RIP Hydroxychloroquine
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https://www.washingtonpost.com/health/2020/05/22/hydroxychloroquine-coronavirus-study/
A study of 96,000 hospitalized coronavirus patients on six continents found that those who received an antimalarial drug promoted by President Trump as a “game changer” in the fight against the virus had a significantly higher risk of death compared with those who did not.
The study, published Friday in the medical journal the Lancet, is the largest analysis to date of the risks and benefits of treating covid-19 patients with antimalarial drugs. It is based on a retrospective analysis of medical records, not a controlled study in which patients are divided randomly into treatment groups — a method considered the gold standard of medicine. But the sheer size of the study was convincing to some scientists.
“It’s one thing not to have benefit, but this shows distinct harm,” said Eric Topol, a cardiologist and director of the Scripps Research Translational Institute. “If there was ever hope for this drug, this is the death of it.”
David Maron, director of preventive cardiology at the Stanford University School of Medicine, said that “these findings provide absolutely no reason for optimism that these drugs might be useful in the prevention or treatment of covid-19...”
The difference between patients who received the antimalarials and those who did not was striking.
For those given hydroxychloroquine, there was a 34 percent increase in risk of mortality and a 137 percent increased risk of a serious heart arrhythmias. For those receiving hydroxychloroquine and an antibiotic — the cocktail endorsed by Trump — there was a 45 percent increased risk of death and a 411 percent increased risk of serious heart arrhythmias.
Those given chloroquine had a 37 percent increased risk of death and a 256 percent increased risk of serious heart arrhythmias. For those taking chloroquine and an antibiotic, there was a 37 percent increased risk of death and a 301 percent increased risk of serious heart arrhythmias.
Cardiologist Steven Nissen of the Cleveland Clinic said the new data, combined with data from smaller previous studies, suggests that the drug “is maybe harmful and that no one should be taking it outside of a clinical trial.”
Jesse Goodman, a former FDA chief scientist who is now a Georgetown University professor, called the report “very concerning.” He noted, however, that it is an observational study, rather than a randomized controlled trial, so it shows correlation between the drugs and certain outcomes, rather than a clear cause and effect.
Peter Lurie, a former top FDA official who now heads the Center for Science in the Public Interest, called the report “another nail in the coffin for hydroxychloroquine — this time from the largest study ever.”
Here's what I don't understand: HCQ is a drug that's been around for decades being used as an antimalarial, in the treatment of lupus, and other diseases. Why is it dangerous now? What is it about the SARS-CoV-2 infection that makes it so.
The article suggests that it is because of a higher dose being used as well as the underlying pathology of the infection:
For years, hydroxychloroquine has been considered a generally safe and effective treatment for malaria, lupus and rheumatoid arthritis.
But those findings of safety were at lower doses than were being used at hospitals during the early days of the surge in patients in the United States and mostly in patients who were healthy.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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What I find so distressing is how HCQ became a partisan issue.
you could peg a voter on his political views depending if one believed in or shunned HCQ while not caring to hold off until there was data.
now you will have people claiming the lancet is a main stream media rag with leftist leanings.
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@bachophile said in RIP Hydroxychloroquine:
What I find so distressing is how HCQ became a partisan issue.
you could peg a voter on his political views depending if one believed in or shunned HCQ while not caring to hold off until there was data.
now you will have people claiming the lancet is a main stream media rag with leftist leanings.
One of the clinicians listed on the article on page 78 in the latest edition was Nancy Pelosi's cousin's physician. You do the math, Bach... do the math.
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I went through the paper
I didn’t know Macrolides also increased the QT interval like the quinines. So maybe the anti inflammatory synergistic effect was offset by the synergistic cardiovascular damage which increased the arrhythmias. Couple that to the fact that age was a risk factor and there is much more cardiovascular comorbidity in the elderly, that in an effort to fight the cytokine storm, they were actually stressing out the heart beyond its capability to compensate.
Interesting. But you would think...”now you tell me....”
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When I first started traveling and went to Nigeria, it was recommend to take anti malaria pills. I forget what exactly it was (do not believe it was Hydroxychloroquine but could have been).
After hearing/reading about side effects, I decided I was better off taking the risk of getting malaria than the possible side effects of the drug.
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@taiwan_girl said in RIP Hydroxychloroquine:
When I first started traveling and went to Nigeria. . .
