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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

#51

Post by acallaghan »

zackees wrote: post #23
acallaghan wrote: post #20

Earlier quoted context omitted.

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. arrythm…

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?

Nothing is in the first line of defence against Covid - it's a novel virus

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

#52

Post by [deleted] »

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.

[deleted]

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

#53

Post by scottmsul »

A cardiotoxicity paper from the WHO in 2017 said the following:

"Despite hundreds of millions of doses administered in the treatment of malaria, there have been no reports of sudden unexplained death associated with quinine, chloroquine or amodiaquine, although each drug causes QT/QTcinterval prolongation. Unfortunately, there are relatively few prospective studies of the electrocardiographic effects of these drugs."

Link to paper: https://www.who.int/malaria/mpac/mpac-mar2017-erg-cardiotoxi...

Link to Chris Martenson's video where I first heard about the 2017 paper: https://www.youtube.com/watch?v=rN_YpFhdii4

Chris Martenson is doing an awesome job staying on top of the science in an apolitical manner.

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

#54

Post by whydoyoucare »

xapata wrote: post #43
0xcafecafe wrote: post #38

Earlier quoted context omitted.

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/

This is an excellent read: https://slatestarcodex.com/2014/12/12/beware-the-man-of-one-... -- basically says one has to be very skeptical of trusting a study that suits the narrative, and how studies can be cherry-picked to align with your narrative.

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

#55

Post by rrmm »

cm2187 wrote: post #33
acallaghan wrote: post #20

Earlier quoted context omitted.

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. arrythm…

The first symptoms aren't necessarily the shortness of breath. In my case I had a week of mild fever before the shortness of breath kicked in. Fever isn't severe. Difficulty to breath is. You can have a policy to be treated when you get the first symptoms, but before these symptoms are severe.

The difficulty there is you're talking about giving it to a lot of people in an outpatient setting.

This is the worst case in terms of risk trade-offs:

Without being admitted as a patient, you will not be monitored as closely especially for coronary complications.

Since you'll be giving it to people before the onset of severe symptoms, you'll be risking side-effects giving it to people who might have been fine without it (and most people will survive with out it).

You'll be giving it to a lot of people which again just increases the chances of serious side-effects.

(PS I hope you're doing well now).

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

#56

Post by Yoric »

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…

> Didier Raoult in his very controversial paper suggested prophylaxis after exposure to the virus.

To be fair, Didier Raoult has changed his own claims several times (including dosage, drug mix and he even switched from chloroquine to hydroxychloroquine – afait, these are different molecules). Including after the studies were started.

This doesn't mean that he's wrong, but at this stage, there are so many red flags that it's hard to take anything he said seriously.

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

#57

Post by Yoric »

lbeltrame wrote: post #14
cataflam wrote: post #13

Earlier quoted context omitted.

> 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.

Did they report any improvement?

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

#58

Post by tialaramex »

lbeltrame wrote: post #8
orwin wrote: post #5

Earlier quoted context omitted.

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 thi…

> most basic thing to do for science (a RCT) is not done.

Randomised Controlled Trials are the gold standard but not the "most basic thing". They are the ideal we'd like to have but often simply aren't an option.

One of the most obvious reasons we often can't do a trial is that we have good reason to believe it would be unreasonably dangerous, which is why these trials stopped.

The opposite scenario happens sometimes too. If all patients treated with Hydroxychloroquine magically got better they'd stop the trial and recommend immediately using it on similar patients.

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

#59

Post by Alex3917 »

scottmsul wrote: post #53

A cardiotoxicity paper from the WHO in 2017 said the following: "Despite hundreds of millions of doses administered in the treatment of malaria, there have been no reports of sudden unexplained death associated with quinine, chloroquine or amodiaquine, although each drug causes QT/QTcinterval prolongation. Unfortunately, there are relatively few prospective studies of the electrocardiographic effects of these drugs."…

Having ACE2 receptors depleted increases blood pressure and changes the properties of blood itself (probably the source of the weird clotting issues), so it makes sense that there would be more risk with Covid-19. Plus many or most Covid patients are probably already polypharming with 5+ drugs already given their age, unlike people going on vacation to Bali or wherever.

I wouldn't trust the trials showing that it's dangerous, but I wouldn't assume it's safe either.

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

#60

Post by klmadfejno »

scottmsul wrote: post #53

A cardiotoxicity paper from the WHO in 2017 said the following: "Despite hundreds of millions of doses administered in the treatment of malaria, there have been no reports of sudden unexplained death associated with quinine, chloroquine or amodiaquine, although each drug causes QT/QTcinterval prolongation. Unfortunately, there are relatively few prospective studies of the electrocardiographic effects of these drugs."…

The data from those hundreds of millions of doses were on people who did not have COVID-19. It's not contradictory to say that the drug does not tend to cause these effects generally, but does cause these effects in a specific context. Like, say, a deadly disease wrecking havoc on your oxygen levels. Maybe it does, maybe it doesn't. Hard to know anything.
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