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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

#311

Post by Reelin »

jamesblonde wrote: post #299
URSpider94 wrote: post #272

Earlier quoted context omitted.

I have no problems with the way this test was set up. It was a quick study that would have told us quickly if there was a huge benefit from HCQ. That wasn't the outcome. Larger tests with better statistical power will tell us if there is a smaller positive effect. My point is, the smaller the beneficial effect, the larger the test will have to be to find it, but also the lower the overall benefit to patients. Again,…

My immediate reaction was that I would not expect to see an effect if you are giving HCQ to patients after they have been hospitalized by the virus. You are now into the inflamation/cytokine storm phase of COVID-19. The best chance of HCQ working is very early, ideally before or directly after exposure. The jury is still out if you take HCQ after the onset of sympthoms if that is also too late. Based on this in-vitro…

> The best chance of HCQ working is very early, ideally before or directly after exposure.

Adding to this, there are at least two reasonably sized ongoing trials of HCQ with appropriate randomization and blinding in North America alone (I believe there are a number of others elsewhere). I would encourage everyone to withhold judgement until either they post results, or a similarly reliable alternative data source appears.

Target size of 3000 (https://clinicaltrials.gov/ct2/show/NCT04308668).

Target size of 400 (https://clinicaltrials.gov/ct2/show/NCT04329923).

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

#312

Post by jamesblonde »

tptacek wrote: post #305
jamesblonde wrote: post #299

Earlier quoted context omitted.

My immediate reaction was that I would not expect to see an effect if you are giving HCQ to patients after they have been hospitalized by the virus. You are now into the inflamation/cytokine storm phase of COVID-19. The best chance of HCQ working is very early, ideally before or directly after exposure. The jury is still out if you take HCQ after the onset of sympthoms if that is also too late. Based on this in-vitro…

For pre-symptomatic C19 patients, we're already doing a large-scale natural experiment, because HCQ is part of widespread protocols for common ailments like RA, and the dosages those patients get are comparable. As I understand it: we're admitting lots of RA patients with C19; there doesn't seem to be a huge effect with early dosages either?

Yeah, it's pretty clear there isn't a huge effect. But there may still be a big enough effect to move the needle. I have no knowledge of the RA/Lupus subgroup, so any anecdotes to share are welcome!

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

#313

Post by tptacek »

Gibbon1 wrote: post #306
tptacek wrote: post #305

Earlier quoted context omitted.

For pre-symptomatic C19 patients, we're already doing a large-scale natural experiment, because HCQ is part of widespread protocols for common ailments like RA, and the dosages those patients get are comparable. As I understand it: we're admitting lots of RA patients with C19; there doesn't seem to be a huge effect with early dosages either?

Problem with that is people with RA and Lupus are typically hyper careful about their health and most likely to be serious about self isolating.

I'll track down the source I read this from, but my claim was specifically that we are hospitalizing people with RA on HCQ already. So that doesn't really respond to what I said.

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

#314

Post by FireBeyond »

_n_b_ wrote: post #166
sadfklsjlkjwt wrote: post #117

Earlier quoted context omitted.

I used to agree with you. Then I realized that drug companies spend more on lawyers than scientists.

This isn’t even remotely close to true. 0.67% on legal[1] versus 17% on R&D[2]. [1] https://ccbjournal.com/articles/benchmark-metrics-pharma-com... [2] https://www.investopedia.com/ask/answers/060115/how-much-dru...

And how much on marketing?

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

#315

Post by Gibbon1 »

jdkee wrote: post #304
anoncareer0212 wrote: post #73

Earlier quoted context omitted.

Hydroxycholorquine is an immunosuppresant not an anti-viral, so the theory here is the problem isn't the virus, but reacting to it. It's not quite as silly as it sounds - this does, rarely, work, specifically with malaria. But, it is pretty silly when you contrast the likelihood of it being a meaningful thereapeutic versus the significance it's taken on

This is the popular origin of the hydroxycloroquine and zinc thesis. https://www.youtube.com/watch?v=U7F1cnWup9M&list=PLQ_IRFkDIn...

Part of the reason I'm suspicious of hydroxycloroquine and zinc is because for decades zinc and cloroquine have been fringe quack medicine staples for treating/preventing colds and flu.

