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Other => Off Topic => Topic started by: Tom Bri on April 14, 2020, 05:34:08 AM

Title: Would you take Hydroxychloroquine?
Post by: Tom Bri on April 14, 2020, 05:34:08 AM
https://www.rasmussenreports.com/public_content/lifestyle/coronavirus/americans_play_politics_with_their_lives_even_when_it_comes_to_covid_19

Rasmussen poll says many would refuse hydroxychloroquine even if they had Covid-19, and it's apparently a political decision.
Would you? Why?
I have given it to patients and so far no one has refused it.
Seriously, this is insane. In fact, I think it's mainly big talkers, and most of these people would take it if their doctors advised.
Title: Re: Would you take Hydroxychloroquine?
Post by: js82 on April 14, 2020, 05:58:57 AM
Me?  Probably, if my doctor recommended.  I'm of an age(30's) and physical condition where I'm unlikely to have adverse effects from the disease, and also don't have any conditions that are problematic for the use hydroxychloroquine.  If I were sick enough to be hospitalized, I would take it if prescribed - but I wouldn't ask for it preemptively prior to hospitalization.  But again - in my case the discussion is likely to be mostly moot.

If we were to extend the question to whether I'd recommend for my parents - in one case probably yes, in the other case possibly not(would need to consult with someone more familiar with the specific risk profile for the drug) - due to their medical situations and the potential risks versus benefits.

This is why I think we really need to keep gathering more data on efficacy.  Those most likely to have issues with this virus are those with certain conditions that put them at higher risk - unfortunately compared with the general population, there's more overlap in this group of those that are at risk from some of the side effects, and those that are most likely to need additional treatment to help them to survive the virus.  Understanding how much benefit patients get from this drug is critical to helping doctors to make a risk vs. benefit decision on when/when not to prescribe it.

To me, the most frustrating part of this is that we *could* have a much larger dataset on the effectiveness of this drug - and yet right now we have a couple small trials plus a large number of anecdotal accounts - if the latter could be turned into numerical data(even if imperfect) it'd help advance the conversation of - is this a "wonder drug", mildly beneficial, or something where(for certain patients) the risks outweigh the benefits?

(disclaimer - I'm not a doctor - I'm a non-medical scientist who has read the published studies on hydroxychloroquine and thinks there's enough evidence to support further testing and an emergency use authorization, but not enough to proclaim it a wonder drug.)


The shame is that this whole situation could have been largely avoided had President Trump simply elected to have a medical professional handle the medical questions - to come up on stage and talk about hydroxychloroquine and its potential benefits and explain the "why" of the situation to the public, rather than try to set himself up for a "if it works, I'll be a hero and get the credit for it" moment.
Title: Re: Would you take Hydroxychloroquine?
Post by: YttriumNitrate on April 14, 2020, 06:16:39 AM
I've taken hydroxychloroquine in the past when traveling for a few weeks in regions with malaria. While it does have some side effects, if I'm to the point where I'm going to the doctor, I would consider those side effects trivial. So I would take it.

A relative of mine took it during the Vietnam war, and has indicated that he really would rather never take it again if at all possible. Of course, I'm pretty sure if he was diagnosed with COVID-19, and it was prescribed by his doctor, he would take it.
Title: Re: Would you take Hydroxychloroquine?
Post by: AnnaGrowsAMustache on April 14, 2020, 06:57:02 AM
I would never take anything recommended by an orange guy who thinks McDonalds is food, and gets most of his information from television.
Title: Re: Would you take Hydroxychloroquine?
Post by: scantee on April 14, 2020, 07:21:34 AM
I mean, if my doctor recommended it, sure, I would take it. The efficacy data for This drug for covid-19 in particular looks to be pretty middling. It’s certainly no wonder drug, rather it works okay for some people at certain stages of the disease.

Stepping back, I hate poll questions like this. Why is this even a question to survey? Clearly they want or are looking for a political divide in responses to this question which is why they are asking in the first place but it’s clear the data are garbage. In real life, almost everyone is going to do what their care team suggests.
Title: Re: Would you take Hydroxychloroquine?
Post by: EvenSteven on April 14, 2020, 09:10:22 AM
The evidence for efficacy of HCQ in the treatment of COVID19 seems to be extremely weak. But the evidence seems much stronger in the treatment of autoimmune diseases, like lupus.

Patients who take HCQ for things like lupus are now unable to get the medicine they need because of the demand for treatment in COVID19. I would not take it, and let someone who actually needs it and would benefit from it have it.

https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/
Title: Re: Would you take Hydroxychloroquine?
Post by: bacchi on April 14, 2020, 09:21:08 AM
https://www.rasmussenreports.com/public_content/lifestyle/coronavirus/americans_play_politics_with_their_lives_even_when_it_comes_to_covid_19

Rasmussen poll says many would refuse hydroxychloroquine even if they had Covid-19, and it's apparently a political decision.
Would you? Why?
I have given it to patients and so far no one has refused it.
Seriously, this is insane. In fact, I think it's mainly big talkers, and most of these people would take it if their doctors advised.

Rasmussen plays politics with its polls.

The evidence is specious. We'll know more in a few months when the real clinical studies are finishing.

Until then, I wouldn't take it. Unless I end up at Duke, where a study is going on, and my doctor is looking at the early, promising, results.
Title: Re: Would you take Hydroxychloroquine?
Post by: Kris on April 14, 2020, 09:37:24 AM
https://www.rasmussenreports.com/public_content/lifestyle/coronavirus/americans_play_politics_with_their_lives_even_when_it_comes_to_covid_19

Rasmussen poll says many would refuse hydroxychloroquine even if they had Covid-19, and it's apparently a political decision.
Would you? Why?
I have given it to patients and so far no one has refused it.
Seriously, this is insane. In fact, I think it's mainly big talkers, and most of these people would take it if their doctors advised.

Rasmussen plays politics with its polls.

The evidence is specious. We'll know more in a few months when the real clinical studies are finishing.

Until then, I wouldn't take it. Unless I end up at Duke, where a study is going on, and my doctor is looking at the early, promising, results.

Exactly. The wording of the questions is... questionable, and the conclusions they draw in that article (and the leading language they use) are also pretty slanted.

Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on April 14, 2020, 09:59:20 AM
With our current knowledge if my doctor recommended me taking hydroxychloroquine for coved-19 I would... find a new doctor. Seriously, the evidence that it will help is scant at best.  Also, having had to take it before as an anti-malaria drug I (and my brother) experienced some pretty serious side effects. Social distancing and self-isolation is way preferable to me than going through that again.
Title: Re: Would you take Hydroxychloroquine?
Post by: geekette on April 14, 2020, 11:16:27 AM
I’d consider being part of a study, if I get Covid-19. I’d really rather avoid it!

Interesting YouTube (https://youtu.be/va6j4JITJoE) from SciShow, on the history of chloroquine, hydroxychloroquine, how it’s thought to work for malaria and lupus, and why some think it might work on Covid (but that studies are needed).

I always wondered why someone decided it even might work, so this was a good, short explanation for me.
Title: Re: Would you take Hydroxychloroquine?
Post by: GuitarStv on April 15, 2020, 05:31:47 AM
I prefer quinine.  Preferable with lime and gin.
Title: Re: Would you take Hydroxychloroquine?
Post by: tralfamadorian on April 15, 2020, 08:55:32 AM
I would change doctors since I'm severely allergic to sulfa drugs.

However, to add my 2c to the intented question- from a layman's view, signs appears to point to the dosage needed to be effective against coronavirus as high enough to cause severe and possibly life-threatening side effects.

I've been skeptical- though still hopeful- about the effectiveness of the anti-malarials since listening to this podcast (https://www.microbe.tv/twiv/twiv-special-denison/) where they interviewed a coronavirologist, which was recorded before the orange one's proclamations. The podcast is long so to summarize, the coronavirologist discusses anti-malarials as a potential treatment saying that they often do well in vitro but have never panned in vivo for coronaviruses in the past.
 
Title: Re: Would you take Hydroxychloroquine?
Post by: vern on April 15, 2020, 02:23:48 PM
https://babylonbee.com/news/liberal-treated-with-hydroxychloroquine-hopes-he-still-dies-of-covid-19-to-prove-trump-is-stupid
Title: Re: Would you take Hydroxychloroquine?
Post by: GuitarStv on April 15, 2020, 02:25:16 PM
Who the hell feels any need to prove Trump's stupidity at this point?  It's not even contested by most of his supporters.
Title: Re: Would you take Hydroxychloroquine?
Post by: Pizzabrewer on April 15, 2020, 03:14:18 PM
I’d prefer to try Remdesivir. It seems to have more science backing it up as a potentially effective treatment.
Title: Re: Would you take Hydroxychloroquine?
Post by: scottish on April 15, 2020, 03:40:02 PM
I already take hydroxychloroquine.    I would rather not, but the consequences (systemic lupus) are considerably worse than the side effects.

The drug is reasonably low risk on normal doses, which are <= 400mg / day.     Unlike the other immuno-suppressants I'm familiar with, it does not have a black label warning.

The first thing to understand is that immuno-suppressants are toxic.    When you first start taking plaquenil you can expect to feel unwell, a bit like a permanent mild hangover.   It took me about 6 weeks to get over these side effects.   It's also teratogenic, which means it's known to cause birth defects.    If I wanted to have more kids, I would have to discontinue the drug for several months and risk the disease.

