Chloroquine
| Evidence Level: L5 | Predicted Indications: 4 |
Table of Contents
- Chloroquine
- Pharmacist Assessment Report
- Chloroquine: Antimalarial and immunomodulatory 4-aminoquinoline → rheumatoid factor-positive polyarticular juvenile idiopathic arthritis
- One-Sentence Summary
- Quick Overview
- Why is This Prediction Reasonable?
- Literature Evidence
- Clinical Trial Evidence
- India Market Information
- Safety Considerations
- Conclusion and Next Steps
- Disclaimer
Chloroquine: Antimalarial and immunomodulatory 4-aminoquinoline → rheumatoid factor-positive polyarticular juvenile idiopathic arthritis
One-Sentence Summary
Chloroquine is an established antimalarial and immunomodulatory agent that is marketed in India. The TxGNN model predicts it may be effective for rheumatoid factor-positive polyarticular juvenile idiopathic arthritis, but currently 0 clinical trials and only 1 indirect publication (a study of a different drug) support this direction, so this is a model prediction only.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | rheumatoid factor-positive polyarticular juvenile idiopathic arthritis |
| TxGNN Prediction Score | 0.9941 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (at least 20) – CDSCO approval status is not included in this data |
| Number of Listed Products | at least 20 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Based on general pharmacological knowledge, chloroquine acts as an immunomodulator by raising lysosomal pH, interfering with autophagy and antigen presentation, and reducing pro-inflammatory cytokine production. These effects are the reason it has long been used as a slow-acting antirheumatic agent.
Rheumatoid factor-positive polyarticular juvenile idiopathic arthritis closely resembles adult seropositive rheumatoid arthritis in its joint-centred, autoantibody-associated inflammation. This similarity explains the very high model score, but the score reflects proximity to rheumatoid disease rather than clinical proof in children.
The only publication retrieved for this specific disease concerns leflunomide, not chloroquine. No study in the data directly tests chloroquine in this condition, so the rationale remains theoretical.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 24334641 | 2014 | Prospective cohort | The Journal of Rheumatology | Real-life long-term experience with leflunomide in juvenile idiopathic arthritis; does not evaluate chloroquine |
Clinical Trial Evidence
Currently no related clinical trials registered.
India Market Information
At least 20 valid single-ingredient registrations are recorded; the list may be partial. Approved indication text is not recorded in the local data. Main products:
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 144057 | Malaquin 250mg Suspension | Bottle of 60 ml suspension | Not recorded |
| 184408 | Resochin Tablet | Strip of 10 tablets | Not recorded |
| 18912 | Amoquin 50mg Syrup | Bottle of 60 ml syrup | Not recorded |
| 147598 | Malswift 40mg Injection | Vial of 30 ml injection | Not recorded |
| 148233 | Malgo 250mg Tablet | Strip of 10 tablets | Not recorded |
Safety Considerations
- Contraindications / conditions requiring caution (from drug-disease relations, not label text): epilepsy, porphyria, liver disease, eye and retinal disease, vision and hearing disorders, psoriasis, neutropenia, agranulocytosis, leukopenia, anemia, G6PD deficiency, substance abuse/dependence, and certain metabolic disorders (glycogen storage disease, cystinuria, galactosemia).
- Drug Interactions: 467 interactions are recorded. Major-level examples include agalsidase beta, bupropion, cisapride, clarithromycin, dolasetron and granisetron (several of these are QT-prolonging or otherwise high-risk combinations). Moderate-level examples include antacids, cimetidine, famotidine, metronidazole, and sulfonylureas and insulin (glucose-lowering effects).
- Cardiac signal in related literature: a case report describes third-degree atrioventricular block under chloroquine therapy in a patient with juvenile-onset arthritis. This warrants attention in any paediatric use.
Please also refer to the package insert for full safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction score is very high, but there are no clinical trials and no study that tests chloroquine in this disease, so the evidence level is L5. Cardiac and retinal safety concerns add caution for paediatric use.
To proceed, the following is needed:
- Studies directly evaluating chloroquine in RF-positive polyarticular JIA
- Mechanism of action data
- Package insert warnings and contraindications from the India label
- Paediatric dosing and a cardiac and ophthalmic safety monitoring plan
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.