Eficácia, efetividade e segurança da Hidroxicloroquina no tratamento da COVID-19: Revisão Sistemática e Meta-análise

Revisão Sistemática com Meta-análise

DOI: 10.13140/RG.2.2.29697.68964/3

RESUMO EXECUTIVO

Introdução: O Brasil passou a ser o novo epicentro da pandemia e recente diretriz do Ministério da Saúde recomenda tratamento precoce com hidroxicloroquina (HCQ) para pacientes com COVID-19.

Objetivo: Avaliar a eficácia, efetividade e segurança da hidroxicloroquina para tratar a COVID-19.

Métodos: Realizou-se uma busca sistemática nas bases Cochrane, MEDLINE via Pubmed, EMBASE e LILACS. Incluiu-se ensaios clínicos, coortes e caso-controle, com pacientes hospitalizados e com grupo comparador, publicados em revistas indexadas revisadas por pares.

Resultados: Foram selecionados seis estudos, dois ensaios clínicos, quatro coortes. Realizou-se meta-análise com três estudos que não apresentaram heterogeneidade significativa. A mortalidade e a ocorrência de eventos adversos graves foram maiores entre os pacientes que utilizaram a hidroxicloroquina.

Conclusão: Ainda na ausência de um estudo robusto que comprove a eficácia da hidroxicloroquina, os estudos
existentes demonstraram que os pacientes dos grupos que utilizaram o medicamento apresentaram desfecho de segurança desfavorável. Seguindo o princípio da não-maleficência, a hidroxicloroquina deve ser restrita até que sua eficácia ou efetividade sejam comprovadas, superando os riscos.

Palavras-chave: Revisão Sistemática. Coronavirus. Hidroxicloroquina. Eficácia. Efetividade.

Abstract:
Introduction: Brazil has become the new pandemic epicenter and a recent guideline from the Ministry of Health recommends early treatment with hydroxychloroquine (HCQ) for patients with COVID-19.

Objective: To evaluate the efficacy, effectiveness, and safety of hydroxychloroquine to treat COVID-19.

Methods: A systematic search was performed on the Cochrane, MEDLINE via Pubmed, EMBASE and LILACS databases. The inclusion criteria for the studies were: clinical trials, cohorts and case-control, with hospitalized patients and a comparator group, published in indexed peer-reviewed journals.

Results: Six studies were selected, two clinical trials and four cohorts. A meta-analysis was performed with three studies that did not show significant heterogeneity. Mortality and the occurrence of serious adverse events were higher among patients who used hydroxychloroquine.

Conclusion: In the absence
of a robust study that proves the efficacy of hydroxychloroquine, existing studies have shown that patients in the groups that used the drug had an unfavorable safety outcome. Following the principle of non-maleficence, hydroxychloroquine must be restricted until its efficacy or effectiveness is proven, overcoming the risks.

Keywords: Systematic Review. Coronavirus. Hydroxychloroquine. Efficacy. Effectiveness.

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