Expanding horizons for clinical applications of chloroquine, hydroxychloroquine, and related structural analogues

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Abstract

Several experimental and clinical studies have transformed the traditional antimalarial role of chloroquine (CHQ) and related structural analogues to potent therapeutic agents for a host of nonmalarial indications. The expanding clinical applicability for these drugs includes rheumatological and cardiovascular disorders (CVD), chronic kidney disease (CKD), oncology, and a variety of nonmalarial infections. These clinical advancements are primarily related to pleiotropic pharmacological actions of these drugs, including immunomodulation, anti-inflammatory properties, and capabilities of inducing autophagy and apoptosis at a cellular level. Historically, many clinical benefits in nonmalarial indications were first recognized through serendipitous observations; however, with numerous ongoing systematic clinical studies, the clinical horizons of these drugs have a promising future.

Keywords: antimalarials, cardiovascular disease, chloroquine, chronic kidney disease, hydroxychloroquine, rheumatology.

Citation: Shukla AM, Wagle Shukla A. Expanding horizons for clinical applications of chloroquine, hydroxychloroquine, and related structural analogues. Drugs in Context 2019; 8: 2019-9-1. DOI: 10.7573/dic.2019-9-1

Contributions: Ashutosh Shukla was involved in the execution, review and critique of the manuscript. Aparna Wagle Shukla was involved in the organization, review and critique of the manuscript. Both authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at https://www.drugsincontext.com/wp-content/uploads/2019/10/dic.2019-9-1-COI.pdf

Acknowledgements: Ashutosh Shukla reports the following VA Merit Grant supports from the Department of Veterans Affairs (I01CX001661: Management of cardiovascular disease in advanced CKD and I01HX002639: A system-wide strategy for KDE to improve the health and health services outcomes among Veterans). Aparna Wagle Shukla reports grants from the NIH and has received grant support from Benign Essential Blepharospasm Research foundation, Dystonia coalition, Dystonia Medical Research foundation, National Organization for Rare Disorders and NIH (KL2 and K23 NS092957-01A1).

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2019 Shukla AM, Wagle Shukla A. https://doi.org/10.7573/dic.2019-9-1. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2019 Shukla AM, Wagle Shukla A. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/expanding-horizons-for-clinical-applications-of-chloroquine,-hydroxychloroquine,-and-related-structural-analogues/

Correspondence: Aparna Wagle Shukla MD, Norman Fixel Institute for Neurological Diseases, 3009 Williston Road, Gainesville, FL 32608, USA. aparna.shukla@neurology.ufl.edu

Provenance: invited; externally peer reviewed.

Submitted: 1 September 2019; Peer review comments to author: 20 September 2019; Revised manuscript received: 8 October 2019; Accepted: 9 October 2019; Publication date: 25 November 2019.

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