Hydroxychloroquine Update for April 6 • Hacker News Board

Re: Hydroxychloroquine Update for April 6

#51

Post by buboard » Mon, Apr 06, 2020, 11:22 PM UTC

benjohnson wrote: post #24

war1025 wrote: post #17

My completely anecdotal experience with the Hydroxychloroquine story is that researchers keep pooh-poohing it and people in the field keep having success with it. All I know is that based on the aggregate of information I've seen thus far, if I come down with Coronavirus, I want to be prescribed that stuff.

Quinine used to come from the bark of a tree - that bark is available as a nutritional supplement. It's also is used to make the bitter taste of Tonic Water.

Someone did the calculations. Ppl need to drink 200 gin tonics per day

Re: Hydroxychloroquine Update for April 6

#52

Post by kevingadd » Mon, Apr 06, 2020, 11:22 PM UTC

xienze wrote: post #36

threeseed wrote: post #26

Earlier quoted context omitted.

This drug is not administered to everyone though. It's only been tested and verified for people with I believe lupus and malaria. So we don't know the implications of rolling it out to millions of people worldwide. That's why you do clinical trials.

> So we don't know the implications of rolling it out to millions of people worldwide. It’s 70+ years old. It’s a well-understood drug. It’s an experimental treatment, not an experimental medicine. It’s also frequently prescribed to grandmas with rheumatoid arthritis.

Being 70 years old and widely prescribed does not mean the function and associated risks of the drug are well-understood. I literally saw a physician mention today in a video ( https://www.youtube.com/watch?v=ILowf7Tw7QY ) that the exact mechanisms at work here are not fully understood. He explained a half dozen different things HCQ/CQ might be doing in this scenario that are all biologically plausible based on what we believe we know.

HCQ/CQ aren't unique in this either. Lithium is widely used as a psychiatric treatment and has been in use for a long time even though for most of that time period we haven't had a good detailed understanding of how exactly it works. Gaps in understanding like that can lead to disaster unless we apply enough caution to match.

Another way to put this: We know some things the drug does, but that doesn't mean we know the complete set of what it does. We know some of the side effects and some of the risks, but unless we have a complete end-to-end understanding of everything happening here there is always going to be a risk worth considering.

Re: Hydroxychloroquine Update for April 6

#53

Post by tptacek » Mon, Apr 06, 2020, 11:23 PM UTC

HarryHirsch wrote: post #48

pazimzadeh wrote: post #30

Taking Chloroquine too soon might promote viral infection by inhibiting the anti-viral response. https://sciencedirect.com/science/article/abs/pii/S016635421... CQ is for patients who have uncontrolled inflammation in response to the virus, not to be taken as a prophylactic.

There is a clinical trial going on to check for just that. The hope is that when taken as a prophylactic it prevents entry into cells and give the immune system an advantage over the pathogen, but as you say, the immunosuppressive effects are a concern. We'll see soon enough.

Repeating myself, but: there's an extent to which that trial has already been running naturally, since lots and lots of people take doses of HCQ comparable to the C19 protocol already, for rheumatoid arthritis. Lots of those people are getting C19. Are you seeing reports that arthritic patients who get C19 are faring better?

Re: Hydroxychloroquine Update for April 6

#54

Post by xienze » Mon, Apr 06, 2020, 11:25 PM UTC

threeseed wrote: post #44

xienze wrote: post #36

Earlier quoted context omitted.

> So we don't know the implications of rolling it out to millions of people worldwide. It’s 70+ years old. It’s a well-understood drug. It’s an experimental treatment, not an experimental medicine. It’s also frequently prescribed to grandmas with rheumatoid arthritis.

> It’s a well-understood drug For treating the issues it was designed for. Not for treating COVID-19.

You could technically say that about Tylenol, but I doubt there’d be anyone jumping up and down about how dangerous it would be for a Covid 19 patient to take 500mg of it daily as part of a treatment regimen. There’s literally NO drugs approved specifically for Covid 19, but there are drugs, like HCQ, which are promising and well-understood in general.

Re: Hydroxychloroquine Update for April 6

#55

Post by robocat » Mon, Apr 06, 2020, 11:25 PM UTC

“hydroxychloroquine itself actually lowers the activity of the innate immune system; that’s why people take it for lupus and for rheumatoid arthritis. Many people are saying that perhaps it will work best if taken early in the course of infection” (from article.)

