clinvestКачественная клиническая практикаKachestvennaya Klinicheskaya Praktika = Good Clinical Practice2588-05192618-8473ООО «Издательство ОКИ10.37489/2588-0519-2020-S4-81-86clinvest-533Research ArticleАКТУАЛЬНЫЕ ОБЗОРЫACTUAL REVIEWВозможность использования гидроксихлорохина для профилактики инфицирования SARS-CoV-2 у контактных лиц и медицинских работниковPossibilities for the use of hydroxychloroquine for pre- and postexposure prophylaxis of SARS-CoV-2 infection among exposed contacts and healthcare personnelhttps://orcid.org/0000-0003-0623-7263ОтделеновВ. А.OtdelenovV. A.

Отделенов Виталий Александрович – доцент кафедры клинической фармакологии и терапии. SPIN-код: 8357-5770

Москва

Otdelenov Vitaly A. – Associate Professor of the Department of Clinical Pharmacology and Therapy. SPIN code: 8357-5770

Moscow

https://orcid.org/0000-0001-7903-2977КрюковА. В.KrykovA. V.

Крюков Александр Викторович – к. м. н., ассистент кафедры онкологии и паллиативной медицины. SPIN-код: 1568-4967

Москва

Kryukov Alexander V. – Candidate of Medical Sciences, assistant of the Department of Oncology and palliative medicine of the Department of Clinical Pharmacology and Therapy. SPIN code: 1568-4967

Moscow

https://orcid.org/0000-0002-4496-3680СычёвД. А.SychevD. A.

Сычёв Дмитрий Алексеевич – д. м. н., профессор, член-корр. РАН, ректор, зав. кафедрой клинической фармакологии и терапии. SPIN-код: 4525-7556

Москва

Sychev Dmitry A. – Doctor of Medical Sciences, Professor, Corresponding Member RAS, Rector, Head. Department of Clinical Pharmacology and Therapy. SPIN code: 4525-7556

Moscow

dmitriy.alex.sychev@gmail.comФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuing Professional Education of the Ministry of Health of RussiaRussian Federation20202810202004SФармаCOVID8186Copyright © Отделенов В.А., Крюков А.В., Сычёв Д.А., 20202020Отделенов В.А., Крюков А.В., Сычёв Д.А.Otdelenov V.A., Krykov A.V., Sychev D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinvest.ru/jour/article/view/533

В настоящее время не обнаружено убедительных научных данных, подтверждающих эффективность и безопасность применения гидроксихлорохина (ГХХ) в качестве первичной доконтактной или постконтактной профилактики инфицирования SARS-CoV-2. С учётом результатов исследований in vitro, свидетельствующих о наличии ингибирующей активности ГХХ в отношении SARS-CoV-2, и на основе временных клинических рекомендаций Минздрава, применение ГХХ для постконтактной профилактики может быть рассмотрено у медицинских работников, контактировавших с пациентами с лабораторно подтверждённым SARS-CoV-2, при отсутствии противопоказаний и значимых межлекарственных взаимодействий. Перед назначением и во время приёма рекомендуется проведение мониторинга безопасности ГХХ (контроль ЭКГ, общего (клинического) и биохимического анализов крови, консультация офтальмолога перед началом длительного курса применения ГХХ).

There currently exists no published robust data which would confirm effectiveness and safety of hydroxychloroquine in pre- and postexposure prophylaxis of SARS-CoV-2 infection. Taking into account in vitro data, which indicates inhibitory activity of hydroxychloroquine against SARS-CoV-2, and interim guidelines by the Ministry of Health of the Russian Federation, hydroxychloroquine can be considered as postexposure prophylaxis among healthcare personnel who have been in contact with patients with laboratory confirmed SARS-CoV-2, provided no contraindications and significant drug interactions are present. Safety monitoring should be performed before prescribing and during the course of treatment (ECG, total blood count and blood biochemistry, ophthalmologist evaluation before long-term treatment).

