Abstract
Early studies suggesting that chloroquine (CQ) and hydroxychloroquine (HCQ) could benefit coronavirus patients brought these old medicines back to the spotlight. This led to an increase in demand and price, turning their counterfeiting a pharmacovigilance issue worldwide. Meanwhile, lack of evidence on effectiveness and safety concerns have reduced their clinical trials in severe COVID-19 cases. Despite the knowledge that CQ and HCQ toxic effects are stereo specific rather than their therapeutic effects, these drugs are available only as racemates. In this context, this work brings a discussion about chiral switching to their eutomers so that CQ and HCQ distomers would become impurities, what may be a viable alternative to test new dose-response curves. Even if it is proven that the use of pure CQ and HCQ enantiomers are useless against COVID-19, chiral switching would certainly improve safety and efficacy in the treatment of many autoimmune inflammatory diseases, benefiting chronic users of these drugs.
Highlights
Why is this fuss all about?In late 2019, a group of patients with a severe acute respiratory syndrome (SARS) of unknown cause appeared in Wuhan, Hubei province, China (Timeline of World Health Organization (WHO)’s Response to COVID-19, n.d.)
The spread of these news and the adoption of CQ and HCQ in public policies to combat COVID-19 by some of the largest world economies, such as the United States and Brazil, have turned these drugs by far the most popular proposed for treatment and prophylaxis, appearing in several clinical studies registered on the United States National Institutes of Health (NIH) website [16, 28, 40, 47, 56, 64 and 67]
The rapid decline of IgG in exposed patients and the risk of antibody-dependent enhancement (ADE) are challenges that can compromise the safety of new vaccines under development
Summary
In late 2019, a group of patients with a severe acute respiratory syndrome (SARS) of unknown cause appeared in Wuhan, Hubei province, China (Timeline of WHO’s Response to COVID-19, n.d.). Studies in China and France claiming the use of CQ and its derivative hydroxychloroquine (HCQ) could be beneficial to coronavirus patients brought these drugs back to the spotlight The spread of these news and the adoption of CQ and HCQ in public policies to combat COVID-19 by some of the largest world economies, such as the United States and Brazil, have turned these drugs by far the most popular proposed for treatment and prophylaxis, appearing in several clinical studies registered on the United States National Institutes of Health (NIH) website [16, 28, 40, 47, 56, 64 and 67]. These molecules still have properties that should be properly exploited to really exhaust all possibilities against diseases
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