The second thing to understand is that plaquenil takes about 30 days before it starts affecting your immune system.    I don't think it's going to help with the 'cytokine storm' I read about with covid 19.   Maybe it causes problems for the virus directly.

And my final comment is that the dosages I'm reading about are 800 or 1000 mg/day, i..e over twice the normal dosage.    I don't know what this does to the toxicity, but it's going to be a lot worse than a mild hangover at this level.

Title: Re: Would you take Hydroxychloroquine?
Post by: Tom Bri on April 15, 2020, 04:18:01 PM
I already take hydroxychloroquine.    I would rather not, but the consequences (systemic lupus) are considerably worse than the side effects.

The drug is reasonably low risk on normal doses, which are <= 400mg / day.     Unlike the other immuno-suppressants I'm familiar with, it does not have a black label warning.

The first thing to understand is that immuno-suppressants are toxic.    When you first start taking plaquenil you can expect to feel unwell, a bit like a permanent mild hangover.   It took me about 6 weeks to get over these side effects.   It's also teratogenic, which means it's known to cause birth defects.    If I wanted to have more kids, I would have to discontinue the drug for several months and risk the disease.

The second thing to understand is that plaquenil takes about 30 days before it starts affecting your immune system.    I don't think it's going to help with the 'cytokine storm' I read about with covid 19.   Maybe it causes problems for the virus directly.

And my final comment is that the dosages I'm reading about are 800 or 1000 mg/day, i..e over twice the normal dosage.    I don't know what this does to the toxicity, but it's going to be a lot worse than a mild hangover at this level.

I took it when I was in the Peace Corps, as a malaria prophylactic. It caused bad dreams but no other side effect for me, at the low doses we took.

Currently we are giving 400mg twice a day for two days, then 200mg twice a day for 3 more days to our patients suspected of or tested positive.

The worrisome side effect is a change in heart rhythm. All of our covid patients are treated on a critical care unit or ICU, so they are all on cardiac telemetry monitoring continuously. If that side effect shows up, we stop the HCQ. It's no big deal. Maybe other hospitals don't monitor cardiac rhythms?
Title: Re: Would you take Hydroxychloroquine?
Post by: HPstache on April 15, 2020, 04:21:18 PM
I already take hydroxychloroquine.    I would rather not, but the consequences (systemic lupus) are considerably worse than the side effects.

The drug is reasonably low risk on normal doses, which are <= 400mg / day.     Unlike the other immuno-suppressants I'm familiar with, it does not have a black label warning.

The first thing to understand is that immuno-suppressants are toxic.    When you first start taking plaquenil you can expect to feel unwell, a bit like a permanent mild hangover.   It took me about 6 weeks to get over these side effects.   It's also teratogenic, which means it's known to cause birth defects.    If I wanted to have more kids, I would have to discontinue the drug for several months and risk the disease.

The second thing to understand is that plaquenil takes about 30 days before it starts affecting your immune system.    I don't think it's going to help with the 'cytokine storm' I read about with covid 19.   Maybe it causes problems for the virus directly.

And my final comment is that the dosages I'm reading about are 800 or 1000 mg/day, i..e over twice the normal dosage.    I don't know what this does to the toxicity, but it's going to be a lot worse than a mild hangover at this level.

I took it when I was in the Peace Corps, as a malaria prophylactic. It caused bad dreams but no other side effect for me, at the low doses we took.

Currently we are giving 400mg twice a day for two days, then 200mg twice a day for 3 more days to our patients suspected of or tested positive.

The worrisome side effect is a change in heart rhythm. All of our covid patients are treated on a critical care unit or ICU, so they are all on cardiac telemetry monitoring continuously. If that side effect shows up, we stop the HCQ. It's no big deal. Maybe other hospitals don't monitor cardiac rhythms?

What have you seen so far for results?  What is your read on whether it works to prevent the really bad symptoms & progression of COVID-19?
Title: Re: Would you take Hydroxychloroquine?
Post by: Tom Bri on April 15, 2020, 10:03:33 PM


I took it when I was in the Peace Corps, as a malaria prophylactic. It caused bad dreams but no other side effect for me, at the low doses we took.

Currently we are giving 400mg twice a day for two days, then 200mg twice a day for 3 more days to our patients suspected of or tested positive.

The worrisome side effect is a change in heart rhythm. All of our covid patients are treated on a critical care unit or ICU, so they are all on cardiac telemetry monitoring continuously. If that side effect shows up, we stop the HCQ. It's no big deal. Maybe other hospitals don't monitor cardiac rhythms?
[/quote]

What have you seen so far for results?  What is your read on whether it works to prevent the really bad symptoms & progression of COVID-19?
[/quote]

It's hard to say, since the disease itself is so new and all we know about the symptoms are what we read about from other countries and what we see ourselves. How much of what I see is corona, and what part is medication side-effects is not easy to tease out.

My opinion is that the HCQ appears to have no particular side effects at the doses and length of time we are using it, 4-5 days. That is, before we started using HCQ the patients had fevers, chills, muscle aches and were absolutely exhausted, to the point that a 35 year old man in excellent shape was unable to walk 6 feet to the toilet. After using HCQ, the last week or so, maybe my patients are better, but maybe I am just catching some easier patients. I'll quiz the docs at work, who see a lot more patients than any individual nurse. I'll let you know in a few days what they say.
Title: Re: Would you take Hydroxychloroquine?
Post by: Tom Bri on April 20, 2020, 03:20:00 AM
I asked one doctor who said he didn't see much effect. I'll quiz more as I run into them at work.

I read all the research I can find, including the early pre-prints:
https://connect.medrxiv.org/relate/content/181

 I notice that the Chinese studies all seem to show a strong positive effect. Studies done in the US are pretty much not showing anything positive or negative. Some of the Euro studies show a positive effect. Sadly, most of the studies are little better than anecdotes at this early stage.

I would take it. It is only being given for a few days, at moderate dosages. Chances of any strong negative side effects are nearly nil unless you have pre-existing heart rhythm problems.

Title: Re: Would you take Hydroxychloroquine?
Post by: BudgetSlasher on April 20, 2020, 08:42:13 AM
My answer is a firmly qualified yes.

Prophylactically: No

With minor Covid-19 Symptoms and no decline: Probably not, but if recommended by a doctor that I trust or have an existing relationship with I would consider their opinion. (I have enough doctors and NPs in the family to get some additional input).

If there was a better  or more promising option available to me option available (say the data, at the time, supported remdesivir or convalescent plasma): No, I would go with the most promising and available to me treatment.

If I was moderately sick and declining or severely sick and it was the only treatment for the disease (not the symptoms) that showed promise: Yes

Title: Re: Would you take Hydroxychloroquine?
Post by: scottish on April 20, 2020, 09:39:39 AM
I asked one doctor who said he didn't see much effect. I'll quiz more as I run into them at work.

I read all the research I can find, including the early pre-prints:
https://connect.medrxiv.org/relate/content/181

 I notice that the Chinese studies all seem to show a strong positive effect. Studies done in the US are pretty much not showing anything positive or negative. Some of the Euro studies show a positive effect. Sadly, most of the studies are little better than anecdotes at this early stage.

I would take it. It is only being given for a few days, at moderate dosages. Chances of any strong negative side effects are nearly nil unless you have pre-existing heart rhythm problems.

400 mg twice a day is a very high dose isn't it, i.e. twice the level approved for lupus?    A moderate dose would be 200mg per day...   (not a doctor, just asking)
Title: Re: Would you take Hydroxychloroquine?
Post by: Tom Bri on April 21, 2020, 09:14:24 AM


400 mg twice a day is a very high dose isn't it, i.e. twice the level approved for lupus?    A moderate dose would be 200mg per day...   (not a doctor, just asking)
[/quote]

It's a loading dose. Some of the research papers gave quite a bit higher doses. One paper out of Brazil started at 1 gram. They ran into problems and cancelled the study.
Title: Re: Would you take Hydroxychloroquine?
Post by: Maenad on April 22, 2020, 03:30:14 PM
https://babylonbee.com/news/liberal-treated-with-hydroxychloroquine-hopes-he-still-dies-of-covid-19-to-prove-trump-is-stupid

Do you realize the Babylon Bee is a satire site like the Onion? I can't tell from you just posting a link.
Title: Re: Would you take Hydroxychloroquine?
Post by: bacchi on April 22, 2020, 07:08:57 PM
https://babylonbee.com/news/liberal-treated-with-hydroxychloroquine-hopes-he-still-dies-of-covid-19-to-prove-trump-is-stupid

Do you realize the Babylon Bee is a satire site like the Onion? I can't tell from you just posting a link.

That's how vern be.

In other news, there's a pre-print study about hydroxy:

https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1

Quote
CONCLUSIONS: In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19. An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone.
(bolded)



And another one: https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v1.full.pdf

Quote from: medrxiv
No   evidence   of   clinical   efficacy   of   hydroxychloroquine   in   patients   hospitalised  for  COVID-19  infection  and  requiring  oxygen:  results  of  a  study using routinely collected data to emulate a target trial


There's a NY/Univ. Albany study being released this week that should reveal more about what works and what doesn't.
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on April 22, 2020, 07:15:51 PM
...oddly, it’s been a few days since Trump or Hannity mentioned hydroxychlorquine. 

