The relationship between hydroxychloroquine plasma concentration and COVID-19 outcomes in rheumatoid arthritis patients in Saudi Arabia

Ismail A Walbi; Hussain Alqhtani; Faleh Alqahtani; Saad Ahmed Alkahtani; Ali Mohamed Alshabi; Amer S Alali; Hassan A Albarqi

doi:10.1016/j.jsps.2022.05.006

The relationship between hydroxychloroquine plasma concentration and COVID-19 outcomes in rheumatoid arthritis patients in Saudi Arabia

Saudi Pharm J. 2022 Jul;30(7):964-970. doi: 10.1016/j.jsps.2022.05.006. Epub 2022 May 23.

Authors

Ismail A Walbi¹, Hussain Alqhtani¹, Faleh Alqahtani², Saad Ahmed Alkahtani¹, Ali Mohamed Alshabi¹, Amer S Alali³, Hassan A Albarqi⁴

Affiliations

¹ Department of Clinical Pharmacy, College of Pharmacy, Najran University, Najran, Saudi Arabia.
² Department of Pharmacology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
³ Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-kharj, Saudi Arabia.
⁴ Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia.

Abstract

Background: The drug hydroxychloroquine (HCQ) is widely used to treat rheumatoid arthritis (RA) and has been repurposed for the treatment of COVID-19. This study aims to determine whether HCQ concentration levels in individuals with RA alter the incidence of COVID-19 or its complications.

Methods: We collected plasma samples from 13 individuals with confirmed rheumatoid arthritis (RA) to measure HCQ concentration levels. The study included individuals at least 18 years old who had been taking HCQ for at least six months at daily doses ranging from 200 to 400 mg.

Results: The study enrolled a total of 13 RA patients. All patients were chronic HCQ users. Among the 13 patients, 7 patients were receiving HCQ at a dose of 200 mg per day, and 6 patients were receiving HCQ at a dose of 400 mg per day. COVID-19 confirmed cases accounted for approximately 46% of all patients. Half of the infected patients (n = 3) were taking a daily dose of 200 mg daily, while the other half were taking 400 mg daily. COVID-19 symptoms ranged from mild to moderate, and the intensity of the symptoms was not severe enough to necessitate hospitalization. COVID-19 symptoms in RA patients included headache, fever, fatigue, dry cough, and loss of taste or smell.

Conclusions: Our findings indicated that there was no correlation between HCQ concentrations in rheumatoid arthritis patients and the occurrence of COVID-19 or its complications.

Keywords: COVID-19 complications; COVID-19 incidence; Hydroxychloroquine; Rheumatoid arthritis.