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Chloroquine, past and present

blogs.sciencemag.org

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Re: Chloroquine, past and present

#31

Post by cameldrv »

altcognito wrote: post #7
AdmiralBumbleB wrote: post #3

This chloroquinine rush is already out of control. My pharmacy is already out of it and is unable to procure from other pharmacies (which are also out already!) My pharmacist placed orders for all her patients to prefill prescriptions (where possible) for the next few months. I can understand a shortage when there's a clear evidence-based need, but the rumour-mill hasn't even ramped to full bore yet and it's already…

This is where having a fully funded CDC and pandemic team in the US pays off. They would have been paying very close attention for weeks on end in China, Italy and South Korea and many approaches could have been already dead-ended before it even significantly reached out shores. To say nothing of actually being in the process of ramping up medications that HAVE shown to be effective. It feels like we are starting fro…

Bingo. On Feb 18, China released the 6th edition of its treatment guidelines that included a Chloroquine recommendation. They've subsequently updated that guidance to reduce the dose

On Feb 19, Chinese authorities published this paper: https://www.ncbi.nlm.nih.gov/pubmed/32074550 which provides basically no details except that Chloroquine works.

Everyone who was paying attention saw this. The U.S. gov should have started ramping up production at that time, but four days later Trump tweeted "The Coronavirus is very much under control in the USA... Stock market starting to look very good to me!"

Re: Chloroquine, past and present

#32

Post by smoyer »

bpaddock wrote: post #6

The Quinism Foundation Warns of Dangers from Use of Antimalarial Quinolines Against COVID‑19. "Use of Chloroquine, Hydroxychloroquine, Mefloquine, Quinine, and Related Quinoline Drugs Risks Sudden and Lasting Neuropsychiatric Effects from Idiosyncratic Neurotoxicity." https://quinism.org/press-releases/dangers-of-antimalarial-q... The Anit-Malaria drugs They are pushing have a common ancestor to Fluoroquinolone antib…

Sorry for your loss

Re: Chloroquine, past and present

#33

Post by Wowfunhappy »

throwaway894345 wrote: post #30
altcognito wrote: post #7

Earlier quoted context omitted.

This is where having a fully funded CDC and pandemic team in the US pays off. They would have been paying very close attention for weeks on end in China, Italy and South Korea and many approaches could have been already dead-ended before it even significantly reached out shores. To say nothing of actually being in the process of ramping up medications that HAVE shown to be effective. It feels like we are starting fro…

I think everyone would like to see the CDC be better funded. Hindsight makes that an obvious mistake, but monitoring C19 should have been their number one priority in any case. From January onwards it was clear that it was the number one threat. There's still no explanation (afaik) for why they rolled their own test instead of using the WHO's test, nor have they effectively communicated their plans for ramping up tes…

> There's still no explanation (afaik) for why they rolled their own test instead of using the WHO's test

The explanation is obvious, isn't it? "We thought our test would work, and it would be better."

It was stupid, to be sure. It would have been a stupid risk even if it had paid off—although in that case, few would be chastising them, and many would be thankful.

Re: Chloroquine, past and present

#34

Post by patrickbuckley »

hprotagonist wrote: post #2

And so to today. As I said yesterday, I find the reports of chloroquine/hydroxychloroquine activity against the coronovirus very interesting, but preliminary. There has as yet been no well-controlled trial, and unfortunately the effects seen are still the sort of thing that can look exciting but disappear when you look closely. I mean that. It happens all the time – ask anyone else who does drug research for a living…

This is a great reminder, thank you for pointing it out. Interestingly during the 1918 Spanish flu aspirin was a new drug and was given to people in an effort to reduce fever. The problem is they gave it in doses that we now know is toxic. There is some evidence that patients treated in hospitals with aspirin had a 30x!!! deathrate vs those treated "homeopathically". This YouTube video goes into the history and context of it ...

https://youtu.be/dT6mHi_8V5E (go to 11:30 in video)

I beleive in modern medicine and science but we should be careful about being overly optimistic and harming people by giving them a powerful drug that hasn't been tested properly.

Edited to add time point in video.

Re: Chloroquine, past and present

#35

Post by camhenlin »

uwuhn wrote: post #25
AdmiralBumbleB wrote: post #3

This chloroquinine rush is already out of control. My pharmacy is already out of it and is unable to procure from other pharmacies (which are also out already!) My pharmacist placed orders for all her patients to prefill prescriptions (where possible) for the next few months. I can understand a shortage when there's a clear evidence-based need, but the rumour-mill hasn't even ramped to full bore yet and it's already…

I bought aquarium chloroquine to use as a last-ditch resort if I basically have to choose between taking it or dying due to hospital overcapacity. No harm to patients there IMO. I spent $60 for the 10 grams recommended for a course (.5 g a day). That was last week, and it's so much more expensive now.