This highlights the lack of leadership we have during this crisis.  During trying times the WH is grasping for a miracle cure while telling people the states should take the lead, even in matters that are best led by a unified federal government.
Title: Re: Would you take Hydroxychloroquine?
Post by: Tass on April 22, 2020, 08:56:10 PM
https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/

That is a follow-up article to this one, which goes a little more into the details of the original French study touting the HCQ-azithromycin combo: https://sciencebasedmedicine.org/are-hydroxychloroquine-and-azithromycin-an-effective-treatment-for-covid-19/

Here's the jaw-dropping part of the study:

Quote
We enrolled 36 out of 42 patients meeting the inclusion criteria in this study that had at least six days of follow-up at the time of the present analysis. A total of 26 patients received hydroxychloroquine and 16 were control patients. Six hydroxychloroquine-treated patients were lost in follow-up during the survey because of early cessation of treatment. Reasons are as follows: three patients were transferred to intensive care unit... one patient died on day3 post inclusion... one patient decided to leave the hospital on day3 post-inclusion... finally, one patient stopped the treatment on day3 post-inclusion because of nausea... The results presented here are therefore those of 36 patients (20 hydroxychloroquine-treated patients and 16 control patients). None of the control patients was lost in follow-up.

The "lost to follow up" patients were excluded from their analysis - so, all the patients who got HCQ but got worse (transferred to ICU or died) were ignored. No wonder they found positive results!

Now, this doesn't mean it's impossible that HCQ is helpful, and obviously some research has been done since then. But this is the paper that started the hype, and it's garbage. Forgive me for being miffed.
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on April 23, 2020, 04:23:30 AM
https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/

That is a follow-up article to this one, which goes a little more into the details of the original French study touting the HCQ-azithromycin combo: https://sciencebasedmedicine.org/are-hydroxychloroquine-and-azithromycin-an-effective-treatment-for-covid-19/

Here's the jaw-dropping part of the study:

Quote
We enrolled 36 out of 42 patients meeting the inclusion criteria in this study that had at least six days of follow-up at the time of the present analysis. A total of 26 patients received hydroxychloroquine and 16 were control patients. Six hydroxychloroquine-treated patients were lost in follow-up during the survey because of early cessation of treatment. Reasons are as follows: three patients were transferred to intensive care unit... one patient died on day3 post inclusion... one patient decided to leave the hospital on day3 post-inclusion... finally, one patient stopped the treatment on day3 post-inclusion because of nausea... The results presented here are therefore those of 36 patients (20 hydroxychloroquine-treated patients and 16 control patients). None of the control patients was lost in follow-up.

The "lost to follow up" patients were excluded from their analysis - so, all the patients who got HCQ but got worse (transferred to ICU or died) were ignored. No wonder they found positive results!

Now, this doesn't mean it's impossible that HCQ is helpful, and obviously some research has been done since then. But this is the paper that started the hype, and it's garbage. Forgive me for being miffed.

Imagine how much stronger my studies could be if I were to drop all the inconvenient results before running my stats!
Title: Re: Would you take Hydroxychloroquine?
Post by: js82 on April 23, 2020, 05:44:22 AM

Now, this doesn't mean it's impossible that HCQ is helpful, and obviously some research has been done since then. But this is the paper that started the hype, and it's garbage. Forgive me for being miffed.

There's some other weird stuff in that study if you sift through the raw data - data patterns that one probably wouldn't expect to occur naturally through random variation.  Makes me think  it's possible there were issues with the tests/labs they were using as well.

But yes, there were a lot of things wrong with the French study.  It should get exactly what it deserves upon peer review..
Title: Re: Would you take Hydroxychloroquine?
Post by: DarkandStormy on April 23, 2020, 11:44:54 AM
https://www.cnn.com/2020/04/21/health/hydroxychloroquine-veterans-study/index.html

Quote
Coronavirus patients taking hydroxychloroquine, a treatment touted by President Trump, were no less likely to need mechanical ventilation and had higher deaths rates compared to those who did not take the drug, according to a study of hundreds of patients at US Veterans Health Administration medical centers.

It's insane to me that doctors are prescribing a drug for covid-19 when there's no medical basis for doing so.
Title: Re: Would you take Hydroxychloroquine?
Post by: scottish on April 23, 2020, 03:45:56 PM
I don't find the results especially surprising.   Hydroxychroloquine is mildly toxic, it seems strange it would help fight off a virus.

On the bright side, I can report no problems renewing my prescription this month!
Title: Re: Would you take Hydroxychloroquine?
Post by: Fireball on April 23, 2020, 04:05:40 PM
https://www.cnn.com/2020/04/21/health/hydroxychloroquine-veterans-study/index.html

Quote
Coronavirus patients taking hydroxychloroquine, a treatment touted by President Trump, were no less likely to need mechanical ventilation and had higher deaths rates compared to those who did not take the drug, according to a study of hundreds of patients at US Veterans Health Administration medical centers.

It's insane to me that doctors are prescribing a drug for covid-19 when there's no medical basis for doing so.

Wait, so they're saying that it's not helpful AND you're more likely to die if you do take it??? Oh, FFS. I mean, I try to not just blatantly bash Trump at every turn, but he shouldn't make it so easy. Work with me, Donald.
Title: Re: Would you take Hydroxychloroquine?
Post by: DarkandStormy on April 23, 2020, 07:57:24 PM
https://www.cnn.com/2020/04/21/health/hydroxychloroquine-veterans-study/index.html

Quote
Coronavirus patients taking hydroxychloroquine, a treatment touted by President Trump, were no less likely to need mechanical ventilation and had higher deaths rates compared to those who did not take the drug, according to a study of hundreds of patients at US Veterans Health Administration medical centers.

It's insane to me that doctors are prescribing a drug for covid-19 when there's no medical basis for doing so.

Wait, so they're saying that it's not helpful AND you're more likely to die if you do take it??? Oh, FFS. I mean, I try to not just blatantly bash Trump at every turn, but he shouldn't make it so easy. Work with me, Donald.

To be fair, a fake medical.expert appeared on one of his favorite Fox News shows (Tucker).and said HQC had "100% success rate" among covid-19 patients.
Title: Re: Would you take Hydroxychloroquine?
Post by: bacchi on April 23, 2020, 08:47:34 PM
Sunlight, I shit you not, is the next miracle cure.

Not in the air, not on a surface, but as a treatment.

https://www.washingtonexaminer.com/news/trump-floats-using-uv-light-or-disinfectant-injections-to-treat-covid-19-patients

Quote
“Deborah [Dr. Birx], have you ever heard of the heat and the light relative to this virus?”

“Not as a treatment,” she said....
Title: Re: Would you take Hydroxychloroquine?
Post by: DarkandStormy on April 23, 2020, 08:54:43 PM
Lol can we inject it into the body? What about disinfectant?
Title: Re: Would you take Hydroxychloroquine?
Post by: Tass on April 23, 2020, 09:05:52 PM
I don't find the results especially surprising.   Hydroxychroloquine is mildly toxic, it seems strange it would help fight off a virus.

I believe it does show some promising results in cell culture, so there was reason to at least investigate it as a treatment. Unfortunately, lots of things work in cell culture that don't work in humans.

(https://imgs.xkcd.com/comics/cells.png)
Title: Re: Would you take Hydroxychloroquine?
Post by: Abe on April 23, 2020, 11:55:29 PM
It showed promising results in cell culture of monkey renal cells that were selected for ease of replicating viruses. I know it’s really hard to culture lung cells, but they could’ve at least done an in vivo monkey trial first. At least redesmivir (which will probably be another bust based on the latest data) had data against coronaviruses in lung cell cultures and monkeys. It’s a bit too much jumping the gun and experimenting on people for my taste.
Title: Re: Would you take Hydroxychloroquine?
Post by: KBecks on April 24, 2020, 05:10:48 AM
What I have heard is hydroxychloroquine + zinc + azithromycin.  The azithromycin might be able to be substituted with another antibiotic.

I might ask for it if I had Covid-19 and moderate symptoms.
Title: Re: Would you take Hydroxychloroquine?
Post by: DarkandStormy on April 24, 2020, 07:02:02 AM
(https://forum.urbanohio.com/uploads/monthly_2020_04/EWVLyifXgAM3TA6.jpeg.182cbfb50820097865f78f9fd8bab068.jpeg)
Title: Re: Would you take Hydroxychloroquine?
Post by: Fireball on April 24, 2020, 07:44:54 AM
What I have heard is hydroxychloroquine + zinc + azithromycin.  The azithromycin might be able to be substituted with another antibiotic.

I might ask for it if I had Covid-19 and moderate symptoms.

I've heard they're strongly looking into bleach and sunlight right now. I would hold off on the hydroxychloroquine combo just a bit longer.
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on April 24, 2020, 07:56:31 AM
Someone is going to inject themselves with bleach, and they are going to die or be hospitalized.
Desperate and scared people will do desperate things.
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on April 24, 2020, 09:20:51 AM
Well the FDA has just issued a warning about taking hydroxychloroquine, against the hype currently being given by Trump and Fox & Friends.

When your own scientists routinely contradict you, rethink your position(s).
Title: Re: Would you take Hydroxychloroquine?
Post by: Maenad on April 24, 2020, 12:55:59 PM
Well the FDA has just issued a warning about taking hydroxychloroquine, against the hype currently being given by Trump and Fox & Friends.

