Abstract
Introduction Chloroquine and hydroxychloroquine are antimalarial drugs widely used in the treatment
of rheumatic diseases. With the global pandemic caused by the new coronavirus, there
was an increase in the prescription of these drugs, which led to a major concern regarding
their ototoxic effects.
Objectives The objective of the present study was to assess existing scientific evidence about
the toxic effects of chloroquine and hydroxychloroquine on the peripheral and/or central
auditory system.
Data Synthesis A systematic literature review was performed by searching the PubMed (Medline), Scopus,
Web of Science, LILACS, and SciELO electronic databases, in a search of articles that
fullfiled the predefined inclusion and exclusion criteria. The review was conducted
in three phases and, in all of them, analyses were performed by two independent researchers.
Disagreements were discussed with a third researcher until a consensus was reached.
A total of 437 articles were found and 8 were included in this review. Seven of the
included studies reported hearing loss in their samples and presented a diagnostic
hypothesis of ototoxicity induced by chloroquine or hydroxychloroquine. The most common
type of hearing loss was sensorineural, with varying laterality and degrees of severity.
The most frequently used audiological test was pure tone audiometry, and only two
studies assessed brainstem evoked responses.
Conclusion The scientific evidence compiled in this research showed that chloroquine and hydroxychloroquine
have an ototoxic effect in the peripheral auditory system. These drugs can cause cochlear
damage, including changes in the stria vascularis and lesions in sensory hair cells.
Keywords chloroquine - hydroxychloroquine - ototoxicity - hearing loss
