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Hydroxychloroquine Probably Isn’t the Answer

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Re: Hydroxychloroquine Probably Isn’t the Answer

#61

Post by ucha »

inamberclad wrote: post #53
ucha wrote: post #45

This morning we had: France ex-IHU Marseille/AP-HP: 79160 cases, 7527 dead, mortality rate 9.5% IHU Marseille/AP-HP: 3005 cases, 33 dead, mortality rate 1.1% France doesn't use HCQ consistently yet. Didier Raoult who heads the IHU in Marseille has been using it systematically on all cases, even mild ones for more than 2 weeks. I doubt such a difference in mortality rate could be explained by a difference in number of…

It also doesn't count for confounding factors. Were all the patients of the same health? Did they all have the same supportive equipment? Did they all begin treatment at the same time after symptom onset? These are all questions that need to be addressed, the sooner the better.

It doesn't. We have to make a decision with uncertainty unfortunately. However, I don't think any of those questions could explain an 8x difference apart from the time of treatment. In Marseille, they treat you immediately independently of the severity of symptoms.

Re: Hydroxychloroquine Probably Isn’t the Answer

#62

Post by Dylan16807 »

gus_massa wrote: post #35
hexl wrote: post #27

Earlier quoted context omitted.

> but without a randomized control trial, there is no way the success can reliably be attributed to the medications That's non-sense, if everyone that had cancer got cured by a miracle drug, would you still demand a randomized control trial?

Yes! I want to be sure that this miracle drug is 100% to eliminate all the other drugs that has nasty side effects and have a lower effectivity. Let's pick some terminal ill patients. I think cancer metastasis in the brain has a very bad prognosis, like less than a year of life expectancy [1]. Let's make a one year trial: 100 patients in the control group that receive the usual treatment and a placebo. 100 patients i…

So you have a cancer that normally has a 90% fatality rate after a year. Someone gives you evidence that they gave this drug to everyone with this cancer in their hospital, and 70/73 survived for a year. Not properly randomized, not properly controlled. Would you really reject their data and find it unconvincing?

Re: Hydroxychloroquine Probably Isn’t the Answer

#63

Post by travisporter »

gus_massa wrote: post #28
PragmaticPulp wrote: post #13

Collectively, we need to get over the idea of all-or-nothing solutions to Coronavirus. We're not going to wake up one day with a "cure" for COVID-19. No one in the medical field actually expects Hydroxychloroquine to produce miraculous recoveries at this point. The idea is that any treatment that slows the progress of the infection will also buy the patient's immune system more time to fight the infection. If we can…

> The idea is that any treatment that slows the progress of the infection will also buy the patient's immune system more time to fight the infection. Is there any serious trial that shows that Hydroxychloroquine has any effect at all?

https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v...

Note that it is not peer reviewed

Re: Hydroxychloroquine Probably Isn’t the Answer

#64

Post by pbreit »

gus_massa wrote: post #28
PragmaticPulp wrote: post #13

Collectively, we need to get over the idea of all-or-nothing solutions to Coronavirus. We're not going to wake up one day with a "cure" for COVID-19. No one in the medical field actually expects Hydroxychloroquine to produce miraculous recoveries at this point. The idea is that any treatment that slows the progress of the infection will also buy the patient's immune system more time to fight the infection. If we can…

> The idea is that any treatment that slows the progress of the infection will also buy the patient's immune system more time to fight the infection. Is there any serious trial that shows that Hydroxychloroquine has any effect at all?

There are several.

Plus it does have proven effect against SARS in vitro.

And this French treatment center seems to be getting good results.

https://www.mediterranee-infection.com/covid-19/

Re: Hydroxychloroquine Probably Isn’t the Answer

#65

Post by cjhopman »

tgafpc2 wrote: post #34

This site also has an article wistfully praising Remdesivir, a proprietary drug with far less evidence than HCQ. I think money might be talking here.

