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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

#101

Post by frank2 »

dlp211 wrote: post #72
phkahler wrote: post #59

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 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.

>If the doctor now publicly claiming 699 treatments with 0 deaths using HCQ turns out to be a blatant fraud I think he may well lose his license given the situation.

I don't think the boards of medical quality assurance of the 50 states care enough about public statements to yank the license of (or even to discipline) a doctor for making a public statement the doctor knew to be false. In general the US medical profession doesn't have the commit to truth that, e.g., physicists do.

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

#102

Post by bart_spoon »

BFatts wrote: post #95
bart_spoon wrote: post #63

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. And? As I said, there has been some anecdotal evidence coming from countries like China, SK, and France indicating it could help. It shouldn't be a strike against a government official for sharing potentially important information. At a certain point we need to stop blaming people in po…

"And?..." Seriously? If there's panic buying (or prescribing, as did occur) then supplies are diminished if not depleted. WHAT GOOD IS THAT?

As I said, the only people prescribing this stuff are actual physicians. You are assuming that a trained MD is going to start prescribing this stuff willy-nilly based on two sentences by the president? If that actually occurs, it's because they agree with him and are prescribing them as they see fit. There isn't "panic" in the equation. Its physicians trying to help their patients.

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

#103

Post by shakezula »

phkahler wrote: post #60
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?

We are talking about HCQ, please dont bring up other issues.

I didn't bring up the issue, but sure. I'll focus on HCQ.

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

#104

Post by jeffdavis »

MiroF wrote: post #98
jeffdavis wrote: post #93

Earlier quoted context omitted.

But the president is not just a mouthpiece, he needs to make decisions based on incomplete information. His administration seems to have opened up channels for trials and off-label usage.

> off-label usage Off-label usage is bad when this is a drug that other people (like those with lupus - see here [0]) need to survive - we need trials first and I'm not sure that is occurring due to the President. This is a problem created by too early messaging when you should be focusing on "stay home" and other clear communication that was absent for weeks before his focus on this drug. [0]: https://www.cnn.com/20…

It seems like this thread has evolved from (1) the president was partisan in his statements about HCQ; (2) the president was political in his statements about HCQ; to (3) he jumped the gun on messaging.

Let's not let the media tear us apart. Not everything is Trump's fault. Not everything is America's fault. And sometimes people who are not Trump or countries that are not America make bad decisions that cost lives. Let's acknowledge these basic facts and work together.

California and Texas seem to be making better choices than NY and Florida. America seems to be doing better than Italy and Spain but worse than Germany. It's not really a partisan thing and it's not really a national identity thing. It's an issue of who in what regions acted strongly enough, and when.

America is a federal system, so we would expect variance between the states, and that's what we're seeing. Same as in Europe. The federal government plays an important role (like preventing test kits from being developed outside the CDC -- bad -- and early travel restrictions -- probably good), but not the only role, and it shows.

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

#105

Post by marcosdumay »

James_Henry wrote: post #71
marcosdumay wrote: post #20

Earlier quoted context omitted.

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 an…

So, evidence is pointing that we have a drug that drastically reduces hospitalization time for the milder cases, can save some 5-10% of the grave cases and is perfectly safe as long as there is a doctor looking at the patients. That is really looking like a large win.

This is one of the drugs on the large study WHO is running worldwide, and is getting a lot of attention. I'm sure we'll have strong evidence either way soon.

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

#106

Post by VBprogrammer »

Mountain_Skies wrote: post #37
D13Fd wrote: post #11

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

Look in the mirror to see how this became a partisan issue. The president made absolutely no partisan statements when mentioning his hope for the drug. It was those looking through dirt colored glasses that took things down that path.

Trump's statements on the issue were completely out of all proportion to the current state of medical knowledge.

The UK government is led by a right wing populist by all accounts and this is what our daily breifing had to say on the matter "And in our determination to prevent as many patients as possible seeing their condition worsen we are conducting rapid clinical trials on those drugs, including anti-malarials, which may be able to reduce the impact of COVID-19 on those affected."

Contrast that with Trump's statements (by Twitter of course): "HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains - Thank You! Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents)....."

If you can't see why there is a problem with the way Trump has spoken about these drugs then I'm afraid I've lost all hope.

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

#107

Post by DubiousPusher »

bart_spoon wrote: post #102
BFatts wrote: post #95

Earlier quoted context omitted.

"And?..." Seriously? If there's panic buying (or prescribing, as did occur) then supplies are diminished if not depleted. WHAT GOOD IS THAT?

As I said, the only people prescribing this stuff are actual physicians. You are assuming that a trained MD is going to start prescribing this stuff willy-nilly based on two sentences by the president? If that actually occurs, it's because they agree with him and are prescribing them as they see fit. There isn't "panic" in the equation. Its physicians trying to help their patients.

No but doctors do respond to pressure from patients who will respond to two sentences from the president.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151257/

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

#108

Post by James_Henry »

marcosdumay wrote: post #105
James_Henry wrote: post #71

Earlier quoted context omitted.

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 an…

So, evidence is pointing that we have a drug that drastically reduces hospitalization time for the milder cases, can save some 5-10% of the grave cases and is perfectly safe as long as there is a doctor looking at the patients. That is really looking like a large win. This is one of the drugs on the large study WHO is running worldwide, and is getting a lot of attention. I'm sure we'll have strong evidence either way…

I don't know that this study is talking about reduced hospitalization times. In fact, mild cases don't end up in the hospital. However, it could be that mild cases end up turning into severe cases that need hospitalization less frequently if this treatment is used. Since hospitalization is only needed in some 20% of cases, it would probably take a larger study to meaningfully determine those effects.

Of course, (and even though this probably isn't the case) if all this treatment does is make the mild and moderate cases (those without and with pneumonia and not needing supplemental oxygen) end faster, we can get to herd immunity that much quicker.

And yes, people are using this drug and are going to be using this drug at an increasing rate, so we'll have plenty of evidence soon.

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

#109

Post by tomcam »

aabeshou wrote: post #85
tomcam wrote: post #80

Earlier quoted context omitted.

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

dont move the goalposts. (1) OP said big pharma wants to downplay HCQ because it doesnt make them as much money. (2) reply says that the fact that pharma donated millions of doses contradicts that (3) OP counters that pharma is donating millions of doses because it gives them an epic tax write-off it has nothing to do with donations being bad. it has to do with the fact that pharma is always doing whats best for them…

> dont move the goalposts.

Thought I was asking for clarification. What goalposts did I move?

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

#110

Post by arcticbull »

James_Henry wrote: post #77
arcticbull wrote: post #9

Earlier quoted context omitted.

Too small a sample size to say.

Could you show me the statistics/theory that show that this is too small a sample size to make meaningful decisions from?

Statistical significance: https://en.wikipedia.org/wiki/Statistical_significance
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