коронавирусгидроксихлорохинCOVID-19coronavirushydroxychloroquineCOVID-19ReferencesГосударственный реестр лекарственных средств. Запрос «гидроксихлорохин», поиск по МНН. [Электронный ресурс]. Доступно по: https://clck.ru/RBf9h Ссылка активна на 14.05.2020State register of medicines. Query «hydroxychloroquine», search by MNN. (In Russ). Доступно по: https://clck.ru/RBf9h Ссылка активна на 14.05.2020Государственный реестр лекарственных средств. Лекарственный препарат Плаквенил. [Электронный ресурс]. Доступно по: https://clck.ru/RBf8n Ссылка активна на 14.05.2020State register of medicines. The drug Plakvenil. (In Russ). Доступно по: https://clck.ru/RBf8n Ссылка активна на 14.05.2020Yao X, Ye F, Zhang M et al. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis. 2020 Jul 28;71(15):732-739. DOI: 10.1093/cid/ciaa237Yao X, Ye F, Zhang M et al. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis. 2020 Jul 28;71(15):732-739. DOI: 10.1093/cid/ciaa237Vincent MJ, Bergeron E, Benjannet S, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J. 2005 Aug 22;2:69. DOI: 10.1186/1743-422X-2-69Vincent MJ, Bergeron E, Benjannet S, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J. 2005 Aug 22;2:69. DOI: 10.1186/1743-422X-2-69Liu J, Cao R, Xu M et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov. 2020 Mar 18;6:16. DOI: 10.1038/s41421-020-0156-0Liu J, Cao R, Xu M et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov. 2020 Mar 18;6:16. DOI: 10.1038/s41421-020-0156-0Keyaerts E, Vijgen L, Maes P, Neyts J, Van Ranst M. In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine. Biochem Biophys Res Commun. 2004 Oct 8;323(1):264-8. DOI: 10.1016/j.bbrc.2004.08.085.Keyaerts E, Vijgen L, Maes P, Neyts J, Van Ranst M. In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine. Biochem Biophys Res Commun. 2004 Oct 8;323(1):264-8. DOI: 10.1016/j.bbrc.2004.08.085.Devaux CA, Rolain JM, Colson P, Raoult D. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int J Antimicrob Agents. 2020 May;55(5):105938. DOI: 10.1016/j.ijantimicag.2020.105938Devaux CA, Rolain JM, Colson P, Raoult D. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int J Antimicrob Agents. 2020 May;55(5):105938. DOI: 10.1016/j.ijantimicag.2020.105938Временные методические рекомендации Министерства здравоохранения РФ по профилактике, диагностике и лечению новой коронавирусной инфекции (COVID-19). 6-е изд., Москва: Министерство здравоохранения Российской Федерации, 2020. (28.04.2020). Доступно по: URL: https://clck.ru/NCM6x Ссылка активна на 14.05.2020THE PROVISIONAL GUIDELINES. Prevention, diagnosis and treatment of new coronavirus infection (COVID-19) 6th ed., Moscow: Ministry of health of the Russian Federation, 2020. (28.04.2020) (In Russ). Доступно по: URL: https://clck.ru/NCM6x Ссылка активна на 14.05.2020Devaux CA, Rolain JM, Colson P et al. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int J Antimicrob Agents. 2020 May;55(5):105938. DOI 10.1016/j.ijantimicag.2020.105938Devaux CA, Rolain JM, Colson P et al. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int J Antimicrob Agents. 2020 May;55(5):105938. DOI 10.1016/j.ijantimicag.2020.105938Barber BE. Chloroquine and Hydroxychloroquine. In: Grayson ML, ed. Kucers’ the use of antibiotics: a clinical review of antibacterial, antifungal, antiparasitic, and antiviral drugs. 7th ed. Boca Raton, FL: CRC Press; 2018: 3030-48.Barber BE. Chloroquine and Hydroxychloroquine. In: Grayson ML, ed. Kucers’ the use of antibiotics: a clinical review of antibacterial, antifungal, antiparasitic, and antiviral drugs. 