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Hydroxychloroquine prophylaxis and treatment is ineffective in macaque and hamster SARS-CoV-2 disease models
Kyle Rosenke, Michael A. Jarvis, Friederike Feldmann, Benjamin Schwarz, Atsushi Okumura, Jamie Lovaglio, Greg Saturday, Patrick W. Hanley, Kimberly Meade-White, Brandi N. Williamson, Frederick Hansen, Lizette Perez-Perez, Shanna Leventhal, Tsing-Lee Tang-Huau, Julie Callison, Elaine Haddock, Kaitlin A. Stromberg, Dana Scott, Graham Sewell, Catharine M. Bosio, David Hawman, Emmie de Wit, Heinz Feldmann
Kyle Rosenke, Michael A. Jarvis, Friederike Feldmann, Benjamin Schwarz, Atsushi Okumura, Jamie Lovaglio, Greg Saturday, Patrick W. Hanley, Kimberly Meade-White, Brandi N. Williamson, Frederick Hansen, Lizette Perez-Perez, Shanna Leventhal, Tsing-Lee Tang-Huau, Julie Callison, Elaine Haddock, Kaitlin A. Stromberg, Dana Scott, Graham Sewell, Catharine M. Bosio, David Hawman, Emmie de Wit, Heinz Feldmann
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Research Article COVID-19 Therapeutics

Hydroxychloroquine prophylaxis and treatment is ineffective in macaque and hamster SARS-CoV-2 disease models

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Abstract

We remain largely without effective prophylactic/therapeutic interventions for COVID-19. Although many human COVID-19 clinical trials are ongoing, there remains a deficiency of supportive preclinical drug efficacy studies to help guide decisions. Here we assessed the prophylactic/therapeutic efficacy of hydroxychloroquine (HCQ), a drug of interest for COVID-19 management, in 2 animal disease models. The standard human malaria HCQ prophylaxis (6.5 mg/kg given weekly) and treatment (6.5 mg/kg given daily) did not significantly benefit clinical outcome, nor did it reduce SARS-CoV-2 replication/shedding in the upper and lower respiratory tract in the rhesus macaque disease model. Similarly, when used for prophylaxis or treatment, neither the standard human malaria dose (6.5 mg/kg) nor a high dose (50 mg/kg) of HCQ had any beneficial effect on clinical disease or SARS-CoV-2 kinetics (replication/shedding) in the Syrian hamster disease model. Results from these 2 preclinical animal models may prove helpful in guiding clinical use of HCQ for prophylaxis/treatment of COVID-19.

Authors

Kyle Rosenke, Michael A. Jarvis, Friederike Feldmann, Benjamin Schwarz, Atsushi Okumura, Jamie Lovaglio, Greg Saturday, Patrick W. Hanley, Kimberly Meade-White, Brandi N. Williamson, Frederick Hansen, Lizette Perez-Perez, Shanna Leventhal, Tsing-Lee Tang-Huau, Julie Callison, Elaine Haddock, Kaitlin A. Stromberg, Dana Scott, Graham Sewell, Catharine M. Bosio, David Hawman, Emmie de Wit, Heinz Feldmann

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Figure 1

Rhesus macaque model — design, drug concentrations, and clinical scoring.

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Rhesus macaque model — design, drug concentrations, and clinical scoring...
Macaques were infected with SARS-CoV-2 by the combined intratracheal, intranasal, oral, and ocular routes. Animals were treated by oral gavage with either vehicle (PBS) or HCQ (6.5 mg/kg in PBS). Administration was either 1 time per week for the prophylaxis arm or starting 12 hours after infection followed by treatment 18, 36, 60, 84, 108, 132, and 156 hours after infection for the treatment arm. Animals were scored for clinical disease twice daily and examinations were performed as indicated. (A and B) Study design. The schematic depicts SARS-CoV-2 infection (I), HCQ or vehicle treatment (T), examinations (E), and necropsy (N). (C and D) Plasma levels of HCQ. HCQ levels were determined in both the prophylaxis and treatment study arms. Measurements reflect predose levels of HCQ at each time point (limit of quantification = 1.5 nM). (E and F) Clinical scores. Clinical scoring was performed twice daily by observation of nonanesthetized animals. The morning score is graphed here. Red squares indicate vehicle-treated animals and blue circles indicate HCQ-treated animals. SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; HCQ, hydroxychloroquine; PS, prophylaxis; TS, treatment.

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ISSN 2379-3708

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