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Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

medrxiv.org

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

#191

Post by DangerousPie »

renewiltord wrote: post #189
DangerousPie wrote: post #168

Earlier quoted context omitted.

Then why are lupus patients struggling to get HCQ right now? Sure in the long run it may be relatively easy to manufacture enough HCQ. But right now stocks are running extremely low because people are trying to use it for COVID without any scientific basis.

They’re struggling because you have chosen this regulatory regime. Generics factories are pumping it out right now.

How is this about regulation? Factories and supply chains can't just suddenly ramp up their production by an order of magnitude or more. You need to build new machines, hire new workers, source new supplies, and figure out how to distribute it all. That can't just happen from one day or another, no matter how little regulation there is on the product.

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

#192

Post by tomohawk »

smacktoward wrote: post #130
tomohawk wrote: post #94

Earlier quoted context omitted.

And then what happens next time? Why spend all the time and effort, only to have what you did nationalized? Incentivizing people to not do productive things like develop drugs seems like a really bad idea.

Nobody’s saying Gilead can’t make a profit. Just that they can’t make an obscene (“have us over a barrel”) profit.

The post I was responding to had the strong implication of a Mafiosi stopping by a store and saying "Nice store you have here - it would be a shame if something happened to it". "You might want to consider our needs and sell us stuff at what we consider a good price".

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

#193

Post by [deleted] »

mcguire wrote: post #99
jeffdavis wrote: post #62

Given the study's small sample size, it seems the only way it would have produced a conclusive result is if the effect size was huge (i.e. miracle cure). The study found some evidence of efficacy, but it was not significant given the sample size. A better headline would say something like: "study finds that HCQ is not a miracle cure for already-hospitalized covid-19 patients".

How much are you willing to pay for "not a miracle cure" on the basis of "eh, it can't hurt"?

[deleted]

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

#194

Post by DanBC »

sheinsheish wrote: post #105

I don’t understand who gets to decide and how, which of these people receive / don’t receive a specific treatment. I’ve always loved medical studies, but now the crisis got me to thinking about the moral decision (playing god?)

You might be interested in this letter from the BMA: https://www.bma.org.uk/media/2283/bma-ethics-guidance-and-ag...

> This note addresses in more detail the relationship between our guidance and those patients who are elderly or who have disabilities. It emphasises that neither age nor disability are in themselves relevant criteria for making decisions about treatment.

This follows on from widespread (and perhaps misleading) reporting about a tool. This tool has NHS branding, but it doesn't appear to have come from NHS_England+Improvement. http://prod-upp-image-read.ft.com/765d3430-7a57-11ea-af44-da...

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

#195

Post by URSpider94 »

capnrefsmmat wrote: post #49

It's important to interpret these results carefully: "no evidence of efficacy" does not imply evidence of no efficacy, and in fact the uncertainty in this study is quite large. The sample size is small enough that it would be very hard for this study to detect the effect of hydroxychloroquine unless that effect is very, very large. From the abstract: > In the HCQ group, 2.8% of the patients died within 7 days vs 4.6%…

This is not the bar that's typically applied for drug trials. The goal of a drug trial is not to prove beyond a shadow of a doubt that it DOESN'T work. The goal is to prove to a high level of confidence that it DOES work.

For example, it's highly unlikely (roughly less than 2.5%) that HCQ reduces the onset of ARDS by half.

If it ultimately turns out that HCQ reduces the rate of death by 5%, we'd have to do a tremendously large trial to distinguish that effect from the control with any confidence that it's not actually killing 2% more people. Additionally, you'd have to consider that vs. the fact that it will kill some fraction of people who take it from its cardiac side effects, even if doctors are vigilant about discontinuing therapy when arhythmias are detected.

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

#196

Post by taborj »

URSpider94 wrote: post #180
3fe9a03ccd14ca5 wrote: post #132

Earlier quoted context omitted.

HCQ is an off-patent drug that is produced in every major country in the world. In fact, many countries have stockpiles of it because of its efficacy at preventing malaria. If there’s a risk of a supply run, it would definitely not last very long. For many people there’s alternatives for treating arthritis and lupus. If it’s shown even to improve the patient’s outcome by even just 10% or more (as this study suggests)…

It's already been politicized, it's too late. The minute that politicians started advocating for a treatment before there was any scientific backing, that ship sailed. Also, this study does NOT suggest that patient outcome is improved by 10% or more. Not in any way. Fewer patients died within the timeframe of this study, but more patients on the drug experienced ARDS; not to mention that 9 patients had to be removed…

> It's already been politicized, it's too late. The minute that politicians started advocating for a treatment before there was any scientific backing, that ship sailed.

In general, that doesn't mean we should simply abandon all attempts to de-politicize it. In fact, it means just the opposite - we should put aside any political aspects and focus on objective data.

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

#197

Post by epistasis »

cabaalis wrote: post #169
the_af wrote: post #92

Earlier quoted context omitted.

I seriously doubt anyone on the planet right now (short of being deranged) wants a treatment not to work. I understand wanting to chastise Trump for being exaggerated and reckless about an unproven treatment, but wanting it not to work? That can't be true.

A proven successful use of this drug would be very inconvenient for multiple media outlets who jumped at the (described as) unfounded claim. It would mean that either (a) the authorities had more information than they did, or that (b) the authorities bet successfully with the same amount of information, which doesn't align with their constant reporting of idiocy.

Not true, it wouldn't inconvenience anybody if this worked out as a treatment, because nobody has claimed that it couldn't be proven to work.

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

#198

Post by StevePerkins »

lonelappde wrote: post #80
koheripbal wrote: post #34

Earlier quoted context omitted.

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 it's become an arbitrary political football to separate "left" vs "right"

Honestly, if this were not linked so tightly at this point to a certain U.S. politician, then I doubt that it would receive much media attention at all. And it would probably be the sort of thing that HN and Reddit would view favorably.

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

#199

Post by URSpider94 »

3fe9a03ccd14ca5 wrote: post #154
rozab wrote: post #150

Earlier quoted context omitted.

Face masks have been shown to be effective at controlling pandemics, and apparently no one (in many western countries) thought to stockpile those.

Facemasks are only produced in a handful of countries. In fact we basically don’t even have the skill set or machinery here to convert factories to producing facemask even if we wanted to. Garment work was moved offshore decades ago. Unlike off-patent prescription drugs.

Which handful are you thinking of? We do make them here in the US... https://www.wired.com/story/surreal-frenzy-inside-us-biggest...

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

#200

Post by _y5hn »

AlexandrB wrote: post #133
_y5hn wrote: post #40

Earlier quoted context omitted.

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

The science may be apolitical, but the choice to accept or reject the science can depend on your politics. I think the anti-vaccination movement has shown that no amount of evidence is sufficient if someone is strongly attached to a belief for ideological reasons.

That is why science is not leadership.
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