Is there any difference in aquarium cloroquine and prescription? I’m assuming mostly manufacturing conditions

How do you plan on measuring your dose and dosing it?

Re: Chloroquine, past and present

#36

Post by wtallis »

bpaddock wrote: post #6

The Quinism Foundation Warns of Dangers from Use of Antimalarial Quinolines Against COVID‑19. "Use of Chloroquine, Hydroxychloroquine, Mefloquine, Quinine, and Related Quinoline Drugs Risks Sudden and Lasting Neuropsychiatric Effects from Idiosyncratic Neurotoxicity." https://quinism.org/press-releases/dangers-of-antimalarial-q... The Anit-Malaria drugs They are pushing have a common ancestor to Fluoroquinolone antib…

> Those that have already been devastated by Fluoroquinolones are extremely upset to hear that a related quinolines drug is being proposed.

Raising awareness of the risks based on your personal experiences is reasonable. But the above statement seems to cross the line into irrationality by pre-deciding that quinolines aren't worth trying here. That casts doubt on whatever scientific arguments you put forth, because it doesn't seem like you're capable of being fair about this.

Re: Chloroquine, past and present

#37

Post by throwaway894345 »

blhack wrote: post #29
throwaway894345 wrote: post #27

Earlier quoted context omitted.

I really hope this virus prompts our disaster management agencies to get their shit together, and specifically to consider supply chain security as part of their threat model (and no, we don't meaningfully do this or we wouldn't have such a pitiful national reserve of respirators and other respiratory treatment devices following SARS and MURS). Not sure exactly what this would look like, but identifying key partners…

How could our disaster management agencies have gotten their shit together to anticipate a run on an old anit-malaria drug?

Optimize for the aspects of the supply chain that don't depend on the specific drug. For example, the packaging of pills probably doesn't need to vary that much in general.

But the point isn't that we are prepared for every eventuality (e.g., chloroquine), but that we are doing due diligence in preparing for the likely eventualities (e.g., general purpose respiratory treatments like ventilators).

Re: Chloroquine, past and present

#38

Post by throwaway894345 »

Wowfunhappy wrote: post #33
throwaway894345 wrote: post #30

Earlier quoted context omitted.

I think everyone would like to see the CDC be better funded. Hindsight makes that an obvious mistake, but monitoring C19 should have been their number one priority in any case. From January onwards it was clear that it was the number one threat. There's still no explanation (afaik) for why they rolled their own test instead of using the WHO's test, nor have they effectively communicated their plans for ramping up tes…

> There's still no explanation (afaik) for why they rolled their own test instead of using the WHO's test The explanation is obvious, isn't it? "We thought our test would work, and it would be better." It was stupid, to be sure. It would have been a stupid risk even if it had paid off—although in that case, few would be chastising them, and many would be thankful.

Agree, and that's kind of my point. Being "fully funded" wasn't the problem--it was hubris/mismanagement.

Re: Chloroquine, past and present

#39

Post by alkonaut »

Nav_Panel wrote: post #17
brucer wrote: post #15

I was intrigued by the results from the recent quick french study: https://www.mediterranee-infection.com/wp-content/uploads/20... I read through the paper, and it's not immediately obvious, but if you look at the two graphs at the bottom, the hydroxychloroquine is 75% effective in the first chart, but only 50% in the second one. That's because the actual test was: Control: 16 hydroxychloroquine: 14 hydroxychloroquin…

It's an antibiotic. Severe patients will be dealing with secondary (bacterial) infections, so it makes sense to use both. But on its own, I expect it would have little effect.

It’s already commonly used as both treatment and profylactic (in healthy risk group patients) for viral pneumonia. Why it works for I think is still not entirely clear.

Being an antibiotic is also convenient because many times you would also get antibiotics to prevent a secondary infection from bacteria.

It’s not exactly a miracle cure (like an antibiotic is against a bacterial pneumonia), but doctors have few tools when it comes to viral pneumonia, so even something that helps a little is welcome.

Re: Chloroquine, past and present

#40

Post by comicjk »

andreygrehov wrote: post #19

Does anyone have any information about the Favipiravir testing going on in China? From what I read, it has a 90% success rate treating coronavirus AND is a super safe drug in general.

Here's a short paper on it [pdf]: https://www.jstage.jst.go.jp/article/ddt/14/1/14_2020.01012/...

Not many details, just that it worked better than some HIV antivirals. Still, worth ramping up production of this in advance of trials. It's a surprisingly small and simple molecule.

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