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  1. Article ; Online: Chloroquine or Hydroxychloroquine for Management of Coronavirus Disease 2019: Friend or Foe?

    Schluenz, Lauren A / Ramos-Otero, Gerardo P / Nawarskas, James J

    Cardiology in review

    2020  Volume 28, Issue 5, Page(s) 266–271

    Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to be a threat to the health of many humans across the world as they confront coronavirus disease 2019 (COVID-19). Previous promising in vitro data that emerged after the SARS-CoV ... ...

    Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to be a threat to the health of many humans across the world as they confront coronavirus disease 2019 (COVID-19). Previous promising in vitro data that emerged after the SARS-CoV outbreak in 2003, along with the emergent need for pharmacologic management strategies in the fight against COVID-19, prompted interest in the use of chloroquine and hydroxychloroquine across the globe. Unfortunately, the in vitro activity of these drugs did not necessarily correlate with most in vivo studies, which showed no consistent efficacy. Safety is also a major concern, with these agents having a known risk of QT prolongation and proarrhythmic effects. In addition, clinical practice guidelines provide no clear consensus on the role of chloroquine or hydroxychloroquine for the management of COVID-19. The United States Food and Drug Administration has declared that the potential benefits of these agents no longer outweigh the possible risks, and unless new emerging information suggests a more favorable risk:benefit ratio, neither chloroquine nor hydroxychloroquine should be recommended for COVID-19 treatment or prevention at this time.
    MeSH term(s) Arrhythmias, Cardiac/chemically induced ; Betacoronavirus ; COVID-19 ; Chloroquine/therapeutic use ; Coronavirus Infections/drug therapy ; Cytochrome P-450 CYP2D6/metabolism ; Drug Interactions ; Enzyme Inhibitors/therapeutic use ; Humans ; Hydroxychloroquine/therapeutic use ; In Vitro Techniques ; Long QT Syndrome/chemically induced ; Pandemics ; Pneumonia, Viral/drug therapy ; Practice Guidelines as Topic ; SARS-CoV-2 ; Torsades de Pointes/chemically induced ; Treatment Outcome
    Chemical Substances Enzyme Inhibitors ; Hydroxychloroquine (4QWG6N8QKH) ; Chloroquine (886U3H6UFF) ; Cytochrome P-450 CYP2D6 (EC 1.14.14.1)
    Keywords covid19
    Language English
    Publishing date 2020-08-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1294965-6
    ISSN 1538-4683 ; 1061-5377
    ISSN (online) 1538-4683
    ISSN 1061-5377
    DOI 10.1097/CRD.0000000000000329
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Chloroquine or Hydroxychloroquine for Management of Coronavirus Disease 2019: Friend or Foe?

    Schluenz, Lauren A / Ramos-Otero, Gerardo P / Nawarskas, James J

    Cardiol Rev

    Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to be a threat to the health of many humans across the world as they confront coronavirus disease 2019 (COVID-19). Previous promising in vitro data that emerged after the SARS-CoV ... ...

    Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to be a threat to the health of many humans across the world as they confront coronavirus disease 2019 (COVID-19). Previous promising in vitro data that emerged after the SARS-CoV outbreak in 2003, along with the emergent need for pharmacologic management strategies in the fight against COVID-19, prompted interest in the use of chloroquine and hydroxychloroquine across the globe. Unfortunately, the in vitro activity of these drugs did not necessarily correlate with most in vivo studies, which showed no consistent efficacy. Safety is also a major concern, with these agents having a known risk of QT prolongation and proarrhythmic effects. In addition, clinical practice guidelines provide no clear consensus on the role of chloroquine or hydroxychloroquine for the management of COVID-19. The United States Food and Drug Administration has declared that the potential benefits of these agents no longer outweigh the possible risks, and unless new emerging information suggests a more favorable risk:benefit ratio, neither chloroquine nor hydroxychloroquine should be recommended for COVID-19 treatment or prevention at this time.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #707022
    Database COVID19

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  3. Article ; Online: Treatment Effectiveness and Medication Use Reduction for Older Adults in Interdisciplinary Pain Rehabilitation.

