- Published
- 27 January 2021
- Journal article
Hydroxychloroquine treatment does not reduce COVID-19 mortality: underdosing to the wrong patients? – Authors' reply
- Authors
-
- Source
- The Lancet Rheumatology
Abstract
We thank Luis Ayerbe and colleagues for the opportunity to further discuss our Article. The choice of our study population—individuals with rheumatoid arthritis or systemic lupus erythematosus—was made to minimise the potential for confounding by indication when estimating the effectiveness of hydroxychloroquine use rather than investigating how to prevent severe COVID-19 in this population. The key question is whether our study had sufficient statistical power to detect a real difference in mortality, if one existed? As stated in the Article, the CIs around our key estimate (hazard ratio 1·03 [95% CI 0·80–1·33]) suggested that we could exclude substantial benefit, although a modest benefit or harm on a relative scale could not be ruled out; therefore, trials were warranted. Ayerbe and colleagues suggest that hydroxychloroquine might be differently effective or ineffective in specific demographics: we note that 25% of those in our study were aged over 75 years and, as reported, we found no evidence of effect modification by age.
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Cite as
Rentsch, C., DeVito, N., Mackenna, B., Morton, C., Bhaskaran, K., Brown, J., Schultze, A., Hulme, W., Croker, R., Walker, A., Williamson, E., Bates, C., Bacon, S., Mehrkar, A., Curtis, H., Evans, D., Wing, K., Inglesby, P., Mathur, R., Drysdale, H., Wong, A., McDonald, H., Cockburn, J., Forbes, H., Parry, J., Hester, F., Harper, S., Smeeth, L., Douglas, I., Dixon, W., Evans, S., Tomlinson, L. & Goldacre, B. 2021, 'Hydroxychloroquine treatment does not reduce COVID-19 mortality: underdosing to the wrong patients? – Authors' reply', The Lancet Rheumatology, 3(3), pp. E172-E173. https://doi.org/10.1016/S2665-9913(21)00030-8