7th ed. Boca Raton, FL: CRC Press; 2018: 3030-48.Sahraei Z, Shabani M, Shokouhi S et al. Aminoquinolines against coronavirus disease 2019 (COVID-19): chloroquine or hydroxychloroquine. Int J Antimicrob Agents. 2020 Apr;55(4):105945. DOI: 10.1016/j.ijantimicag.2020.105945Sahraei Z, Shabani M, Shokouhi S et al. Aminoquinolines against coronavirus disease 2019 (COVID-19): chloroquine or hydroxychloroquine. Int J Antimicrob Agents. 2020 Apr;55(4):105945. DOI: 10.1016/j.ijantimicag.2020.105945Zhou D, Dai SM, Tong Q. COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression. J Antimicrob Chemother. 2020 Jul 1;75(7):1667-1670. DOI: 10.1093/jac/dkaa114Zhou D, Dai SM, Tong Q. COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression. J Antimicrob Chemother. 2020 Jul 1;75(7):1667-1670. DOI: 10.1093/jac/dkaa114COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. [Internet]. [cited 2002 May 14] Available from: https://covid19treatmentguidelines.nih.gov/COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. [Internet]. [cited 2002 May 14] Available from: https://covid19treatmentguidelines.nih.gov/Coronavirus (COVID-19) Update: FDA Reiterates Importance of Close Patient Supervision for ‘Off-Label’ Use of Antimalarial Drugs to Mitigate Known Risks, Including Heart Rhythm Problems [Internet]. [cited 2002 May 14] Available from: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-reiterates-importance-close-patientsupervision-label-useCoronavirus (COVID-19) Update: FDA Reiterates Importance of Close Patient Supervision for ‘Off-Label’ Use of Antimalarial Drugs to Mitigate Known Risks, Including Heart Rhythm Problems [Internet]. [cited 2002 May 14] Available from: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-reiterates-importance-close-patientsupervision-label-useHRS COVID-19 Task Force Update: April 21, 2020. [Internet]. [cited 2002 May 14] Available from: https://www.hrsonline.org/COVID19Challenges-Solutions/hrs-covid-19-task-force-update-april-21-2020HRS COVID-19 Task Force Update: April 21, 2020. [Internet]. [cited 2002 May 14] Available from: https://www.hrsonline.org/COVID19Challenges-Solutions/hrs-covid-19-task-force-update-april-21-2020Liverpool Drug Interaction Group, University of Liverpool, Pharmacology Research Labs. Detailed recommendations for interactions with experimental COVID-19 therapies. [Internet]. [cited 2002 May 14] Available from: https://www.covid19-druginteractions.org/Liverpool Drug Interaction Group, University of Liverpool, Pharmacology Research Labs. Detailed recommendations for interactions with experimental COVID-19 therapies. [Internet]. [cited 2002 May 14] Available from: https://www.covid19-druginteractions.org/Clinicaltrials.gov Search Results for «Hydroxychloroquine prophylaxis healthcare | COVID-19» [Internet]. [cited 2002 May 14] Available from: https://clck.ru/RBfCCClinicaltrials.gov Search Results for «Hydroxychloroquine prophylaxis healthcare | COVID-19» [Internet]. [cited 2002 May 14] Available from: https://clck.ru/RBfCCGiudicessi JR, Noseworthy PA, Friedman PA, Ackerman MJ. Urgent Guidance for Navigating and Circumventing the QTc-Prolonging and Torsadogenic Potential of Possible Pharmacotherapies for Coronavirus Disease 19 (COVID-19). Mayo Clin Proc. 2020 Jun;95(6):1213-1221. DOI: 10.1016/j.mayocp.2020.03.024Giudicessi JR, Noseworthy PA, Friedman PA, Ackerman MJ. Urgent Guidance for Navigating and Circumventing the QTc-Prolonging and Torsadogenic Potential of Possible Pharmacotherapies for Coronavirus Disease 19 (COVID-19). Mayo Clin Proc. 2020 Jun;95(6):1213-1221. DOI: 10.1016/j.mayocp.2020.03.024

The authors declare that there are no conflicts of interest present.