RIP Hydroxychloroquine

[Loki]

@Axtremus said in RIP Hydroxychloroquine:

https://www.politico.com/news/2020/08/02/trump-health-official-hydroxychloroquine-390601
— — — —
official in the Trump administration's Covid-19 response effort said Sunday there is no evidence that hydroxychloroquine is an effective treatment for the virus, despite President Donald Trump's continued promotion of the anti-malaria drug.

In an interview on NBC's "Meet the Press," administration testing czar Brett Giroir said he could not recommend hydroxychloroquine because trials "do not show any benefit."

"We need to move on from that and talk about what is effective,” Giroir, assistant secretary at the Department of Health and Human Services said.
— — — —

Last I heard is that it was dangerous and could kill you. Did they back off that or ignore it? What’s the media position on harm?

[George K]

@Loki said in RIP Hydroxychloroquine:

Last I heard is that it was dangerous and could kill you. Did they back off that or ignore it? What’s the media position on harm?

Plaquenil has been around for decades and has a good safety profile, when used as an anti-malarial, and when used in Lupus and rheumatoid arthritis. 400 mg seems to be a safe dose in those conditions. I'm too lazy to look up what doses were used in the treatment of patients with COVID-19. My understanding is that cardiac toxicity is one of the concerns.

I'm also too lazy to look up the studies saying it's of no use - what doses were given? At what stage of disease?

[George K]

https://www.realclearpolitics.com/articles/2020/08/04/an_effective_covid_treatment_the_media_continues_to_besmirch_143875.html

There are now 53 studies that show positive results of hydroxychloroquine in COVID infections. There are 14 global studies that show neutral or negative results -- and 10 of them were of patients in very late stages of COVID-19, where no antiviral drug can be expected to have much effect. Of the remaining four studies, two come from the same University of Minnesota author. The other two are from the faulty Brazil paper, which should be retracted, and the fake Lancet paper, which was.

Millions of people are taking or have taken hydroxychloroquine in nations that have managed to get their national pandemic under some degree of control. Two recent, large, early-use clinical trials have been conducted by the Henry Ford Health System and at Mount Sinai showing a 51% and 47% lower mortality, respectively, in hospitalized patients given hydroxychloroquine. A recent study from Spain published on July 29, two days before Margaret Sullivan’s strafing of “fringe doctors,” shows a 66% reduction in COVID mortality in patients taking hydroxychloroquine. No serious side effects were reported in these studies and no epidemic of heartbeat abnormalities.

This is ground-shaking news. Why is it not being widely reported? Why is the American media trying to run the U.S. pandemic response with its own misinformation?

>Steven Hatfill is a veteran virologist who helped establish the Rapid Hemorrhagic Fever Response Teams for the National Medical Disaster Unit in Kenya, Africa. He is an adjunct assistant professor in two departments at the George Washington University Medical Center where he teaches mass casualty medicine. He is principle author of the prophetic book “Three Seconds Until Midnight -- Preparing for the Next Pandemic,” published by Amazon in 2019.

[Jolly]

What happens if it turns out Trump was right?

BTW, and for the record, docs at The Lake in Baton Rouge (which has 8 COVID wards) routinely prescribe the cocktail. Sometimes in medicine, you believe your eyes.

[Doctor Phibes]

It clearly should never have been politicised in the way that it has.

[George K]

One of the criticisms I saw leveled against this article is that the articles that the author cites as showing a positive result were not double-blind studies.

So, from a practical point, let me ask this:

You start developing symptoms of COVID-19, and your doc sees that you test positive.

He says to you, "Hey, we're conducting a large study of people infected with SARS-CoV-2. It's a double blind study on the effectiveness of HCQ. We don't know, and you won't know, if you're getting a placebo or the medication. Can I sign you up?"

Who would say "Sure! I'd be thrilled to have a 50/50 chance of getting a placebo vs a drug that might work.?"

[jon-nyc]

@George-K said in RIP Hydroxychloroquine:

Who would say "Sure! I'd be thrilled to have a 50/50 chance of getting a placebo vs a drug that might work.?"

Most people who have ever participated in a drug trial do just that.

[Doctor Phibes]

I must admit my first thought when I read anything on HCQ is 'what's their agenda?', which is pretty sad.

[LuFins Dad]

@jon-nyc said in RIP Hydroxychloroquine:

@George-K said in RIP Hydroxychloroquine:

Who would say "Sure! I'd be thrilled to have a 50/50 chance of getting a placebo vs a drug that might work.?"

Most people who have ever participated in a drug trial do just that.

Most of those studies aren’t dealing with an illness with as much public hysteria as COVID-19.

[George K]

@Doctor-Phibes said in RIP Hydroxychloroquine:

I must admit my first thought when I read anything on HCQ is 'what's their agenda?', which is pretty sad.

Remember when they said that TRump had a financial stake in pushing HCQ?