    Schumann, Matthew E / Lapid, Maria I / Cunningham, Julie L / Schluenz, Lauren / Gilliam, Wesley P

    Mayo Clinic proceedings. Innovations, quality & outcomes

    2020  Volume 4, Issue 3, Page(s) 276–286

    Abstract: Objective: To examine the effectiveness of an interdisciplinary pain rehabilitation program (IPRP) that incorporates medication tapering on improving pain-related and performance-based outcomes for older adults with chronic noncancer pain and determine ... ...

    Abstract Objective: To examine the effectiveness of an interdisciplinary pain rehabilitation program (IPRP) that incorporates medication tapering on improving pain-related and performance-based outcomes for older adults with chronic noncancer pain and determine the proportion who demonstrated reliable improvement in outcome.
    Patients and methods: This 2-year retrospective clinical cohort study examined treatment outcomes of 134 older adult patients 65 years or older with chronic noncancer pain who completed a 3-week IPRP with physician-supervised medication tapering between January 1, 2015, and December 31, 2017. Pain, pain catastrophizing, depressive symptoms, and quality of life were assessed at pretreatment, posttreatment, and follow-up. Physical performance and medication use were assessed pre- and posttreatment. Outcomes were examined using a series of repeated-measures analyses of variance, examining effect size and reliable change.
    Results: Significant treatment effects (
    Conclusion: Older adults with chronic noncancer pain demonstrated improved pain-related outcomes, physical performance, and decreased medication use following IPRP treatment. Results support the effectiveness of IPRPs in enhancing the physical and emotional functioning of older adults with chronic pain while also facilitating the reduction of medications that place them at risk for adverse events.
    Language English
    Publishing date 2020-05-08
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2542-4548
    ISSN (online) 2542-4548
    DOI 10.1016/j.mayocpiqo.2020.01.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Treatment Effectiveness and Medication Use Reduction for Older Adults in Interdisciplinary Pain Rehabilitation

    Matthew E. Schumann, PhD / Maria I. Lapid, MD / Julie L. Cunningham, PharmD / Lauren Schluenz, PharmD / Wesley P. Gilliam, PhD

    Mayo Clinic Proceedings: Innovations, Quality & Outcomes, Vol 4, Iss 3, Pp 276-

    2020  Volume 286

    Abstract: Objective: To examine the effectiveness of an interdisciplinary pain rehabilitation program (IPRP) that incorporates medication tapering on improving pain-related and performance-based outcomes for older adults with chronic noncancer pain and determine ... ...

    Abstract Objective: To examine the effectiveness of an interdisciplinary pain rehabilitation program (IPRP) that incorporates medication tapering on improving pain-related and performance-based outcomes for older adults with chronic noncancer pain and determine the proportion who demonstrated reliable improvement in outcome. Patients and Methods: This 2-year retrospective clinical cohort study examined treatment outcomes of 134 older adult patients 65 years or older with chronic noncancer pain who completed a 3-week IPRP with physician-supervised medication tapering between January 1, 2015, and December 31, 2017. Pain, pain catastrophizing, depressive symptoms, and quality of life were assessed at pretreatment, posttreatment, and follow-up. Physical performance and medication use were assessed pre- and posttreatment. Outcomes were examined using a series of repeated-measures analyses of variance, examining effect size and reliable change. Results: Significant treatment effects (P<.001) with large effect sizes were observed for all self-report and physical performance outcome measures at posttreatment and 6-month follow-up (42.5% response rate). There were no significant differences in outcome based on opioid use status at admission. Reliable change analyses revealed that 76.9% (n=103 of 134) evidenced improvement in at least 1 pain-related outcome measure at posttreatment, and 87.7% (n=50 of 57), at follow-up. Patients also had significant reductions (P<.01) in medications at posttreatment (opioids, benzodiazepines, sedative-hypnotics, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, and anticonvulsants). Conclusion: Older adults with chronic noncancer pain demonstrated improved pain-related outcomes, physical performance, and decreased medication use following IPRP treatment. Results support the effectiveness of IPRPs in enhancing the physical and emotional functioning of older adults with chronic pain while also facilitating the reduction of ...
    Keywords Medicine (General) ; R5-920
    Subject code 150
    Language English
    Publishing date 2020-06-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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