When your own scientists routinely contradict you, rethink your position(s).

That's what a reasonable human being would do, yes.
Title: Re: Would you take Hydroxychloroquine?
Post by: Tass on April 24, 2020, 07:53:51 PM
What I have heard is hydroxychloroquine + zinc + azithromycin.  The azithromycin might be able to be substituted with another antibiotic.

I might ask for it if I had Covid-19 and moderate symptoms.

The hydroxychloroquine + azithromycin combo was recommended against this week by the NIH because both have the same dangerous cardiac side effect, and that side effect was cropping up in treated COVID-19 patients. I wouldn't ask for that combo, but even if you did I'm not sure if you'd get it at this point.

That was before, and separate from, the FDA recommendation against HCQ alone that @nereo just mentioned upthread.
Title: Re: Would you take Hydroxychloroquine?
Post by: Villanelle on April 24, 2020, 08:57:36 PM
I don't find the results especially surprising.   Hydroxychroloquine is mildly toxic, it seems strange it would help fight off a virus.

I believe it does show some promising results in cell culture, so there was reason to at least investigate it as a treatment. Unfortunately, lots of things work in cell culture that don't work in humans.

(https://imgs.xkcd.com/comics/cells.png)

This reminds me of people saying something is all-natural, as though that means it is safe.  You know what else is natural?  Cyanide. 
Title: Re: Would you take Hydroxychloroquine?
Post by: oldtoyota on April 24, 2020, 10:12:55 PM
What I have heard is hydroxychloroquine + zinc + azithromycin.  The azithromycin might be able to be substituted with another antibiotic.

I might ask for it if I had Covid-19 and moderate symptoms.

I've heard they're strongly looking into bleach and sunlight right now. I would hold off on the hydroxychloroquine combo just a bit longer.

I hear that was the drug to use for a week. Now, we have moved on to injecting sunlight and inhaling Clorox.

Would you inhale Clorox if your doctor suggested it?

Title: Re: Would you take Hydroxychloroquine?
Post by: Fireball on April 24, 2020, 10:29:50 PM
What I have heard is hydroxychloroquine + zinc + azithromycin.  The azithromycin might be able to be substituted with another antibiotic.

I might ask for it if I had Covid-19 and moderate symptoms.

I've heard they're strongly looking into bleach and sunlight right now. I would hold off on the hydroxychloroquine combo just a bit longer.

I hear that was the drug to use for a week. Now, we have moved on to injecting sunlight and inhaling Clorox.

Would you inhale Clorox if your doctor suggested it?

My post was intended to be playful sarcasm in case that wasn't evident.
Title: Re: Would you take Hydroxychloroquine?
Post by: jim555 on April 24, 2020, 11:38:02 PM
I've been mainlining Lysol and I feel great, so fresh and clean.
Title: Re: Would you take Hydroxychloroquine?
Post by: GuitarStv on April 25, 2020, 05:42:38 AM
I've been mainlining Lysol and I feel great, so fresh and clean.

You haven't lived until you've injected UV light.  I'll admit that it's tricky to capture in the syringe (you need to work quickly) though.
Title: Re: Would you take Hydroxychloroquine?
Post by: jim555 on April 25, 2020, 06:00:10 AM
I've been mainlining Lysol and I feel great, so fresh and clean.

You haven't lived until you've injected UV light.  I'll admit that it's tricky to capture in the syringe (you need to work quickly) though.
UV rectal works wonders, or so I've heard.
Title: Re: Would you take Hydroxychloroquine?
Post by: GuitarStv on April 25, 2020, 06:17:16 AM
I've been mainlining Lysol and I feel great, so fresh and clean.

You haven't lived until you've injected UV light.  I'll admit that it's tricky to capture in the syringe (you need to work quickly) though.
UV rectal works wonders, or so I've heard.

Bit of a stretch to get the bulb up there the first time, but then you're golden.
Title: Re: Would you take Hydroxychloroquine?
Post by: hops on April 25, 2020, 12:26:33 PM
I've taken this at 400 mg daily for years. Overall, it's the mildest of my meds, but as @scottish mentioned it takes some time to build up a tolerance. The first few weeks my biggest problems were rashes, but my rheumatologist strongly encouraged sticking with it to see what happened.

It's been fantastic for me and for two relatives who took it long-term without issue. One of the many troubling things about the circus Trump and his cronies created around hydroxychloroquine, besides the flagrant irresponsibility of touting unproven treatments and causing drug shortages, is in the future new lupus or RA patients (and sometimes spondylitis patients) might think back on the scary C19 headlines and be too afraid to try it even though their own situations and dosages are quite different.
Title: Re: Would you take Hydroxychloroquine?
Post by: Tom Bri on April 26, 2020, 01:20:23 AM
What I have heard is hydroxychloroquine + zinc + azithromycin.  The azithromycin might be able to be substituted with another antibiotic.

I might ask for it if I had Covid-19 and moderate symptoms.

The hydroxychloroquine + azithromycin combo was recommended against this week by the NIH because both have the same dangerous cardiac side effect, and that side effect was cropping up in treated COVID-19 patients. I wouldn't ask for that combo, but even if you did I'm not sure if you'd get it at this point.

That was before, and separate from, the FDA recommendation against HCQ alone that @nereo just mentioned upthread.

The side effect is a lengthened Qtc. In our covid patients on HCQ the patients are all on continuous cardiac monitoring. We know if they are having this side effect and stop the treatment. I had one patient who had a history of prolonged Qtc. He was not put on HCQ.

This side effect is a non-issue, and a distraction from the basic question of whether the drug combo works or not. Plenty of doctors think it does. Others just hope it does and use it on that hope. There is plenty of good, scientific evidence that it should work, or at least help.
Title: Re: Would you take Hydroxychloroquine?
Post by: BikeFanatic on April 26, 2020, 03:03:48 AM
Exactly what Tombri said. HCQ prolongs QT interval on EKG, so if you are on another drug that prolongs QT interval, and there are a ton that do, like antidepressant, anti anxiety meds. Then you are more at risk for Torsades des pointes, a lethal cardiac arrhythmia. So no I would not take HCQ unless I was prescribed and monitored, or very sick and felt it was worth the risks.
Title: Re: Would you take Hydroxychloroquine?
Post by: KBecks on April 26, 2020, 06:22:32 AM
This is concerning for people who have heart conditions or take drugs that are not compatible.  Obviously, a doctor will evaluate and consult with the patient and talk about the risks, etc. 

I think that any patient can also self-advocate and ask for the treatment if they are interested in it and feel like they are an appropriate candidate.

Note that I mentioned Zinc, and it seems that many are not including that in their mention of Hydroxychloroquine.  My understanding is that the two work together.
Title: Re: Would you take Hydroxychloroquine?
Post by: scottish on April 26, 2020, 07:36:11 AM
Why the fixation on hydroxychloroquine?    (The bleach/UV discussion is too silly to consider.)    There are thousands and thousands of drugs out there.     If we were to setup small trials with each drug, I'm sure you would find several that pass the p-test with respect to COVID-19.

We could try all of the immuno-suppressants: imuran, methotrexate, all the mono-clonal antibodies.

For that matter, if the problem is inflammation in the lungs, why aren't doctors prescribing corticosteroids like prednisone?   They are cheap, fast acting and readily available.   



Title: Re: Would you take Hydroxychloroquine?
Post by: hops on April 26, 2020, 08:37:23 AM
Why the fixation on hydroxychloroquine?    (The bleach/UV discussion is too silly to consider.)    There are thousands and thousands of drugs out there.     If we were to setup small trials with each drug, I'm sure you would find several that pass the p-test with respect to COVID-19.

We could try all of the immuno-suppressants: imuran, methotrexate, all the mono-clonal antibodies.

For that matter, if the problem is inflammation in the lungs, why aren't doctors prescribing corticosteroids like prednisone?   They are cheap, fast acting and readily available.

Corticosteroids and some biologics are among the many options already being looked at, but fortunately it appears that none of Trump's golf buddies have placed large financial bets on them, so he's not yet rhapsodized about "tremendous, beautiful clones of antibodies -- and some would add to it, mono," in that egregiously stupid way of his.

https://www.theatlantic.com/health/archive/2020/04/coronavirus-immune-response/610228/

Hopefully, for the safety of their listeners, Ingraham & Co. will remain disinterested in these potential treatments. None are expected to be one size fits all solutions, a nuance that tends to be lost on the anti-science crowd.
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on April 26, 2020, 11:49:12 AM
.

Note that I mentioned Zinc, and it seems that many are not including that in their mention of Hydroxychloroquine.  My understanding is that the two work together.

Seems like classic moving of goalposts to me.  Hydroxychloroquine was touted by Trump and Hannity and others as a potential miracle cure.  Then it became Hydroxychloroquine + azithromycin.  As soon as that was shown to offer no improvement and potential harm it got switched to Hydroxchloroquine + azithromycin + zinc.

The support for this trio-cocktail is about what it was when this whole thing began with just hydroxychloroquine; which is basically zilch in terms of clinical studies. Like hydroxychloroquine, zinc carries its own side effects nad risk, particulalry when taken in larger doses.  It’s a heavy metal.  It can cause liver damage, particularly in people who already have liver damage.