A proprietary drug whose maker has said they will donate all 1.5 million doses that they currently have. That's more than they'll be able to produce over the next year (1 million) even after greatly increasing that production capacity.

Re: Hydroxychloroquine Probably Isn’t the Answer

#66

Post by rrss »

ucha wrote: post #45

This morning we had: France ex-IHU Marseille/AP-HP: 79160 cases, 7527 dead, mortality rate 9.5% IHU Marseille/AP-HP: 3005 cases, 33 dead, mortality rate 1.1% France doesn't use HCQ consistently yet. Didier Raoult who heads the IHU in Marseille has been using it systematically on all cases, even mild ones for more than 2 weeks. I doubt such a difference in mortality rate could be explained by a difference in number of…

Seems like those statistics would be pretty easily explained by Marseille being a week or two behind other areas in France on the epidemic curve.

Pennsylvania: 11510 cases, 150 deaths, mortality rate 1.3%

Is Pennsylvania also using HCQ systematically on all cases? I don't think these crude CFRs are useful.

Re: Hydroxychloroquine Probably Isn’t the Answer

#67

Post by pbreit »

gus_massa wrote: post #36
Mountain_Skies wrote: post #30

Earlier quoted context omitted.

Double blind peer reviewed trials are a good goal but in the middle of a crisis you can't let a desire for perfection get in the way of the good. There is enough imperfect evidence that this treatment stack (that is, several drugs used in combination with hydroxychloroquine) has benefits that it should be considered a potential part of a solution. Waiting a couple of years for perfect studies to be carefully conducte…

> There is enough imperfect evidence that this treatment stack [...] has benefits that it should be considered a potential part of a solution. Is there any evidence? Do you have a link to the best evidence so far? Did someone tried a similar treatment and get the same result? It is not necessary to have a perfect study, because there too little time. But how hard is to make a study with a randomized control group? Yo…

Yes, there is quite a bit of evidence.

Proven against SARS in vitro: https://www.ncbi.nlm.nih.gov/pubmed/15351731

And much evidence for efficacy against COVID-19 in humans: https://twitter.com/__ice9/status/1246549028382408706

Re: Hydroxychloroquine Probably Isn’t the Answer

#68

Post by h_r »

Dylan16807 wrote: post #55
h_r wrote: post #32

Earlier quoted context omitted.

It's simply a problem of what is considered to be evidence in the scientific community. If everyone "got cured by a miracle drug", that implies you already have the compelling evidence in hand that the drug, in fact, is a cure. This is an example of begging the question.

It's not begging the question at all! The entire point is that you can have compelling evidence without a randomized controlled trial.

Again, this is the very thing that needs to be shown. You're simply repeating the same mistake.

The post I was responding to really had no _point_, per se. It merely asserted that it's ridiculous to require such experiments because... miracle drug!

Re: Hydroxychloroquine Probably Isn’t the Answer

#69

Post by pbreit »

stri8ed wrote: post #16

Not to diminish the possible successes, but without a randomized control trial, there is no way the success can reliably be attributed to the medications. That's not to say they should stop prescribing it, simply due to lack of formal trials. But the perceived benefits should not be taken at face value, yet.

Why is medecine the only subject that requires such a thing?

Re: Hydroxychloroquine Probably Isn’t the Answer

#70

Post by pbreit »

jacquesm wrote: post #12
mrfusion wrote: post #2

I think this drug has become too politicized to be able to have a factual scientific debate.

"If there was any effect of this drug on COVID-19, it was minimal. Hydroxychloroquine, whose toxicity is far lower, may be safer than chloroquine. But that doesn't matter if the drugs are ineffective." What's political about that? The whole idea that if there were a simple and cheap cure that it would be politicized to the point where it won't see widespread application is ridiculous.

It's very clear that the resistance to these drugs is an intense case of Trump Derangement Syndrome.

There's an almost perfect correlation between reaction to these drugs and Trump support.

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