Yet HCQ takes a very long time to act as an efficient immunosuppressant (1 to 3 months for Lupus) as per https://news.ycombinator.com/item?id=22798370 which seemed factual; but anyone have references to how long HCQ takes to become immunosuppressant?

Hydroxychloroquine has a long half life in the body, so you have to wonder what effects there will be from using it, especially if it turns out to be ineffective.

The original idea HCQ was useful was from long term users of HCQ, which may have quite different biological effects from short term usage in reaction to dosing.

Also perhaps Lupus has a confounding factor that makes Lupus sufferers less susceptible to Covid19?

Re: Hydroxychloroquine Update for April 6

#56

Post by rsynnott » Mon, Apr 06, 2020, 11:25 PM UTC

moron4hire wrote: post #41

Why are we talking about drugs in the public media? This is like people demanding certain drugs from their doctors because they saw it in pharmaceutical commercial.

Because various high profile idiots have been lying about them. In an ideal world maybe this would be staying out of the public eye, but it’s a bit late to put the genie back in the bottle now.

Re: Hydroxychloroquine Update for April 6

#57

Post by tptacek » Mon, Apr 06, 2020, 11:26 PM UTC

kevingadd wrote: post #40

dionian wrote: post #34

Earlier quoted context omitted.

Chloroquine is more toxic than Hydrochloroquine, isn't it?

IIRC the addition of the hydroxy to the drug means it's going to be more water-soluble so it would be easier to excrete in urine and flush it out of the system, which would count as "less toxic" if you squint when reading the paper I haven't seen any detailed discussions of the differences in toxicity, but one physician made a comment to that effect.

You probably don't have to derive the relative toxicities axiomatically, since volumes appear to have been written about the lower toxicity of HCQ compared to CQ.

Re: Hydroxychloroquine Update for April 6

#58

Post by throwaway_pdp09 » Mon, Apr 06, 2020, 11:26 PM UTC

stri8ed wrote: post #33

m0zg wrote: post #3

Counterpoint: http://www.leparisien.fr/societe/sante/chloroquine-ne-perdon... You can do double blind studies until your patients are literally blue in the face, or you can try what works now. That is literally the choice at the moment. According to Peter Navarro, a good percentage of NYC patients are getting HCQ at the onset of symptoms now. Cuomo wants more of it, because it "appears to be working". Oklahoma is giv…

> Kentucky is giving it to patients, too. Source? > Italy saw its numbers of deaths stabilize once they started giving it. It appears the total number of cases also decreased. Which would suggest effect is likely due to social distancing. > Marseille (where Raoult's hospital is) has the lowest fatality rate in all of France Source?

Agree with you. There should be some kind of sanction for dumb posts that make claims without references. Downvoting isn't enough.

Re: Hydroxychloroquine Update for April 6

#59

Post by threeseed » Mon, Apr 06, 2020, 11:26 PM UTC

moron4hire wrote: post #41

Why are we talking about drugs in the public media? This is like people demanding certain drugs from their doctors because they saw it in pharmaceutical commercial.

Because it's actively being pushed by right-wing media and the President.

We have a Presidential election in November. And there is a proven, strong correlation between the strength of the economy and your chance of being elected. You can't have a strong economy and people feeling happy when they are stuck at home without a job and fearful of leaving the house.

So they need to get people back to work. And the only way that happens is if you can convince people that it's okay to get COVID-19 because there is some magical drug that will cure you if you end up in hospital.

Re: Hydroxychloroquine Update for April 6

#60

Post by hexl » Mon, Apr 06, 2020, 11:26 PM UTC

pazimzadeh wrote: post #30

Taking Chloroquine too soon might promote viral infection by inhibiting the anti-viral response. https://sciencedirect.com/science/article/abs/pii/S016635421... CQ is for patients who have uncontrolled inflammation in response to the virus, not to be taken as a prophylactic.

If I remember correctly, someone on twiv's podcast said that the inmune inhibition occurs months into treatment for lupus patients taking HCG. So, Could you explain in layman terms why this is not the case? Most of us have no clue about what's being discussed in the paper.