We ought to be even more skeptical of adding a third chemical to a cocktail of drugs which has already been shown to be ineffective and potentially dangerous.
Title: Re: Would you take Hydroxychloroquine?
Post by: scottish on April 26, 2020, 01:22:44 PM
When you take a drug cocktail and something goes wrong, you have no idea what's causing the problem.   It could be an individual drug or an interaction between multiple drugs that you're taking, or even something unrelated to the drugs.     A common solution is to add another drug, to cancel out the side effects of the current drugs.

I don't know what you're worried about, this sounds like a good plan to me!
Title: Re: Would you take Hydroxychloroquine?
Post by: Abe on April 26, 2020, 02:07:07 PM
What I have heard is hydroxychloroquine + zinc + azithromycin.  The azithromycin might be able to be substituted with another antibiotic.

I might ask for it if I had Covid-19 and moderate symptoms.

The hydroxychloroquine + azithromycin combo was recommended against this week by the NIH because both have the same dangerous cardiac side effect, and that side effect was cropping up in treated COVID-19 patients. I wouldn't ask for that combo, but even if you did I'm not sure if you'd get it at this point.

That was before, and separate from, the FDA recommendation against HCQ alone that @nereo just mentioned upthread.

The side effect is a lengthened Qtc. In our covid patients on HCQ the patients are all on continuous cardiac monitoring. We know if they are having this side effect and stop the treatment. I had one patient who had a history of prolonged Qtc. He was not put on HCQ.

This side effect is a non-issue, and a distraction from the basic question of whether the drug combo works or not. Plenty of doctors think it does. Others just hope it does and use it on that hope. There is plenty of good, scientific evidence that it should work, or at least help.

Please cite the evidence. Everything I’ve seen suggests it doesn’t. I’m interested to know since in vitro studies showed it inhibits viral replication in certain cell lines (they didn’t try it in pneumocyte cell lines, probably due to time constraints). I don’t know enough about the drug to have a strong opinion on it. I do know enough about drug discovery to be suspicious of jumping from in vitro to clinical trials.

I found the following (none of these published yet, like most covid studies):
Chinese RCT, 62 patients, showed benefit in duration of fever and cough by 1 day
https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v3

Chinese RCT: 150 patients showed no difference in any clinical outcome
https://www.medrxiv.org/content/10.1101/2020.04.10.20060558v1

French case-control study, 20 patients: decreased viral load, no clinical outcome reported
https://www.medrxiv.org/content/10.1101/2020.03.16.20037135v1

Meta-analysis of 7 trials/studies: no benefit in clinical outcomes, decrease in viral load noted with HCQ
https://www.medrxiv.org/content/10.1101/2020.04.14.20065276v1

US VA retrospective review, 368 patients: higher risk of death on multi variate analysis with HCQ or HCQ+AZ
 https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v2

Multinational claims data review of safety of HCQ + sulfasalazine or HCQ +AZ: increased 30d cardiac mortality and angina admissions with HCQ+AZ
https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v1

Single institution review of QT prolongation in covid-19 patients: 17% had critical prolongation with HCQ+AZ (mostly men), none developed torsades
https://www.medrxiv.org/content/10.1101/2020.04.22.20075671v1
another showed 11% risk:
https://www.medrxiv.org/content/10.1101/2020.04.02.20047050v1

So far it looks like there’s improvement in labs, but no clear clinical benefit with some cardiac arrhythmia risk. I agree that QTc prolongation isn’t a huge issue, but would like to see some clear benefit first. Azithromycin isn’t even that effective against hospital acquired pneumonia, Id use something else if we’re trying to provide prophylaxis against secondary pneumonias, honestly. Then this wouldn’t even be an issue.
Title: Re: Would you take Hydroxychloroquine?
Post by: hops on April 27, 2020, 04:30:15 PM
News on Kevzara, another arthritis treatment being tested on Covid-19 patients:

https://www.statnews.com/2020/04/27/arthritis-drug-kevzara-disappoints-as-coronavirus-treatment/

Monoclonal antibody/cytokine storm related, if anyone was interested.
Title: Re: Would you take Hydroxychloroquine?
Post by: DarkandStormy on April 27, 2020, 06:44:32 PM
What I have heard is hydroxychloroquine + zinc + azithromycin.  The azithromycin might be able to be substituted with another antibiotic.

I might ask for it if I had Covid-19 and moderate symptoms.

The hydroxychloroquine + azithromycin combo was recommended against this week by the NIH because both have the same dangerous cardiac side effect, and that side effect was cropping up in treated COVID-19 patients. I wouldn't ask for that combo, but even if you did I'm not sure if you'd get it at this point.

That was before, and separate from, the FDA recommendation against HCQ alone that @nereo just mentioned upthread.

The side effect is a lengthened Qtc. In our covid patients on HCQ the patients are all on continuous cardiac monitoring. We know if they are having this side effect and stop the treatment. I had one patient who had a history of prolonged Qtc. He was not put on HCQ.

This side effect is a non-issue, and a distraction from the basic question of whether the drug combo works or not. Plenty of doctors think it does. Others just hope it does and use it on that hope. There is plenty of good, scientific evidence that it should work, or at least help.

No, there's not. Literally the opposite. Jesus Christ.
Title: Re: Would you take Hydroxychloroquine?
Post by: HPstache on April 28, 2020, 11:12:37 AM
Apparently University of Washington Medicine is not convinced that the VA trail was the death knell for using HCQ in the treatment for COVID-19.  They are starting another trail administering HCQ  early in the infection time frame and also in conjunction with Azithromycin.  I am very curious to see the results.

https://komonews.com/news/local/new-uw-medicine-clinical-trial-to-treat-covid-19-outpatients-with-hydrocholorquine
Title: Re: Would you take Hydroxychloroquine?
Post by: Villanelle on April 28, 2020, 12:39:43 PM
I saw that based on some evaluations of outcomes in China, they are doing a trial of the active ingredient in Pepcid.  Yes, the antacid.

When I read that, I was extremely grateful that just a few days ago I bought some (for antacid purposes) as likely if/when words spreads, there will be a run on it. 
Title: Re: Would you take Hydroxychloroquine?
Post by: Tom Bri on April 29, 2020, 03:27:02 AM
What I have heard is hydroxychloroquine + zinc + azithromycin.  The azithromycin might be able to be substituted with another antibiotic.

I might ask for it if I had Covid-19 and moderate symptoms.

The hydroxychloroquine + azithromycin combo was recommended against this week by the NIH because both have the same dangerous cardiac side effect, and that side effect was cropping up in treated COVID-19 patients. I wouldn't ask for that combo, but even if you did I'm not sure if you'd get it at this point.

That was before, and separate from, the FDA recommendation against HCQ alone that @nereo just mentioned upthread.

The side effect is a lengthened Qtc. In our covid patients on HCQ the patients are all on continuous cardiac monitoring. We know if they are having this side effect and stop the treatment. I had one patient who had a history of prolonged Qtc. He was not put on HCQ.

This side effect is a non-issue, and a distraction from the basic question of whether the drug combo works or not. Plenty of doctors think it does. Others just hope it does and use it on that hope. There is plenty of good, scientific evidence that it should work, or at least help.

No, there's not. Literally the opposite. Jesus Christ.

Yes, there is. Literally decades worth of research. Effects on immune system. Antiviral effects. Little of it directly relevant to the current crisis, but it is suggestive. What we have in recent research is lots of low-quality studies, some of which show strong positive effects and others that show no effects. It's a wash. But to say that there is no evidence that it should be beneficial is simply wrong. Can you differentiate between 'should' and 'does'? Nowhere do I claim strong positive effects. At best, hope.
Title: Re: Would you take Hydroxychloroquine?
Post by: Tom Bri on April 29, 2020, 03:33:11 AM


For that matter, if the problem is inflammation in the lungs, why aren't doctors prescribing corticosteroids like prednisone?   They are cheap, fast acting and readily available.

They are being used, but cautiously. The early studies out of China did not show benefit, and some showed negative effects. As far as I know, no one knows why. I have gotten to the point where I no longer read the Chinese studies, since they don't track well with later studies from other countries.

Same with Hydroxychloroquine. Early Chinese studies showed strong benefit, and some of the early Euro and US studies do too, but others do not. So far no real good, long-term studies, due to the fast pace of the pandemic. It'll be years before we have good data.
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on April 29, 2020, 05:06:01 AM


For that matter, if the problem is inflammation in the lungs, why aren't doctors prescribing corticosteroids like prednisone?   They are cheap, fast acting and readily available.

They are being used, but cautiously. The early studies out of China did not show benefit, and some showed negative effects. As far as I know, no one knows why. I have gotten to the point where I no longer read the Chinese studies, since they don't track well with later studies from other countries.

Same with Hydroxychloroquine. Early Chinese studies showed strong benefit, and some of the early Euro and US studies do too, but others do not. So far no real good, long-term studies, due to the fast pace of the pandemic. It'll be years before we have good data.

Medical ethics are very clear: in the absence of good data we must proceed with an abundance of caution. The existence of decent studies which failed to find a significant benefit or found a negative impact should be deeply concerning even among others which demonstrate a positive outcome.  You are correct that we will not know the long term impacts for some time.  First, do no harm.
Title: Re: Would you take Hydroxychloroquine?
Post by: DarkandStormy on April 29, 2020, 06:46:43 AM
Yes, there is. Literally decades worth of research. Effects on immune system. Antiviral effects. Little of it directly relevant to the current crisis, but it is suggestive. What we have in recent research is lots of low-quality studies, some of which show strong positive effects and others that show no effects. It's a wash. But to say that there is no evidence that it should be beneficial is simply wrong. Can you differentiate between 'should' and 'does'? Nowhere do I claim strong positive effects. At best, hope.

https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2

Quote
A malaria drug widely touted by President Donald Trump for treating the new coronavirus showed no benefit in a large analysis of its use in U.S. veterans hospitals. There were more deaths among those given hydroxychloroquine versus standard care, researchers reported.

