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Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

medrxiv.org

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Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#71

Post by James_Henry »

marcosdumay wrote: post #20
arcticbull wrote: post #6

The sample size is 62 and the mortality rates are between 0% and 7% depending primarily on age and co-morbidities. I don't think we can draw any meaningful conclusions from this other than what we already know: seems worth looking into HCQ more.

How does the 2 cases of collateral effects compare to the normal consequences of the drug? It is very likely that we can draw conclusions about those.

The side effects were a headache and a rash, neither one serious. The worrisome side effects of HCQ are also given in the paper: "Retinopathy is one of the major adverse reactions of long-term therapy with HCQ. Besides, patients with rheumatoid diseases treated with HCQ occasionally experience arrhythmias."

Luckily, long-term use of the drug isn't necessary here because the immune system successfully responds with antibodies to fight of the virus, so retinopathy isn't an issue. Also, as the paper states, "Fortunately, deciding on individual treatment plans scientifically, monitoring adverse reactions timely, to avoid overdose, short-term application of HCQ is relatively safe."

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#72

Post by dlp211 »

phkahler wrote: post #59
Justsignedup wrote: post #38

Earlier quoted context omitted.

He heard something about these two drugs, and without any scientific evidence he announced it, causing a panic-grab for the drugs. Unfortunately even the CDC was saying we don't have evidence supporting it.

>> He heard something about these two drugs, and without any scientific evidence he announced it, causing a panic-grab for the drugs. Unfortunately even the CDC was saying we don't have evidence supporting it. He simply reported that it looked promising in early studies, like we had already seen reported here on HN. His other action was apparently to lean the FDA to find out ASAP rather than heming and hawing for yea…

I can't believe I have to say this, but the POTUS is not some hacker news comment. What they say has large and far reaching consequences and they shouldn't be spouting off about anecdotal evidence. Their comments had already caused a shortage of HCQ, and led to at least one death.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#73

Post by James_Henry »

Alex3917 wrote: post #42
tangue wrote: post #24

I live in an island where during a viral outbreak some were advocating for chloroquine against the Chikungunya virus. The initial in-vitro tests were promising but it turns out during human trials it has a reverse effect and delayed adaptive immune responses (1). It's sad to see scientific method destroyed by politics and social networks. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977261/

> It's sad to see scientific method destroyed by politics and social networks. If there were such a thing as phase 5 trials with at least a million participants, it would be completely insane to use anything that had only undergone phase 3 clinical trials. People should make rational decisions based on the best evidence that's available at the time. Whether or not it's rational to take HCQ, there's nothing magical ab…

>To me this raises the question of whether clinical trials are really even possible right now in the first place, or whether making decisions based off in vitro data is the best we can do for right now.

I don't think I understand this. We have a clinical trial with in vivo data right here though, right?

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#74

Post by dlp211 »

airstrike wrote: post #43
shakezula wrote: post #36

Earlier quoted context omitted.

The President literally called it a "Democrat hoax" How is it not the administration's doing then?

The president called his alleged mishandling of the situation a "Democratic hoax". He didn't call COVID-19 a hoax or the treatment we're discussing

So it wasn't a hoax and this is really a distinction without a difference.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#75

Post by _ea1k »

shakezula wrote: post #36
_ea1k wrote: post #33

Earlier quoted context omitted.

That is not at all a fair assessment of what happened. I won't blame specific groups (there is plenty of fault to go around), but it wasn't the administration that made things partisan there.

The President literally called it a "Democrat hoax" How is it not the administration's doing then?

The speech that you are referring to is unrelated to my comment.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#76

Post by DubiousPusher »

phkahler wrote: post #59
Justsignedup wrote: post #38

Earlier quoted context omitted.

He heard something about these two drugs, and without any scientific evidence he announced it, causing a panic-grab for the drugs. Unfortunately even the CDC was saying we don't have evidence supporting it.

>> He heard something about these two drugs, and without any scientific evidence he announced it, causing a panic-grab for the drugs. Unfortunately even the CDC was saying we don't have evidence supporting it. He simply reported that it looked promising in early studies, like we had already seen reported here on HN. His other action was apparently to lean the FDA to find out ASAP rather than heming and hawing for yea…

You are talking about the president as if he is just some guy BSing at a BBQ. By discussing an unproven treatment he knowingly or not put his thumb on the scale of science, which is generally something we do not want.

We don't want scientific investments made because the president seems into them. We want those choices made by experts who are hopefully disinterested as possible. We want them considering the most likely successful treatments from their expert point of view.

You essentially can't have that now. And this goes beyond influence. The administration has been leaning on the FDA to give this ememgency approval.

This appears safe from the very preliminary studies we have but problems can develop at scale. These drugs are known to cause heart rhythm issues. It's conceivable that deploying then at scale in an emergency could lead to increase in fatal cardiac episodes. Were this drug not to actually work, large scale deployment would almost certainly do more harm than good.

The presidential podium confers added weight to everything a person says for good or ill and therefore should be used cautiously.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#78

Post by Alex3917 »

James_Henry wrote: post #73
Alex3917 wrote: post #42

Earlier quoted context omitted.

> It's sad to see scientific method destroyed by politics and social networks. If there were such a thing as phase 5 trials with at least a million participants, it would be completely insane to use anything that had only undergone phase 3 clinical trials. People should make rational decisions based on the best evidence that's available at the time. Whether or not it's rational to take HCQ, there's nothing magical ab…

>To me this raises the question of whether clinical trials are really even possible right now in the first place, or whether making decisions based off in vitro data is the best we can do for right now. I don't think I understand this. We have a clinical trial with in vivo data right here though, right?

> We have a clinical trial with in vivo data right here though, right?

AFAIK there's no clinical trial data, but there is in vivo data. My point though is that these are drugs that block viral replication, and we're mostly only administering them after the virus has already finished replicating. So in that scenario of course it's going to look ineffective regardless of whether it actually works or not. I don't believe the data showing it works, but I also don't believe the data showing it doesn't work.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#79

Post by randcraw »

zionic wrote: post #48
D13Fd wrote: post #11

I wish the current U.S. administration hadn't tried to turn this into a partisan issue.

This really sounds like your bias showing. The media made this partisan, not the administration.

No. The administration made repeated wild unsubstantiated claims of a "cure" for a pandemic that the press properly pushed back on given the near zero experimental evidence behind the claim.

This issue is partisan only if partisans act unthinkingly. The press had damned good reason to act as it did. The 'administration' did not.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#80

Post by tomcam »

_red wrote: post #27
dogma1138 wrote: post #22

Earlier quoted context omitted.

Haven’t many big pharmas pledged to or have donated millions of doses already? Seems a bit in odds with your claims.

Donate something that cost you 0.10 per pill and getting a tax write-off for $2.00 per pill. Sure, why not?

So... making those donations was bad? Would you prefer they not do it?
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