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Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

medrxiv.org

31–40 of 379 posts

Re: Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

#32
post #26

It was observed that between 7% and 28% of hospitalized have acute myocardial injury [1-4]. When one looks at Epocrates (database for drugs which is why I'm not linking anything here) the severe adverse reactions of hydroxycholoroquine include QT prolongation, cardiomyopathy, and torsade de pointes. Just to define some things here, QT prolongation is the time from your Q wave to your T wave, or the start of an electr…

> between 7% and 28% of hospitalized have acute myocardial injury So, for a younger (< 60) otherwise healthy person whose chance of death with covid is less than 1%, it would seem ill advised to take this medication at the onset of symptoms, unless the the disease itself causes similar or higher rates of heart damage.

It's only advised if it actually works. If it doesn't work, then there's still no point in taking it because the side effects are still bad. And there's no good evidence that it even works, and some mild evidence that it doesn't.

Re: Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

#33
post #2

TLDR: French publication, non randomized 181 patients (hospitalized with pneumonia and O2 requirement) with control group (84 with HCQ, 97 without HCQ), no efficacy but adverse effects for some.

If this is accurate, perhaps the title could be edited to reflect the fact that it's a single study?

Re: Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

#34

Personally I'm witholding judgment until the results of the PATCH trial ( https://clinicaltrials.gov/ct2/show/NCT04329923 ) arrive, as it'll finally give us some decent statistical power, and be a full, double-blind RCT. It also has multiple study arms (health-care worker prophylaxis, home-quarantined early stage, hospitalized later-stage), so if it turns out that HCQ is effective but that by the time patients are ho…

Yeah, the devil is really in the details about exactly when and how you administer it.

Doctors are already saying that it's definitely no magic bullet, but they debate whether it is effective at a certain stage of illness.

What I don't understand is why we're focusing so much on this specific drug when there are some great antivirals out thee that have a more effective theoretical mechanism of action. (eg Remdesivir)

Re: Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

#35
post #30

This trial wasn't randomized, but a quasi randomized trial for HCQ whose preprint was leaked is here: https://www.dropbox.com/s/8b2govfsa6n0xbq/NEJM_Clinical%20Ou... Study indicates that one adverse effect of HCQ (on top of not improving patient outcomes) is increased ventilator times.

From the paper:

A total of 63 patients were included with 32 in the hydroxychloroquine arm.

Hydroxychloroquine administration was associated with a need for escalation of respiratory support level compared to those that did not receive hydroxychloroquine at 5 days (p=0.013). The same findings were observed in a baseline-matched subgroup analysis. Absolute lymphocyte change in the hydroxychloroquine group was no different than supportive care alone (p=0.413).

Hydroxychloroquine use trended towards worsening neutrophil-to-lymphocyte ratio compared to supportive care alone (+9.59 vs +1.58, p=0.51) as well as a higher risk for intubation (p=0.051).

Re: Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

#36

Personally I'm witholding judgment until the results of the PATCH trial ( https://clinicaltrials.gov/ct2/show/NCT04329923 ) arrive, as it'll finally give us some decent statistical power, and be a full, double-blind RCT. It also has multiple study arms (health-care worker prophylaxis, home-quarantined early stage, hospitalized later-stage), so if it turns out that HCQ is effective but that by the time patients are ho…

Yeah, the devil is really in the details about exactly when and how you administer it. Doctors are already saying that it's definitely no magic bullet, but they debate whether it is effective at a certain stage of illness. What I don't understand is why we're focusing so much on this specific drug when there are some great antivirals out thee that have a more effective theoretical mechanism of action. (eg Remdesivir)

It's being focused on in the news, but the others are also being tested. The big problem is like the GP raised, we need proper testing to really be able to say much about the ability of any of these drugs to help.

[1] https://www.fiercebiotech.com/biotech/gilead-clinical-data-h...

Re: Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

#37

Personally I'm witholding judgment until the results of the PATCH trial ( https://clinicaltrials.gov/ct2/show/NCT04329923 ) arrive, as it'll finally give us some decent statistical power, and be a full, double-blind RCT. It also has multiple study arms (health-care worker prophylaxis, home-quarantined early stage, hospitalized later-stage), so if it turns out that HCQ is effective but that by the time patients are ho…

Yeah, the devil is really in the details about exactly when and how you administer it. Doctors are already saying that it's definitely no magic bullet, but they debate whether it is effective at a certain stage of illness. What I don't understand is why we're focusing so much on this specific drug when there are some great antivirals out thee that have a more effective theoretical mechanism of action. (eg Remdesivir)

Because this drug can be cheaply manufactured out of patent. Let's say Remdesivir is the only drug that works, it's basically an admission that Gilead is going to have us over a barrel.

Re: Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

#38

Given that I need hydroxychloroquine to treat my rheumatoid arthritis, I'd like this hypothesis to be either proven or disproven as rapidly and as unambiguously as possible.

You want it disproven, otherwise you won't be able to get your hands on hydroxychloroquine.

Re: Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

#39
post #13

Earlier quoted context omitted.

Who is Dr. Chris Martenson and which hospital does he work at? He seems to be suffering a name collision with some economics PhD guy who appears on Fox.

Savage.

Not quite as savage as you think.

His PhD is in Neurotoxicology. Of all the things Martenson has been wrong about over the years, this particular event is a bit more in his wheelhouse than the economics or energy topics he typically covers.

Re: Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

#40

Given that I need hydroxychloroquine to treat my rheumatoid arthritis, I'd like this hypothesis to be either proven or disproven as rapidly and as unambiguously as possible.

Because HCQ’s efficacy was briefly endorsed by a controversial political figure I fear that there’s no evidence in either direction will convince the true believers. This is now a political issue, like global warming. Hopefully someone is ramping up production so availability improves for those that actually need it.

The science providing data is apolitical. It just takes its due time.
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