The nationwide study was not a rigorous experiment. But with 368 patients, it’s the largest look so far of hydroxychloroquine with or without the antibiotic azithromycin for COVID-19, which has killed more than 171,000 people as of Tuesday.

Quote
About 28% who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. About 22% of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival.

Hydroxychloroquine made no difference in the need for a breathing machine, either.

The largest study to date showed no difference and more deaths in patients who were given hydroxychloroquine.

The first person to widely promote hydroxychloroquine faked his credentials to get on Fox News, where President Trump then picked it up and started promoting it (he has a financial stake in a company that produces it....hmmm....).

https://www.dailymail.co.uk/news/article-8143845/Malaria-cure-coronavirus-promoter-cryptocurrency-hustler-fake-Stanford-University-claim.html
Quote
Rigano first touted the use of chloroquine on Monday March 13, publishing a document on Google which was presented to look like a scientific paper, but which is not and which Google has now removed because it is in violation of its terms of service.

It was written by Rigano and by James Todaro, a former ophthalmologist in Dearborn, Michigan, turned cryptocurrency investor.

And now docs are prescribing HCQ based on this bunk scientific paper promoted by a crypto trader and a guy who has to fake his credentials.  Truly wild.
Title: Re: Would you take Hydroxychloroquine?
Post by: HPstache on April 29, 2020, 08:21:46 AM
Yes, there is. Literally decades worth of research. Effects on immune system. Antiviral effects. Little of it directly relevant to the current crisis, but it is suggestive. What we have in recent research is lots of low-quality studies, some of which show strong positive effects and others that show no effects. It's a wash. But to say that there is no evidence that it should be beneficial is simply wrong. Can you differentiate between 'should' and 'does'? Nowhere do I claim strong positive effects. At best, hope.

https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2

Quote
A malaria drug widely touted by President Donald Trump for treating the new coronavirus showed no benefit in a large analysis of its use in U.S. veterans hospitals. There were more deaths among those given hydroxychloroquine versus standard care, researchers reported.

The nationwide study was not a rigorous experiment. But with 368 patients, it’s the largest look so far of hydroxychloroquine with or without the antibiotic azithromycin for COVID-19, which has killed more than 171,000 people as of Tuesday.

Quote
About 28% who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. About 22% of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival.

Hydroxychloroquine made no difference in the need for a breathing machine, either.

The largest study to date showed no difference and more deaths in patients who were given hydroxychloroquine.

The first person to widely promote hydroxychloroquine faked his credentials to get on Fox News, where President Trump then picked it up and started promoting it (he has a financial stake in a company that produces it....hmmm....).

https://www.dailymail.co.uk/news/article-8143845/Malaria-cure-coronavirus-promoter-cryptocurrency-hustler-fake-Stanford-University-claim.html
Quote
Rigano first touted the use of chloroquine on Monday March 13, publishing a document on Google which was presented to look like a scientific paper, but which is not and which Google has now removed because it is in violation of its terms of service.

It was written by Rigano and by James Todaro, a former ophthalmologist in Dearborn, Michigan, turned cryptocurrency investor.

And now docs are prescribing HCQ based on this bunk scientific paper promoted by a crypto trader and a guy who has to fake his credentials.  Truly wild.

Why do you think UW is willing to do yet another study if it's so obvious that it doesn't work?
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on April 29, 2020, 08:32:54 AM

Why do you think UW is willing to do yet another study if it's so obvious that it doesn't work?
Cynically:  Grant money. 
More optimistically: To bring clarity to previous studies and hopefully gain some insight about future promising pathways.  There's value in knowing when and why and for whom it doesn't work, and potentially there may be circumstances when it does (i.e. during early administration, as is the intent of this particualr study).

Don't discount grant money and confirming a negative result though.  As a researcher myself there's a lot of projects who's expectation going in is to refute a current hypothesis.  Negative results are still valuable.  This is part of the scientific method.
Title: Re: Would you take Hydroxychloroquine?
Post by: Abe on April 29, 2020, 08:40:02 PM
It says on their website they’ve been given money by the Gates foundation to study its use for post-exposure prophylaxis based on an in vitro study that noted decreased viral replication in a monkey cell line (kidney cells). It’s the kind of thing that’d not be funded at all in conventional times, but here we are. So it meets both of @nereo ’s possible explanations. They don’t reference any clinical studies showing a benefit for symptomatic covid-19 patients. They specifically exclude people with heart disease, or on any medication that could interact with HCQ to cause arrhythmia. Also the trial started before the latest data on HCQ came out. I think overall it’s a low risks study that has a better chance of success than therapeutic trials on critically ill patients.
Title: Re: Would you take Hydroxychloroquine?
Post by: Pizzabrewer on April 29, 2020, 09:03:28 PM
So there’s new data out showing that Remdesivir has a positive effect.
Title: Re: Would you take Hydroxychloroquine?
Post by: Abe on April 29, 2020, 10:29:30 PM
Yeah it shortens average length of hospitalization by 3 days (11 vs 14). It’s not clear there’s a difference in survival (8 vs 11%, p value not given). This was an interim analysis and needs to be reviewed further.
Title: Re: Would you take Hydroxychloroquine?
Post by: Poundwise on May 20, 2020, 02:35:05 PM
"Sen. Charles Schumer of New York said the VA needs to provide Congress more information about a recent bulk order for $208,000 worth of hydroxychloroquine. President Donald Trump has heavily promoted the malaria drug, without evidence, as a treatment for Covid-19."

"The analysis of hospital data, done by independent researchers at two universities with VA approval, was not a rigorous experiment. Researchers analyzed medical records of 368 older male veterans hospitalized with confirmed coronavirus infection at VA medical centers who died or were discharged by April 11.

About 28% of veterans who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone."

https://www.politico.com/news/2020/05/10/schumer-veterans-coronavirus-drugs-247059
Title: Re: Would you take Hydroxychloroquine?
Post by: bacchi on May 20, 2020, 03:14:30 PM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on May 20, 2020, 03:34:49 PM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”
Title: Re: Would you take Hydroxychloroquine?
Post by: Kris on May 20, 2020, 03:38:31 PM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

I tend to agree.
Title: Re: Would you take Hydroxychloroquine?
Post by: hops on May 21, 2020, 09:59:53 AM
For those of us who require this medication for conditions that actually call for it, his latest announcement was like a scene from a horror movie -- just when you think the monster's been dispatched, it pops right back to life. The chances he's actually taking it are slim to none, but either way all this does is jeopardize the health of his most ardent followers, people whose health is probably in enough jeopardy already if they're following his lead on other C19 matters.
Title: Re: Would you take Hydroxychloroquine?
Post by: Fireball on May 21, 2020, 10:23:03 AM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

Absolute zero chance that he's taking HCQ. He's just trying to save face.   
Title: Re: Would you take Hydroxychloroquine?
Post by: sixwings on May 21, 2020, 10:26:29 AM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

It's very possible he's being given a gummy bear and told it's medicine.
Title: Re: Would you take Hydroxychloroquine?
Post by: MasterStache on May 21, 2020, 10:27:28 AM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

Absolute zero chance that he's taking HCQ. He's just trying to save face.
I disagree. It's the bestest bigly drug. Some very good, in fact great people like this drug. It's good and fantastic. In fact some very good people say it might even cure windmill cancer. We shall call it the "super duper drug."   
Title: Re: Would you take Hydroxychloroquine?
Post by: js82 on May 21, 2020, 10:36:27 AM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

Absolute zero chance that he's taking HCQ. He's just trying to save face.

It's entirely possible that his doctor prescribed him a too-low-to-hurt, too-low-to-possibly-help dose, as well.  Both the efficacy and side effects of just about any drug are dose-dependent.

The doctors taking care of the president would not allow him to take something that they think has any meaningful risk of harm.  Particularly when there are other drugs out there that show some benefit that are potentially lower-risk.
Title: Re: Would you take Hydroxychloroquine?
Post by: GuitarStv on May 21, 2020, 11:10:40 AM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

Absolute zero chance that he's taking HCQ. He's just trying to save face.
I disagree. It's the bestest bigly drug. Some very good, in fact great people like this drug. It's good and fantastic. In fact some very good people say it might even cure windmill cancer. We shall call it the "super duper drug."

Windmill cancer is the toughest cancer to cure. . .
Title: Re: Would you take Hydroxychloroquine?
Post by: MasterStache on May 21, 2020, 11:24:39 AM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

Absolute zero chance that he's taking HCQ. He's just trying to save face.
I disagree. It's the bestest bigly drug. Some very good, in fact great people like this drug. It's good and fantastic. In fact some very good people say it might even cure windmill cancer. We shall call it the "super duper drug."