I dunno, I guess we're all different.
When I first started traveling, I went to the beach. -
@Rainman said in RIP Hydroxychloroquine:
@taiwan_girl said in RIP Hydroxychloroquine:
When I first started traveling and went to Nigeria. . .
I dunno, I guess we're all different.
When I first started traveling, I went to the beach.Don't like Nigers?.....
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@taiwan_girl said in RIP Hydroxychloroquine:
When I first started traveling and went to Nigeria, it was recommend to take anti malaria pills.
I used it in Senegal. No effects that I remember noticing.
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Although in other news, the New England reported some benefit for Remdesivir.
https://www.nejm.org/doi/full/10.1056/NEJMoa2007764
Weird how somehow Remdesivir was not such a partisan issue.
That HCQ became so partisan is so fucked up. If trump had pushed Remdesivir instead of HCQ, maybe the base would have got behind that.
It never seemed to make much sense to me that HCQ would be an effective antiviral.
We gave it to patients in our institution because the whole world was giving it to patients on very thin evidence, but at the beginning people were reaching for anything to help.
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This is from 2020 June 20:
https://www.nih.gov/news-events/news-releases/nih-halts-clinical-trial-hydroxychloroquine
NIH halts clinical trial of hydroxychloroquine
Study shows treatment does no harm, but provides no benefit
“A clinical trial to evaluate the safety and effectiveness of hydroxychloroquine for the treatment of adults hospitalized with coronavirus disease 2019 (COVID-19) has been stopped by the National Institutes of Health. A data and safety monitoring board (DSMB) met late Friday and determined that while there was no harm, the study drug was very unlikely to be beneficial to hospitalized patients with COVID-19. After its fourth interim analysis the DSMB, which regularly monitors the trial, recommended to the National Heart, Lung, and Blood Institute (NHLBI), part of NIH, to stop the study. NHLBI halted the trial immediately.
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Why has hydroxychloroquine been disregarded?
First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.
Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.
In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.
Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.
But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients.
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@bachophile said in RIP Hydroxychloroquine:
now you will have people claiming the lancet is a main stream media rag with leftist leanings.
Well, it is! And Eric Topol, the guy who said,“It’s one thing not to have benefit, but this shows distinct harm,” is probably a lefty Democrat and also black and gay hootchie-cooch to Jeffrey Epstein!
Success is measured by your discipline and inner peace. – Mike Ditka
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@Catseye3 said in RIP Hydroxychloroquine:
@bachophile said in RIP Hydroxychloroquine:
now you will have people claiming the lancet is a main stream media rag with leftist leanings.
Well, it is! And Eric Topol, the guy who said,“It’s one thing not to have benefit, but this shows distinct harm,” is probably a lefty Democrat and also black and gay hootchie-cooch to Jeffrey Epstein!
What do you know about Plaquenil?
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I remain agnostic about hydroxychloroquine, just sharing this because it’s funny.
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@George-K
The Lancet article has been discredited.“After publication of our Lancet Article,1 several concerns were raised with respect to the veracity of the data and analyses conducted by Surgisphere Corporation and its founder and our co-author, Sapan Desai, in our publication. We launched an independent third-party peer review of Surgisphere with the consent of Sapan Desai to evaluate the origination of the database elements, to confirm the completeness of the database, and to replicate the analyses presented in the paper.
Our independent peer reviewers informed us that Surgisphere would not transfer the full dataset, client contracts, and the full ISO audit report to their servers for analysis as such transfer would violate client agreements and confidentiality requirements. As such, our reviewers were not able to conduct an independent and private peer review and therefore notified us of their withdrawal from the peer-review process.
We always aspire to perform our research in accordance with the highest ethical and professional guidelines. We can never forget the responsibility we have as researchers to scrupulously ensure that we rely on data sources that adhere to our high standards. Based on this development, we can no longer vouch for the veracity of the primary data sources. Due to this unfortunate development, the authors request that the paper be retracted.
We all entered this collaboration to contribute in good faith and at a time of great need during the COVID-19 pandemic. We deeply apologise to you, the editors, and the journal readership for any embarrassment or inconvenience that this may have caused.“One rumor is that Surgisphere consists of a cryptocurrency trader, a science fiction writer, and an online sex performer. So much for peer reviewed.
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https://www.politico.com/news/2020/08/02/trump-health-official-hydroxychloroquine-390601
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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.
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