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

#316

Post by jamesblonde »

Reelin wrote: post #311
jamesblonde wrote: post #299

Earlier quoted context omitted.

My immediate reaction was that I would not expect to see an effect if you are giving HCQ to patients after they have been hospitalized by the virus. You are now into the inflamation/cytokine storm phase of COVID-19. The best chance of HCQ working is very early, ideally before or directly after exposure. The jury is still out if you take HCQ after the onset of sympthoms if that is also too late. Based on this in-vitro…

> The best chance of HCQ working is very early, ideally before or directly after exposure. Adding to this, there are at least two reasonably sized ongoing trials of HCQ with appropriate randomization and blinding in North America alone (I believe there are a number of others elsewhere). I would encourage everyone to withhold judgement until either they post results, or a similarly reliable alternative data source app…

Can Minnesota really recruit 3k people in the next 2 weeks? The second Patch trial won't report until 2021.

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

#317

Post by FireBeyond »

forgingahead wrote: post #148

This whole debate is insane to me -- some people that so-called "experts" don't like mentioned HCQ as a possible treatment for coronavirus, and we've ended up in some bizarro world where everyone is shouting and fingers are being pointed over something that really shouldn't be controversial or perceived as some sinister plot to destroy clever society. 1. HCQ has been used for many decades 2. The side effects are gene…

> some people that so-called "experts" don't like mentioned HCQ as a possible treatment for coronavirus

Let's call a spade a spade. Trump, not 'some people'. Trump's medical training amounts to what, exactly? He heard that a drug has some beneficial effects on a similar disease and is all aboard, and HE is the one "some people say it's an amazing drug", "it can't hurt you" (except when it can), "I'm seeing people who will die without it" (based on what, exactly?). Oh, "and I directly profit from it".

People aren't screaming that HCQ "shouldn't be used", but that a President shouldn't be using his position (and complete lack of medical training) to be promising things that are at best unproven, and at worst, factually incorrect.

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

#318

Post by FireBeyond »

downerending wrote: post #205
Goronmon wrote: post #175

Earlier quoted context omitted.

People are in opposition to the president promoting drugs with unproven effectiveness as a miracle cure for an ongoing pandemic. I didn't think testing drugs before giving them to people was considered "irrational" as you state, but I guess that is where we are now.

It's "irrational" to oppose an idea just because it comes from someone you despise. It's not like this is coming from the National Enquirer --he has access to some of the brightest minds in the world. The efficacy picture on these drugs is quite confusing, and it's not out of the question that they will turn out to be crucially useful. Giving up on them without further investigation doesn't seem wise at this point. B…

> It's not like this is coming from the National Enquirer--he has access to some of the brightest minds in the world.

And yet on multiple occasions he's been seen tweeting and announcing policies in lockstep with segments on Fox News opinion shows.

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

#319

Post by Reelin »

jamesblonde wrote: post #316
Reelin wrote: post #311

Earlier quoted context omitted.

> The best chance of HCQ working is very early, ideally before or directly after exposure. Adding to this, there are at least two reasonably sized ongoing trials of HCQ with appropriate randomization and blinding in North America alone (I believe there are a number of others elsewhere). I would encourage everyone to withhold judgement until either they post results, or a similarly reliable alternative data source app…

Can Minnesota really recruit 3k people in the next 2 weeks? The second Patch trial won't report until 2021.

Yeah I was wondering about that myself. There are 5 participating locations listed, but even then it's a large sample size and an aggressive time frame. On the other hand, just about any healthy adult who recently came into contact with a confirmed positive case is eligible to enroll so maybe it won't be so difficult under the circumstances?

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

#320

Post by souprock »

chasd00 wrote: post #238
thepangolino wrote: post #179

Earlier quoted context omitted.

The way HCQ is by accumulating in cells. It inhibits the replication of viruses by interfering with endosome/lysosome trafficking or viral protein maturation during virion maturation. (basically stops the virus from replicating)

and, correct me if i'm wrong, zinc helps take it with a grain of salt but https://www.snopes.com/fact-check/zelenko-669-coronavirus-pa...

With the right grain of salt, you get zinc. Suggestions: zinc acetate, zinc chloride, zinc citrate
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