Windmill cancer is the toughest cancer to cure. . .
I am sure a few doses of Hydroxychloroquine with a side of bleach and a dab of UV light would do the trick.
Title: Re: Would you take Hydroxychloroquine?
Post by: GuitarStv on May 21, 2020, 12:58:35 PM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

Absolute zero chance that he's taking HCQ. He's just trying to save face.
I disagree. It's the bestest bigly drug. Some very good, in fact great people like this drug. It's good and fantastic. In fact some very good people say it might even cure windmill cancer. We shall call it the "super duper drug."

Windmill cancer is the toughest cancer to cure. . .
I am sure a few doses of Hydroxychloroquine with a side of bleach and a dab of UV light would do the trick.

Only if Mexico pays for it!
Title: Re: Would you take Hydroxychloroquine?
Post by: partgypsy on May 21, 2020, 01:10:17 PM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

Absolute zero chance that he's taking HCQ. He's just trying to save face.

It's entirely possible that his doctor prescribed him a too-low-to-hurt, too-low-to-possibly-help dose, as well.  Both the efficacy and side effects of just about any drug are dose-dependent.

The doctors taking care of the president would not allow him to take something that they think has any meaningful risk of harm.  Particularly when there are other drugs out there that show some benefit that are potentially lower-risk.

That is my guess. That if he demanded it, his doctors are giving him a close to placebo level dose. No side effects but no benefits either. And I don't think any of these studies looked at propholactic use of this drug, so that adds to the stupidity.  Drug trials take months to go through, and also this is not a quick infection. There are people in the hospital 6 weeks after being admitted. I think we are going to have to look at alot of different treatments, get inspiration from what docs are testing "live" that seem beneficial, and go from there. But we won't have a lot of answers until some time passes.
Title: Re: Would you take Hydroxychloroquine?
Post by: Pizzabrewer on May 21, 2020, 01:47:30 PM
Q    Can you explain, sir, though, you — what is the evidence that it has a preventative effect?

THE PRESIDENT:  Here we go.  Are you ready?  Here’s my evidence.  I get a lot of positive calls about it.  The only negative I’ve heard was the study where they gave it — was it the VA?  With, you know, people that aren’t big Trump fans gave it — and we’ve done the greatest job maybe of anything in the VA, because I got VA Choice and VA Accountability both approved.  Accountability, Tilman, is where you can fire bad people that work in the VA that you couldn’t fire them.

We had thousands of people that were sadists, that were stealing, that were robbers, that were horrible people.  They’d beat up our veterans.  They couldn’t do it in primetime, but they did it when they were sick.

And we got Accountability.  Nobody thought you could get it because of the unions and civil service.  I got it passed so that now you fire bad people in the VA.  We got rid of tremendously bad people that should have never been there.  But I also got — probably, even more importantly, if you can say that; maybe not — VA Choice.

So if you have to wait on line for a doctor, you go outside, you have a private doctor, we pay the bill.  We work out deals with doctors.  We have pricing.  So you go out, you pay the bill.  And it was a great thing that we did, so we’ve done a great job with the VA.

But they had a report come out and the results of the report — it was a very unscientific report, by the way.  But I get a lot of tremendously positive news on the hydroxy.  And I say, “Hey.”  You know the expression I’ve used, Jon?  “What do you have to lose?”  Okay?  “What do you have to lose?”
Title: Re: Would you take Hydroxychloroquine?
Post by: DarkandStormy on May 21, 2020, 02:36:59 PM
With, you know, people that aren’t big Trump fans gave it — and we’ve done the greatest job maybe of anything in the VA, because I got VA Choice and VA Accountability both approved.

Btw, President Obama signed this into law in 2014: https://apnews.com/375515aecedb4aed949e4f2eb9c54eb6

I know the media has just baked in Trump's incessant lying, but no reason we need to accept it.
Title: Re: Would you take Hydroxychloroquine?
Post by: hops on May 22, 2020, 07:41:24 AM
The latest in a line of damning studies:

https://www.washingtonpost.com/health/2020/05/22/hydroxychloroquine-coronavirus-study/
Title: Re: Would you take Hydroxychloroquine?
Post by: GuitarStv on May 22, 2020, 08:02:42 AM
The latest in a line of damning studies:

https://www.washingtonpost.com/health/2020/05/22/hydroxychloroquine-coronavirus-study/

Fake news libtard deep state lame stream media smear piece.
Title: Re: Would you take Hydroxychloroquine?
Post by: Bateaux on May 22, 2020, 04:04:49 PM
If I knew my doctor supports Trump,  I'd get a new doctor.
Title: Re: Would you take Hydroxychloroquine?
Post by: bacchi on May 22, 2020, 05:19:56 PM
The latest in a line of damning studies:

https://www.washingtonpost.com/health/2020/05/22/hydroxychloroquine-coronavirus-study/

Fake news libtard deep state lame stream media smear piece.

Nailed it!

Quote from: thedonald.win
WAPO is filled up to the gills with Deep State CIA psyop operatives.

Quote
Fuck the Lamestream media.

Etc., etc.

Maybe these comments are generated from an algorithm?

---------
from random import randrange

if article.source == "Washington Post":
  rand = randrange(10)
  if rand < 7:
    print "WAPO is deep state media!"
  else:
    print "Chinese garbage!"
---------

Title: Re: Would you take Hydroxychloroquine?
Post by: Fireball on May 22, 2020, 05:20:30 PM
Well, Trump is taking it and has been for almost 2 weeks now. His "evidence" of its efficacy is that he's heard about it working from lots of people.

Lancet published an editorial about Trump's belief in "magic bullets" last week.

I’m not convinced that Trump is actually taking it.   He’s lied about so much else- particularly when it comes to his health.
By saying he’s taking it (even if he isn’t) he’s doubling down on his earlier hype without any actual side effects.  His backers get to say “well he seems to be just fine!” (As if that’s some great endorsement of a medicine) and “if the president is taking it certainly it has to be good!”

Absolute zero chance that he's taking HCQ. He's just trying to save face.

It's entirely possible that his doctor prescribed him a too-low-to-hurt, too-low-to-possibly-help dose, as well.  Both the efficacy and side effects of just about any drug are dose-dependent.

The doctors taking care of the president would not allow him to take something that they think has any meaningful risk of harm.  Particularly when there are other drugs out there that show some benefit that are potentially lower-risk.

Entirely possible, but given Trump's propensity for lying, I think the default stance has to be that he's doing what comes most natural to him.
Title: Re: Would you take Hydroxychloroquine?
Post by: js82 on May 23, 2020, 08:52:48 AM
If I knew my doctor supports Trump,  I'd get a new doctor.

I don't care who people I interact with support politically, as long as they're competent at what they do and treat others with decency.  If they let their political biases affect how they do their job, that's another matter entirely.

That said, the body of evidence regarding hydroxychloroquine has evolved, and not positively.  Two months ago you could make a case that it was worth exploring further based off the preliminary data.  Now I don't think you can justify hydroxychloroquine over alternatives(say, remdesevir) given the mounting body of evidence.  I see clinging to hydroxychloroquine as a treatment of choice as a decision that's likely to be motivated by political biases rather than rational examination of data, given the scientific evidence against it at the present time.
Title: Re: Would you take Hydroxychloroquine?
Post by: GuitarStv on May 23, 2020, 02:21:30 PM
Can you make a case where a rational, competent medical practitioner would support the Donald Trump?  I'm just going through the things that Trump has done that are pandemic related (dismantling the US's response organizations, ignoring information about the pandemic he received early on, telling people to use dangerous and untested drugs, accusing medical practitioners of lying about the amounts of PPE they need, accusing medical practitioners of stealing PPE, continuously failing to act in the manner recommended by his medical advisors, etc.) and I'm not sure the case can honestly be made.  A doctor would have to be irrational or incompetent to support Trump based on his pandemic response alone, so it's probably a good idea to avoid someone like that if possible.
Title: Re: Would you take Hydroxychloroquine?
Post by: MasterStache on May 25, 2020, 08:45:57 AM
Can you make a case where a rational, competent medical practitioner would support the Donald Trump?  I'm just going through the things that Trump has done that are pandemic related (dismantling the US's response organizations, ignoring information about the pandemic he received early on, telling people to use dangerous and untested drugs, accusing medical practitioners of lying about the amounts of PPE they need, accusing medical practitioners of stealing PPE, continuously failing to act in the manner recommended by his medical advisors, etc.) and I'm not sure the case can honestly be made.  A doctor would have to be irrational or incompetent to support Trump based on his pandemic response alone, so it's probably a good idea to avoid someone like that if possible.
https://www.cbsnews.com/news/pro-trump-doctors-publicly-support-reopening-views-coronavirus-pandemic/ (https://www.cbsnews.com/news/pro-trump-doctors-publicly-support-reopening-views-coronavirus-pandemic/)

The sad fact that they need an initiative to find doctors is truly frightening. I mean, all you have to do is make reasonable, responsible decisions and doctors are likely to support you.
Title: Re: Would you take Hydroxychloroquine?
Post by: jim555 on June 15, 2020, 11:40:15 AM
"WASHINGTON — The Food and Drug Administration on Monday said it had withdrawn an emergency approval for use of the malaria drug hydroxychloroquine as a Covid-19 treatment."

https://www.statnews.com/2020/06/15/fda-revokes-hydroxychloroquine/

So much for the wonder drug magic bullet.
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on June 15, 2020, 11:45:31 AM
i'm both shocked and dissappointed that it took as long as it did.

