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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

#41

Post by frenchyatwork »

cm2187 wrote: post #25
frenchyatwork wrote: post #21

Earlier quoted context omitted.

The risk of treating patients with pain-reducing levels of ASA (aspirin) is actually a significant issue, and it's not hard to find papers covering this issue, and reporting data on it. It's usually in older populations who are more likely to be in pain and also more likely to die from a stomach bleed.

Yeah. But like every drug in the world has contraindications. By this standard all drugs are dangerous and should be banned from trials.

I think I misunderstood you. I thought you were suggesting we should give drugs to people regardless of the fact that the randomized controlled trials say that the drug doesn't provide any significant benefit. Giving widespread ASA to a population that wouldn't benefit from it would be a bad idea.

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

#42

Post by ceejayoz »

ytNumbers wrote: post #35
ceejayoz wrote: post #28

Earlier quoted context omitted.

Remdesivir doesn't have the sudden cardiac death side effect, though, does it? HCQ's issue may be a bad combination of "has to be taken early" and "has significant side effects".

HCQ has been around for 70 years. Remdesivir's issue is that everyone gets to be the guinea pig. Sometimes it's better to go with the devil you know.

> HCQ has been around for 70 years.

Not in an antiviral context, and certainly not for SARS-CoV-2.

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

#43

Post by xapata »

0xcafecafe wrote: post #38
OneGuy123 wrote: post #3

"coronavirus is what happens when you put the reproducibility crisis in charge of the planet"

Can someone please elaborate on this? What is the "reproducibility crisis" in this case?

"Most published research findings are false" (not reproducible)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/

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

#44

Post by fratajcz »

zabana wrote: post #40

Interestingly enough, the french military are still using it to treat their personnel.

They have only confirmed ordering some in case it is proven to be useful. (this was 1 month ago)

https://factuel.afp.com/oui-larmee-francaise-sest-procure-de...

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

#45

Post by frenchyatwork »

halflings wrote: post #26
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.

Aspirin can be deadly if used to treat patients with an hemorrhage. Likewise, treating patients that are infected by a virus is not like preventing malaria in heathy people might to be exposed to a deadly virus like malaria, especially when most deaths are from older people which might be more sensitive to side effects.

Maybe this is pedantic, but malaria isn't caused by a virus. It's caused by a single-celled group of eukaryots called Plasmodium.

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

#46

Post by Luc »

flashyfaffe2 wrote: post #37

This is what I appreciate in YC feed. You got far more better information gathered in one than the MSN article shared initially.

For better information, I would suggest following the credentialed scientific experts on Twitter. You can get information straight from the very best people in their field.

Here, I feel it's a bit of a crap shoot, and half the comments are misinformed & happy to share it.

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

#47

Post by umvi »

0xcafecafe wrote: post #38
OneGuy123 wrote: post #3

"coronavirus is what happens when you put the reproducibility crisis in charge of the planet"

Can someone please elaborate on this? What is the "reproducibility crisis" in this case?

Reproducibility crisis is well known, especially in social sciences. However, it affects other science fields as well.

In a nutshell, the crisis is that there is far more incentive to churn out a new publication/study than reproduce an existing one. So we have tons of studies that are the only one of its kind that have not been reproduced. The crisis part comes in where attempts to reproduce the results of these studies fail which throws into question the legitimacy of the entire field's publications.

So you can imagine how putting your faith into covid-19 related studies (such as effects of hydroxychloroquine) that were rushed and results not reproduced independently can result in problems down the road.

Science is probably the best tool we have for determining truth. However, it takes a long time and a lot of effort to converge on the truth and people put far more faith than they ought to in the results of fresh publications that have results they like (or fear).

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

#48

Post by maxerickson »

lbeltrame wrote: post #10
pjc50 wrote: post #6

This 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.

You are describing a decision making framework with no real world applicability.

Like, how do we decide which things to study with RCTs? We ask experts...

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

#49

Post by vixen99 »

ceejayoz wrote: post #29
zackees wrote: post #23

Earlier quoted context omitted.

It HCQ doesn't work, why is it the common first line of defense used internationally? Why does scholar.google.com list so many papers showing that it's effective?

Because it's a highly effective and widespread malaria (and RA/lupus) treatment?

The dose for malaria is 200mg. It's the higher doses that are associated with heart arythmia in covid patients. According to a trial reported in https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s129...

"No serious cardiac adverse effects were recorded in malaria clinical trials of 35,548 participants who received quinoline and structurally related antimalarials with close follow-up including 18,436 individuals who underwent ECG evaluation."

"Chloroquine is the most widely used antimalarial drug in history. It has a terminal elimination half-life of one month and an annual consumption of hundreds of tonnes for over 50 years, so it may be the drug to which humans have been exposed to most. Despite producing consistent QT prolongation, the only case reports of TdP and sudden death have been for its use for non-malaria indications such as systemic lupus erythematosus or rheumatoid arthritis, where high doses are used for much longer than in malaria treatment, or in overdose"

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

#50

Post by cm2187 »

frenchyatwork wrote: post #41
cm2187 wrote: post #25

Earlier quoted context omitted.

Yeah. But like every drug in the world has contraindications. By this standard all drugs are dangerous and should be banned from trials.

I think I misunderstood you. I thought you were suggesting we should give drugs to people regardless of the fact that the randomized controlled trials say that the drug doesn't provide any significant benefit. Giving widespread ASA to a population that wouldn't benefit from it would be a bad idea.

Well I am personally in favour of doing randomized control trials, not to cancel them based on what appear to be a weak statistical analysis. There was an argument to not wait at the peak of the epidemic rather than not treating (and some of these trials are only starting, which baffles me). But these trials should have been done from the outset.

Doctors in the heat of the moment cannot wait for a randomized trial. They started keeping patients off intrusive ventilators without doing a randomized trial, based on annecdotal evidence.

But these trials still need to happen.

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