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Chloroquine, past and present

blogs.sciencemag.org

81–90 of 320 posts

Re: Chloroquine, past and present

#81
There are papers out there that qualify chloroquine and derivates as effective in case of viral infections with viruses related to covid-19 [0] and try to explain what the mechanism could be :

« The exact mechanism of antiviral intervention by chloroquine is not yet elucidated but is possibly a multitarget mechanism, depending on the time point at which the drug is added »

[0] https://aac.asm.org/content/53/8/3416

Re: Chloroquine, past and present

#82
post #50

Is there not an argument that given chloroquine's apparent efficacy, albeit statistically weakly or improperly demonstrated (so far), along with its long history of relative safety in anti-malarial prophylaxis (with known caveats), set against an exponential growth in dangerous pneumonia - it is therefore rational to want to at least offer it to all suspected cases and healthworkers in balance of the serious risks th…

The possible side effects include permanent blindness. Giving this drug to people while you simply don't know if it does any good is only justifiable if you do it within a properly designed clinical trial. Which is the thing you should do. If you feel lots of people should get this drug - do a large trial. Will give us better data.

The half life is 2 months. That's crazy.

Re: Chloroquine, past and present

#83
post #49

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 seems to be a really obvious explanation of why they rolled their own test instead of using the WHO's test: there was no WHO test when they did it, the two different tests were developed in parallel (and they're not the only country which developed their own test either, there are something like seven different ones used in various countries). The CDC had already been using its own test internally when the WHO…

I didn't see any such explanation on the CDC page either, and I thought I was pretty thorough in searching for it. I did know that they were developed concurrently, but I'm unaware of any information about why they couldn't at any point pivot and use the WHO test, for example. Why is this information so hard to find?

Re: Chloroquine, past and present

#84
post #55
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…

The study wasn't randomized. It tells you basically nothing. I really don't understand why anyone approves such studies. They could've done something useful and we'd know a little bit now.

to the best of my knowledge, there has been no randomized study against placebo of several important things - like parachutes.

Next time I am in a burning plane, I'll make sure to refuse a parachute, as the lack of studies means anecdotal evidence tells us basically nothing.

Re: Chloroquine, past and present

#85
post #78

We definitely want more studies, but IMO we're reaching a tipping point. We have anecdotal evidence from China and South Korea, and this quite flawed, but at least data-containing study from France. Chloroquine's safety profile isn't great, but the safety profile of COVID is way worse. If you look at Chemotherapy for example, one would never take any of those drugs unless you had cancer. COVID isn't quite as bad as c…

The half life is 2 months. Any bad reaction will linger. Compared to antibiotics with a 8 hour half life. Lets stay home instead.

>Lets stay home instead.

For a couple of weeks, fine. However on the other end of this spectrum is "Millions starve".

At some point we need to ask is that fair to the youth? (note: I'm an old fart)

Re: Chloroquine, past and present

#86

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…

>> fully funded CDC Is there evidence that more money would have solved the constant CDC problems and incompetencies that are coming up? It seems like a throwaway obvious statement, but plenty of government agencies - and private companies - don't operate a lot more effectively with more money.

with more money, the CDC would not have delivered one non working test, but like 2 or 3 non working tests.

Re: Chloroquine, past and present

#87
post #78

We definitely want more studies, but IMO we're reaching a tipping point. We have anecdotal evidence from China and South Korea, and this quite flawed, but at least data-containing study from France. Chloroquine's safety profile isn't great, but the safety profile of COVID is way worse. If you look at Chemotherapy for example, one would never take any of those drugs unless you had cancer. COVID isn't quite as bad as c…

The half life is 2 months. Any bad reaction will linger. Compared to antibiotics with a 8 hour half life. Lets stay home instead.

OTOH that also means that the doses being used aren't as much higher than the prophylaxis dose as they appear. If you take it regularly, even at low doses, it builds up.

I'm all for staying home for now, but at some point we will have to come out, and we need something to help those that are already infected.

If CQ works as prophylaxis, we could potentially have a sort of interim herd immunity by having large portions of the population that could tolerate CQ taking it prophylactically while we wait for a vaccine. This is basically the current approach in regions with a lot of Malaria, and they've been waiting for a vaccine for a very long time.

The danger of course is SARS-CoV-2 developing resistance to Chloroquine as Malaria has. We need lots of people working as fast as possible on a vaccine.

Re: Chloroquine, past and present

#88
A vaccine was developed in haste for an outbreak of swine flu in 1976 (CDC feared it was a repeat of 1918 flu) and about 45 million Americans received it but 450 people developed GBS (Guillaine-Barre Syndrome) as a result.

Going on a hunch or unproven stuff is simply going to give the anti-vaxxer idiots further ammo

Re: Chloroquine, past and present

#89
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…

As someone who is 2.5 years away from a fluoroquinolone reaction and still trying to get back they are no joke.

The mental/physical damage they can produce is not something you would expect.

Re: Chloroquine, past and present

#90

Is there not an argument that given chloroquine's apparent efficacy, albeit statistically weakly or improperly demonstrated (so far), along with its long history of relative safety in anti-malarial prophylaxis (with known caveats), set against an exponential growth in dangerous pneumonia - it is therefore rational to want to at least offer it to all suspected cases and healthworkers in balance of the serious risks th…

The main dangers for the general public are the acute toxicity and drug interactions. Take chloroquine, which comes in 500mg tablets, it does not take many tablets to get to toxic or even lethal dose. The drugs can prolong QT intervals, so combination with other drugs with similar side effects like some antibiotics or antidepressants could be dangerous.
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