[jodi]

@George-K Steve was prescribed 2 (200mg) tabs TID the first day, then 1 (200mg) tab TID on days 2 - 5. Were told to go BID if the nausea got too bad (and the nausea got really bad, I think he want to twice a day the last two days)

[Loki]

@George-K said in RIP Hydroxychloroquine:

@Doctor-Phibes said in RIP Hydroxychloroquine:

I must admit my first thought when I read anything on HCQ is 'what's their agenda?', which is pretty sad.

Remember when they said that TRump had a financial stake in pushing HCQ?

NYT. What a bunch of putz’s. I never thought in my lifetime I would say that about them but hey that’s where they are.

[Aqua Letifer]

@Loki said in RIP Hydroxychloroquine:

NYT. What a bunch of putz’s. I never thought in my lifetime I would say that about them but hey that’s where they are.

#metoo (Remember that? What happened to that?)

But hey, Rolling Stone's surprising me. They seem to have some staff and managers still struggling to carry on.

[Jolly]

@Aqua-Letifer said in RIP Hydroxychloroquine:

@Loki said in RIP Hydroxychloroquine:

NYT. What a bunch of putz’s. I never thought in my lifetime I would say that about them but hey that’s where they are.

#metoo (Remember that? What happened to that?)

But hey, Rolling Stone's surprising me. They seem to have some staff and managers still struggling to carry on.

Then, may they succeed.

[George K]

All the studies on HCQ:

https://c19study.com/?fbclid=IwAR0w3T4BvOPw5K_jOCBpDmZGzt4MR317ROpbYcg8oLZg0w7Oc3LXZFLemWk

Delay in treatment delays effectiveness of HCQ.

[Jolly]

Interesting.

As I've said, I would take the cocktail.

[George K]

1. It's not double-blind
2. It's retrospective
3. It's large: 8000-plus patients.

https://www.sciencedirect.com/science/article/pii/S0924857920303423?via%3Dihub

Abstract
Background
Hydroxychloroquine (HCQ) has been largely used and investigated as therapy of COVID-19 across various settings, at total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (2400 mg in total over five days) was recommended for hospitalized patients with COVID-19.

Methods
We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital surveillance data. Patients treated either with HCQ alone and supportive care (HCQ group) were compared to patients treated with supportive care only (no-HCQ group) using a competing risks proportional hazards regression with discharge alive as competing risk, adjusted for demographic and clinical features with robust standard errors.

Results
Of 8075 patients with complete discharge data on 24th of May and diagnosed before the 1st of May, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable analysis, the mortality was lower in the HCQ group compared to the no-HCQ group (adjusted hazard ratio [HR] 0.684, 95% confidence interval [CI] 0.617–0.758). Compared to the no-HCQ group, mortality in the HCQ group was reduced both in patients diagnosed ≤ 5 days (n=3975) and > 5 days (n=3487) after symptom onset (adjusted HR 0.701, 95% CI 0.617–0.796 and adjusted HR 0.647, 95% CI 0.525–0.797, respectively).

Conclusions
Compared to supportive care only, low-dose HCQ monotherapy was independently associated with lower mortality in hospitalized patients with COVID-19 diagnosed and treated early or later after symptom onset.

It's not clear to me what "supportive care" only means. A ventilator is "supportive" in the sense that it doesn't really cure anything. It allows other therapies to work or allows healing to occur.

[Rainman]

Well, let's make it completely political.

Republicans get to be administered HCQ, democrats do not.

Any takers?

[George K]

Once again, just to be clear, I remain agnostic on the effectiveness of HCQ in treating COVID-19. The fact that there are studies that show its effectiveness under conditions which can be controlled (when given, what other treatments are used) are encouraging.

Or at least eyebrow-raising.

Also, the hysteria over its cardio toxicity, IMO is an example of the politicization of the drug. It's dose-dependent. It's a drug with a decades-long history of safety, given in appropriate doses.

Any drug is a poison - if you take enough of it.

[George K]

https://www.theguardian.com/world/2021/aug/19/french-scientist-who-pushed-unproven-covid-drug-hydroxychloroquine-may-be-forced-from-post?utm_source=dlvr.it&utm_medium=twitter

The French scientist who promoted the discredited hydroxychloroquine treatment for Covid-19 backed by Donald Trump faces being pushed out of the infectious diseases institute he founded, amid concerns from key members over its role in feeding conspiracy theories and an investigation by regulators into its clinical studies.

Didier Raoult has built a worldwide following throughout the pandemic for his support of the malaria drug despite its failure in randomised control trials. Multiple studies, including by the Recovery trial and the World Health Organisation, have found hydroxychloroquine to be ineffective in treating Covid-19.

University professors must retire at the age of 68 in France. Raoult turned 69 in March, and so from 31 August will no longer be eligible to continue his post as a researcher and medical practitioner at the University of Aix-Marseille and Marseille University Hospitals.

His age does not disqualify him from continuing as director of the Marseille-based infectious diseases institute he founded, IHU Méditerranée Infection, but François Crémieux, the director of Assistance Publique-Hôpitaux de Marseille (AP-HM), one of the founding member institutions of the IHU, told Le Monde it is not reasonable for Raoult to continue there after he ceases to practise medicine and conduct university research.