to drug development and patient management. Am Heart J 2002;144:769-781. Go to original source... Go to PubMed...
    9. Clerkin KJ, Fried JA, Raikhelkar J, et al. COVID-19 and Cardiovascular Disease. Circulation 2020;141:1648-1655. Go to original source... Go to PubMed...
    10. Chen Z, Hu J, Zhang Z, et al. Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. MedRxiv 2020:2020.03.22.20040758. Go to original source...
    11. Mercuro NJ, Yen CF, Shim DJ, et al. Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19). JAMA Cardiology 2020;5:1036-1041. Go to original source... Go to PubMed...
    12. Saleh M, Gabriels J, Chang D, et al. Effect of Chloroquine, Hydroxychloroquine, and Azithromycin on the Corrected QT Interval in Patients With SARS-CoV-2 Infection. Circ Arrhythm Electrophysiol 2020;13:e008662. Go to original source... Go to PubMed...
    13. Capel RA, Herring N, Kalla M, et al. Hydroxychloroquine reduces heart rate by modulating the hyperpolarization-activated current If: Novel electrophysiological insights and therapeutic potential. Heart Rhythm 2015;12:2186-2194. Go to original source... Go to PubMed...
    14. Cairoli E, Danese N, Teliz M, et al. Cumulative dose of hydroxychloroquine is associated with a decrease of resting heart rate in patients with systemic lupus erythematosus: a pilot study. Lupus 2015;24:1204-1209. Go to original source... Go to PubMed...
    15. Romani S, Gérard A, Fresse A, et al. Insights on the evidence of cardiotoxicity of hydroxychloroquine prior and during COVID-19 epidemic. Clin Transl Sci 2021;14:163-169. Go to original source... Go to PubMed...
    16. Rubinstein E, Camm J. Cardiotoxicity of fluoroquinolones. J Antimicrob Chemother 2002;49:593-596. Go to original source... Go to PubMed...
    17. Viskin S, Justo D, Halkin A, Zeltser D. Long QT syndrome caused by noncardiac drugs. Prog Cardiovasc Dis 2003;45:415-427. Go to original source... Go to PubMed...
    18. Afsin A, Ecemis K, Asoglu R. Effects of Short-Term Hydroxychloroquine Plus Moxifloxacin Therapy on Corrected QT Interval and Tp-e Interval in Patients With COVID-19. J Clin Med Res 2020;12:604-611. Go to original source... Go to PubMed...
    19. Tisdale JE, Jaynes HA, Kingery JR, et al. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes 2013;6:479-487. Go to original source... Go to PubMed...
    20. Sala M, Vicentini A, Brambilla P, Montomoli C, Jogia JR, Caverzasi E, et al. QT interval prolongation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy. Ann Gen Psychiatry 2005;4:1. Go to original source... Go to PubMed...
    21. Kim EJ, Shin WH, Kim KS, Han SS. Safety pharmacology of DW-224a, a novel fluoroquinolone antibiotic agent. Drug Chem Toxicol 2004;27:295-307. Go to original source... Go to PubMed...
    22. Mason JW, Moon TE. Moxifloxacin Increases Heart Rate in Humans. Antibiotics (Basel, Switzerland) 2017;6:5. Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content


    Cor et Vasa

    You are accessing a site intended for medical professionals, not the lay public. The site may also contain information that is intended only for persons authorized to prescribe and dispense medicinal products for human use.

    I therefore confirm that I am a healthcare professional under Act 40/1995 Coll. as amended by later regulations and that I have read the definition of a healthcare professional.


    No
    Yes