France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
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Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
#2A shame, since the Lancet paper has problems[1][2] in particular related to the baseline of the HCQ-treated vs non-HCQ treated patients. And by admission of the authors themselves, it is not a substitute of a RCT.
And this before the results of the Minnesota trial are out. At this point I hope those are negative, so that it does not show that countries are overreacting.
[1] https://statmodeling.stat.columbia.edu/2020/05/25/hydroxychl... and related posts
[2] https://twitter.com/StevePhillipsMD/status/12638995692528967...
PS: The title is misleading. The ban is on the use on severe diseases, not all of them, according to the text in the news.
Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
#3"coronavirus is what happens when you put the reproducibility crisis in charge of the planet"
Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
#4Meh. It wouldn't surprise me if these trials are being run by the makers of Remdesivir or some other drug, and they're purposely killing folks to make their treatment look more effective. It's a pretty common tactic in the pharma industry for drug makers to do trials with enormous doses of their competitors products to make them look more dangerous by comparison, and given that this whole thing has turned into a multi-billion dollar cash grab I would assume that that's what's happening here unless proven otherwise.
It's the same thing with famatodine, where someone observed that folks taking it for heartburn have a lower risk of death. So rather than doing an RCT with giving folks 10mg orally (a normal dose), someone started doing an RCT with like 140mg injected.
Just thinking about it logically, why would you ever give someone a drug that ostensibly works by blocking viral replication when they've already had the virus for multiple weeks? It makes zero sense, which tells you there is something shady going on.
Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
#5A shame, since the Lancet paper has problems[1][2] in particular related to the baseline of the HCQ-treated vs non-HCQ treated patients. And by admission of the authors themselves, it is not a substitute of a RCT. And this before the results of the Minnesota trial are out. At this point I hope those are negative, so that it does not show that countries are overreacting. [1] https://statmodeling.stat.columbia.edu/2020…
Yes, i'm not a proponent of HCQ, not without RCT as some of my previous post might tell you, but the "raw" data of the Lancet study seems pretty well harmonized for raw data, i wouldn't trust this study for my national policies.
I can't take HCQ as i already have extrasystole and a allergies treatment that already can cause arythmia, so i hope this won't be the "best" treatment, but really this paper, while interesting, should not be used to take decisions.
Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
#6This is essentially the Andrew Wakefield fiasco on speedrun, isn't it?
My skepticism was founded entirely on seeing who was promoting this idea, and it is slowly being vindicated.
Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
#7A shame, since the Lancet paper has problems[1][2] in particular related to the baseline of the HCQ-treated vs non-HCQ treated patients. And by admission of the authors themselves, it is not a substitute of a RCT. And this before the results of the Minnesota trial are out. At this point I hope those are negative, so that it does not show that countries are overreacting. [1] https://statmodeling.stat.columbia.edu/2020…
Lancet isn't the only paper that has raised issues with HCQ treatment.
Sciencemag [1] has this to say:
However, both HCQ and AZ have potential cardiac toxicity (QT prolongation, which can lead to fatal arrhythmia), and HCQ additionally has the potential for negative effects on the eye. Understanding risk-benefit ratios is paramount if these drugs are to become a standard of care for COVID-19. Several post hoc analyses carried out in the United States and Europe suggest modest benefit, at best, from HCQ monotherapy for COVID-19 patients; one large post hoc analysis among U.S. veterans suggests that there is harm to patients from HCQ. Given the mechanistic rationale but lack of well-designed clinical studies and potential for drug-induced toxicity, there is a key need for controlled, randomized trials to test the efficacy and safety of these drugs for COVID-19 patients.
[1]: https://science.sciencemag.org/content/sci/368/6493/829.full...
I don't think it's a "shame" that some have decided to stop wtih HCQ when other viable treatments seem to have less concerning side-effects. Either way, we will know very soon with greater certainty as ongoing randomized trials finish up.
Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
#8A shame, since the Lancet paper has problems[1][2] in particular related to the baseline of the HCQ-treated vs non-HCQ treated patients. And by admission of the authors themselves, it is not a substitute of a RCT. And this before the results of the Minnesota trial are out. At this point I hope those are negative, so that it does not show that countries are overreacting. [1] https://statmodeling.stat.columbia.edu/2020…
Yes, i'm not a proponent of HCQ, not without RCT as some of my previous post might tell you, but the "raw" data of the Lancet study seems pretty well harmonized for raw data, i wouldn't trust this study for my national policies. I can't take HCQ as i already have extrasystole and a allergies treatment that already can cause arythmia, so i hope this won't be the "best" treatment, but really this paper, while interesti…
As I wrote elsewhere (check my post history) I personally think that if the effect is there, it is small. I don't really mind if HCQ doesn't work, but I get mad when people say "follow the science", and the most basic thing to do for science (a RCT) is not done.
Let's see if the U of Minnesota trial is published soon. The PI of the study tweeted he had sent revisions to the manuscript, and hoped for a publication this week (and he however added that he thought the same last week).
Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
#9A shame, since the Lancet paper has problems[1][2] in particular related to the baseline of the HCQ-treated vs non-HCQ treated patients. And by admission of the authors themselves, it is not a substitute of a RCT. And this before the results of the Minnesota trial are out. At this point I hope those are negative, so that it does not show that countries are overreacting. [1] https://statmodeling.stat.columbia.edu/2020…
Lancet isn't the only paper that has raised issues with HCQ treatment. Sciencemag [1] has this to say: However, both HCQ and AZ have potential cardiac toxicity (QT prolongation, which can lead to fatal arrhythmia), and HCQ additionally has the potential for negative effects on the eye. Understanding risk-benefit ratios is paramount if these drugs are to become a standard of care for COVID-19. Several post hoc analyse…
Most of these analyses were done in late-stage COVID-19 patients, when any antiviral won't work (same results with remedisivir, lopinavir/ritonavir/ribavirin), that's why the discussion won't stop. Didier Raoult in his very controversial paper suggested prophylaxis after exposure to the virus.
And guess what, no one (save the U of Minnesota trial, AFAICS) has done a RCT on that.
EDIT: I think it's a "shame" because all analyses so far focused on the late-stage disease, as I said, and because hopefully real RCT results will be out soon (like, real soon, or so I hope).
Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears
#10This is essentially the Andrew Wakefield fiasco on speedrun, isn't it? My skepticism was founded entirely on seeing who was promoting this idea, and it is slowly being vindicated.
> My skepticism was founded entirely on seeing who was promoting this idea
The proponent has no effect on the null hypothesis. What was needed was a RCT: no results are out for any, at this point.