Hydroxychloroquine reduces interleukin-6 levels after myocardial infarction: The randomized, double-blind, placebo-controlled OXI pilot trial. (15th August 2021) - Ulander, Lotta
Abstract: Objectives: To determine the anti-inflammatory effect and safety of hydroxychloroquine after acute myocardial infarction. Method: In this multicenter, double-blind, placebo-controlled OXI trial, 125 myocardial infarction patients were randomized at a median of 43 h after hospitalization to receive hydroxychloroquine 300 mg ( n = 64) or placebo ( n = 61) once daily for 6 months and, followed for an average of 32 months. Laboratory values were measured at baseline, 1, 6, and 12 months. Results: The levels of interleukin-6 (IL-6) were comparable at baseline between study groups ( p = 0.18). At six months, the IL-6 levels were lower in the hydroxychloroquine group ( p = 0.042, between groups), and in the on-treatment analysis, the difference at this time point was even more pronounced ( p = 0.019, respectively). The high-sensitivity C-reactive protein levels did not differ significantly between study groups at any time points. Eleven patients in the hydroxychloroquine group and four in the placebo group had adverse events leading to interruption or withdrawal of study medication, none of which was serious ( p = 0. 10, between groups). Conclusions: In patients with myocardial infarction, hydroxychloroquine reduced IL-6 levels significantly more than did placebo without causing any clinically significant adverse events. A larger randomized clinical trial is warranted to prove the potential ability of hydroxychloroquine to reduce cardiovascular endpoints after myocardial infarction. Highlights: The first randomized trial of hydroxychloroquine in patients with a recent myocardial infarction. Hydroxychloroquine reduced IL-6 levels more than placebo when treatment was continued six months. Treatment with hydroxychloroquine was safe. The number of adverse events did not differ between the hydroxychloroquine and placebo groups. A larger trial is warranted to prove if hydroxychloroquine can reduce cardiovascular endpoints.