Use of repurposed and adjuvant drugs in hospital patients with covid-19 : multinational network cohort study
Prats-Uribe, Albert (Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK)
Sena, Anthony G. (Department of Medical Informatics, Erasmus University Medical Center, Rotterdam)
Lai, Lana Yin Hui (Division of Cancer Sciences, School of Medical Sciences, University of Manchester)
Ahmed, Waheed-Ul-Rahman (College of Medicine and Health, University of Exeter)
Alghoul, Heba (Faculty of Medicine, Islamic University of Gaza)
Alser, Osaid (Harvard Medical School)
Alshammari, Thamir (College of Pharmacy, Riyadh Elm University)
Areia, Carlos (Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford)
Carter, William (University of Colorado Anschutz Medical Campus, Aurora)
Casajust, Paula (Trial Form Support (Barcelona, Catalunya))
Dawoud, Dalia (National Institute for Health and Care Excellence, London)
Golozar, Asieh (Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore)
Jonnagaddala, Jitendra (School of Population Health, UNSW Sydney)
Mehta, Paras P. (College of Medicine, University of Arizona)
Gong, Mengchun (DHC Technologies, Beijing)
Morales, Daniel R. (Department of Public Health, University of Southern Denmark)
Nyberg, Fredrik (School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg)
Posada, Jose D. (Department of Medicine, Stanford University School of Medicine)
Recalde, Martina (Universitat Autònoma de Barcelona)
Roel, Elena (Universitat Autònoma de Barcelona)
Shah, Karishma (Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK)
Shah, Nigam H. (Department of Medicine, Stanford University School of Medicine, Stanford)
Schilling, Lisa M. (University of Colorado Anschutz Medical Campus, Aurora)
Subbian, Vignesh (College of Engineering, University of Arizona Tucson)
Vizcaya, David (Bayer Pharmaceuticals, Sant Joan Despí)
Zhang, Lin (School of Population and Global Health, University of Melbourne, Melbourne)
Zhang, Ying (DHC Technologies, Beijing)
Zhu, Hong (Nanfang University, Southern Medical University, Guangzhou)
Liu, Li (Nanfang University, Southern Medical University, Guangzhou)
Cho, Jaehyeong (Department of Biomedical Informatics, Ajou University School of Medicine, Suwon)
Lynch, Kristine E. (VA Informatics and Computing Infrastructure, VA Salt Lake City Healthcare System; Department of Internal Medicine, University of Utah School of Medicine)
Matheny, Michael E. (Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville)
You, Seng Chan (Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul)
Rijnbeek, Peter R. (Department of Medical Informatics, Erasmus University Medical Center, Rotterdam)
Hripcsak, George (Department of Biomedical Informatics, Columbia University, New York)
Lane, Jennifer C. E. (Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford)
Burn, Edward (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Reich, Christian (IQVIA, Cambridge)
Suchard, Marc A. (Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles)
Duarte-Salles, Talita 1985- (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Kostka, Kristin (OHDSI Center at The Roux Institute, Northeastern University, Portland)
Ryan, Patrick B. (Columbia University Irving Medical Center, New York)
Prieto-Alhambra, Daniel (Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford)

Date:	2021
Abstract:	To investigate the use of repurposed and adjuvant drugs in patients admitted to hospital with covid-19 across three continents. Multinational network cohort study. Hospital electronic health records from the United States, Spain, and China, and nationwide claims data from South Korea. 303 264 patients admitted to hospital with covid-19 from January 2020 to December 2020. Prescriptions or dispensations of any drug on or 30 days after the date of hospital admission for covid-19. Of the 303 264 patients included, 290 131 were from the US, 7599 from South Korea, 5230 from Spain, and 304 from China. 3455 drugs were identified. Common repurposed drugs were hydroxychloroquine (used in from <5 (<2%) patients in China to 2165 (85. 1%) in Spain), azithromycin (from 15 (4. 9%) in China to 1473 (57. 9%) in Spain), combined lopinavir and ritonavir (from 156 (<2%) in the VA-OMOP US to 2,652 (34. 9%) in South Korea and 1285 (50. 5%) in Spain), and umifenovir (0% in the US, South Korea, and Spain and 238 (78. 3%) in China). Use of adjunctive drugs varied greatly, with the five most used treatments being enoxaparin, fluoroquinolones, ceftriaxone, vitamin D, and corticosteroids. Hydroxychloroquine use increased rapidly from March to April 2020 but declined steeply in May to June and remained low for the rest of the year. The use of dexamethasone and corticosteroids increased steadily during 2020. Multiple drugs were used in the first few months of the covid-19 pandemic, with substantial geographical and temporal variation. Hydroxychloroquine, azithromycin, lopinavir-ritonavir, and umifenovir (in China only) were the most prescribed repurposed drugs. Antithrombotics, antibiotics, H2 receptor antagonists, and corticosteroids were often used as adjunctive treatments. Research is needed on the comparative risk and benefit of these treatments in the management of covid-19.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	The BMJ, Vol. 373 (may 2021) , ISSN 1756-1833

DOI: 10.1136/bmj.n1038
PMID: 33975825

12 p, 9.5 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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