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France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

reuters.com

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Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

#11

Post by cm2187 »

Alex3917 wrote: post #4

Meh. 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 mult…

Particularly in the case of a 1950s drug that has been consumed by millions of people, and which as far as I know was available without prescription until covid. It’s like saying aspirin is dangerous. Sure. At a certain dosage.

Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

#13

Post by cataflam »

lbeltrame wrote: post #2

A 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…

> 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.

And the RCTs are still going and will finish, unless there is a major negative effect noticed in them, which is not the case so far.

Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

#14

Post by lbeltrame »

cataflam wrote: post #13
lbeltrame wrote: post #2

A 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…

> 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. And the RCTs are still going and will finish, unless there is a major negative effect noticed in them, which is not the case so far.

Indeed, there is hope that a definitive answer will come out (at this point, given how politicized the discourse is, any answer in either direction willl be fine).

FTR, the U of Minnesota trials used normal dosages and (according to its PI) did not report any cardiotoxicity so far.

Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

#15

Post by mxcrossb »

lbeltrame wrote: post #9
pen2l wrote: post #7

Earlier quoted context omitted.

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 a…

It seems like we’re in trouble if we try to pursue a drug that has to be administered early in the disease process. Such a large percentage of people recover on their own that even a very effective drug has limited returns. And of course you need the infrastructure to detect the disease early and deliver huge supplies. It makes me worry that all antivirals we try will fail.

Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

#16

Post by mariodiana »

cm2187 wrote: post #11
Alex3917 wrote: post #4

Meh. 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 mult…

Particularly in the case of a 1950s drug that has been consumed by millions of people, and which as far as I know was available without prescription until covid. It’s like saying aspirin is dangerous. Sure. At a certain dosage.

Exactly. And the dosage being given for COVID-19 patients is comparable to the dosage given for patients with chronic conditions such as lupus, only the COVID-19 patients are given the drug for something like a week, while the chronic patients are given the drug indefinitely.

Meanwhile, drugs like benzodiazepines are basically just dumped on a largely unwitting populace with the tacit blessing of these very same people who are fretting about hydroxychloroquine. There is more than simply the disinterested caution of science going on here.

Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

#17

Post by lbeltrame »

mxcrossb wrote: post #15
lbeltrame wrote: post #9

Earlier quoted context omitted.

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 a…

It seems like we’re in trouble if we try to pursue a drug that has to be administered early in the disease process. Such a large percentage of people recover on their own that even a very effective drug has limited returns. And of course you need the infrastructure to detect the disease early and deliver huge supplies. It makes me worry that all antivirals we try will fail.

> It seems like we’re in trouble if we try to pursue a drug that has to be administered early in the disease process.

This is the same for remedisivir, and also for ritonavir/lopinavir/ribavirin: they must be given within 7 days of symptom onset to be effective. In fact, the latter was deemed unsuccesful in a first paper, because it was given late, then it was reconsidered when given earlier during the disease.

This is not surprising, given how the disease works (outlined also by the Cell paper from yesterday): at some point the consequences of the highly altered inflammatory reaction greatly surpass the effects of the replication of the virus itself.

This calls more for extensive and early testing, IMO.

Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

#18

Post by lbeltrame »

mariodiana wrote: post #16
cm2187 wrote: post #11

Earlier quoted context omitted.

Particularly in the case of a 1950s drug that has been consumed by millions of people, and which as far as I know was available without prescription until covid. It’s like saying aspirin is dangerous. Sure. At a certain dosage.

Exactly. And the dosage being given for COVID-19 patients is comparable to the dosage given for patients with chronic conditions such as lupus, only the COVID-19 patients are given the drug for something like a week, while the chronic patients are given the drug indefinitely. Meanwhile, drugs like benzodiazepines are basically just dumped on a largely unwitting populace with the tacit blessing of these very same peop…

To be honest, dosage varies a lot across countries. The trials in Brazil gave very high dosage, which can probably explain the deaths from cardiotoxicity there.

Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

#19

Post by bonzini »

cm2187 wrote: post #11
Alex3917 wrote: post #4

Meh. 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 mult…

Particularly in the case of a 1950s drug that has been consumed by millions of people, and which as far as I know was available without prescription until covid. It’s like saying aspirin is dangerous. Sure. At a certain dosage.

Quinine-based drugs are no small thing. They are neurotoxic even at low dosages, for example (the somewhat-related antimalaric drug mefloquine very often causes really bad nightmares, at the very low prophylactic dosage, and it has a long half life so they persist even a few weeks after you've stopped taking it).

Re: France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears

#20

Post by acallaghan »

lbeltrame wrote: post #2

A 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…

If it had any effect on covid-19, it'd be very obvious by now. There isn't some massive conspiracy here, it just doesn't work. The reason trials have stopped is because France, Italy, Belgium & the UK have seen worse outcomes generally, directly because of it.

I don't get the 'it needs to be taken before symptoms!' argument - like we can possibly give a immunosuppressant with non-negligible side-effects (e.g. arrythmia) to billions of people with no scientific evidence of it working on covid at all.

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