Will Trump still claim to be taking it?
Title: Re: Would you take Hydroxychloroquine?
Post by: jim555 on June 15, 2020, 12:06:01 PM
They sent out 20 million HCQ tablets in April, what a waste of taxpayer funds.
Title: Re: Would you take Hydroxychloroquine?
Post by: Pizzabrewer on June 15, 2020, 12:40:09 PM
But I thought it was one of the "biggest game-changers in the history of medicine", and the most powerful man in the world and self-proclaimed "smart guy" said he had a "good feeling" about it?  And besides, what do you have to lose?

Surely such wisdom should trump something as nonsensical as the FDA.
Title: Re: Would you take Hydroxychloroquine?
Post by: GuitarStv on June 15, 2020, 12:42:24 PM
They sent out 20 million HCQ tablets in April, what a waste of taxpayer funds.

Mexico will pay for it.
Title: Re: Would you take Hydroxychloroquine?
Post by: DarkandStormy on June 15, 2020, 12:42:41 PM
https://www.rasmussenreports.com/public_content/lifestyle/coronavirus/americans_play_politics_with_their_lives_even_when_it_comes_to_covid_19

Rasmussen poll says many would refuse hydroxychloroquine even if they had Covid-19, and it's apparently a political decision.
Would you? Why?
I have given it to patients and so far no one has refused it.
Seriously, this is insane. In fact, I think it's mainly big talkers, and most of these people would take it if their doctors advised.
"WASHINGTON — The Food and Drug Administration on Monday said it had withdrawn an emergency approval for use of the malaria drug hydroxychloroquine as a Covid-19 treatment."

https://www.statnews.com/2020/06/15/fda-revokes-hydroxychloroquine/

So much for the wonder drug magic bullet.

No, I wouldn't take it.  It's not FDA-approved.  It has shown no benefits.  In fact, it has shown to *increase deaths* in covid patients who took it.  If my doctor suggested I take it, I'd switch doctors.

What is probably better as a treatment of covid symptoms - especially symptoms in the lungs - is steroids.
Title: Re: Would you take Hydroxychloroquine?
Post by: Laserjet3051 on June 15, 2020, 02:24:46 PM
I took hydroxychloroquine at the insistence of my doctor for my visit to Northern Brasil. As an FDA-approved anti-malarial, it seemed like reasonable advice and I didnt suffer any ill effects, nor contracted malaria. Given my benign rsponse to it, sure i might take it for covid, that is, if i wasnt asymptomatic.
Title: Re: Would you take Hydroxychloroquine?
Post by: nereo on June 15, 2020, 02:54:32 PM
I took hydroxychloroquine at the insistence of my doctor for my visit to Northern Brasil. As an FDA-approved anti-malarial, it seemed like reasonable advice and I didnt suffer any ill effects, nor contracted malaria. Given my benign rsponse to it, sure i might take it for covid, that is, if i wasnt asymptomatic.

Just because you didn’t have an adverse reaction to a drug once doesn’t mean you won’t suffer I’ll effects during subsequent courses. Drug very often have cumulative effects


I’m curious why you would take a drug that the FDA has now removed from its list of potential treatments
Title: Re: Would you take Hydroxychloroquine?
Post by: hops on June 16, 2020, 08:47:35 AM
Preemptively cringing this morning at the way the media's about to descend on dexamethasone, and the false sense of security the reporting might give people who only want to hear words like "life-saving" and "cure" and "game-changer" without understanding the broader context:

https://www.bbc.com/news/health-53061281

Here's a reminder (from page two) that steroids have long looked like the best bet for helping some patients:

https://www.theatlantic.com/health/archive/2020/04/coronavirus-immune-response/610228/

Physician reactions on Twitter (not unlike physician reaction in my living room earlier) range from the obvious "Show us the data!", to skepticism due to decades of mixed opinion about steroids in treating ARDS, to warnings to not take it as a preventative. I've also seen an "It's already been hard to get this for our cancer patients in recent months and this will make it worse."
Title: Re: Would you take Hydroxychloroquine?
Post by: caffeine on July 03, 2020, 07:45:14 AM
Incredible. It seems the only reason the media was so against hydroxychloroquine is because Trump was publicly optimistic about it - likely because he was briefed on it being used in non-clinical capacity.

https://www.henryford.com/news/2020/07/hydro-treatment-study (https://www.henryford.com/news/2020/07/hydro-treatment-study)
https://www.cnn.com/2020/07/02/health/hydroxychloroquine-coronavirus-detroit-study/index.html (https://www.cnn.com/2020/07/02/health/hydroxychloroquine-coronavirus-detroit-study/index.html)

In a peer-reviewed study of 2,541 patients, hydroxychloroquine "cut the death rate significantly" without "heart-related side-effects." Its been published today in the International Journal of Infectious Diseases.

https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext (https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext)

Conclusion:

Quote
In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact.

If I get the COVIDs, I guess I'll take hydroxychloroquine if my doctor recommends it, but now I may actually strongly suggest it.
Title: Re: Would you take Hydroxychloroquine?
Post by: js82 on July 03, 2020, 08:51:49 AM
Incredible. It seems the only reason the media was so against hydroxychloroquine is because Trump was publicly optimistic about it - likely because he was briefed on it being used in non-clinical capacity.

Several early studies failed to show benefit.  Not everything is a media conspiracy.  Science is an evolutionary process.


That said, this study is interesting, but there's more to look at here than just HCQ.  Specifically, this study isn't truly looking at the effects of AZM + HCQ in isolation:

Steroids were given to 78.9% of the HCQ group, 74.3% of the HCQ+AZM group, but only 35.7% of the control group.  Thus, the groups were clearly not being treated the same in other ways besides whether or not they got HCQ.  There are already studies showing that certain steroids can significantly cut covid mortality:

https://www.statnews.com/2020/06/16/major-study-finds-common-steroid-reduces-deaths-among-patients-with-severe-covid-19/

Also noteworthy is that the HCQ-only patients were in the best shape at the start - they had the lowest mean mSOFA (a screening for organ failure) score, which is one measure of overall patient duress.

Based on this, it's impossible to say how much of the total effect can be attributed to HCQ itself.  Not dismissing the study, but there's clearly more work to be done to hone in on what the optimal treatment protocol for Covid is, and in isolating the impacts of individual components. Remdesevir has shown measurable benefits too, as has dexamethasone.  Clearly *something* about the treatment group led to better outcomes in the above study, but there were more differences between the groups besides just HCQ.  Understanding all of that is the key to developing the best possible treatment protocols.  The optimal treatment protocol will probably eventually involve multiple drugs - though it's not clear which combination is best at this point.

Conclusion:

Quote
In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact.


For the sake of accuracy, there's absolutely nothing in this study to suggest that azithromycin did anything useful.  The AZM+HCQ group fared worse than the group with HCQ alone(although they were also objectively sicker), and there's no statistical difference in mortality rates between the control group and AZM alone.
Title: Re: Would you take Hydroxychloroquine?
Post by: caffeine on July 03, 2020, 10:33:05 AM
For the sake of accuracy, there's absolutely nothing in this study to suggest that azithromycin did anything useful.  The AZM+HCQ group fared worse than the group with HCQ alone, and there's no statistical difference in mortality rates between the control group and AZM alone.

Your analysis contradicts the study. The study concludes AZM+HCQ reduced morbidity when controlled for risk factors.

The Study: https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext
   
Quote
In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact.
   
Results

Quote
Of 2,541 patients, with a median total hospitalization time of 6 days (IQR: 4-10 days), median age was 64 years (IQR:53-76 years), 51% male, 56% African American, with median time to follow-up of 28.5 days (IQR:3-53). Overall in-hospital mortality was 18.1% (95% CI:16.6%-19.7%); by treatment: hydroxychloroquine + azithromycin, 157/783 (20.1% [95% CI: 17.3%-23.0%]), hydroxychloroquine alone, 162/1202 (13.5% [95% CI: 11.6%-15.5%]), azithromycin alone, 33/147 (22.4% [95% CI: 16.0%-30.1%]), and neither drug, 108/409 (26.4% [95% CI: 22.2%-31.0%])​. Primary cause of mortality was respiratory failure (88%); no patient had documented torsades de pointes. From Cox regression modeling, predictors of mortality were age>65 years (HR:2.6 [95% CI:1.9-3.3]), white race (HR:1.7 [95% CI:1.4-2.1]), CKD (HR:1.7 [95%CI:1.4-2.1]), reduced O2 saturation level on admission (HR:1.5 [95%CI:1.1-2.1]), and ventilator use during admission (HR: 2.2 [95%CI:1.4-3.3]). Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine + azithromycin 71% compared to neither treatment (p < 0.001).
         
Title: Re: Would you take Hydroxychloroquine?
Post by: MudPuppy on July 03, 2020, 10:58:21 AM
Not just “failed to show benefit” in early studies, either. They showed actively worse outcomes, largely because of the potential cardiac side effects of the drug. There was enough evidence showing risk for harm that the FDA pulled it’s emergency approval. Not a conspiracy, just uncharted waters and a drug with not great positive evidence.
Title: Re: Would you take Hydroxychloroquine?
Post by: gentmach on July 03, 2020, 11:20:35 AM
Incredible. It seems the only reason the media was so against hydroxychloroquine is because Trump was publicly optimistic about it - likely because he was briefed on it being used in non-clinical capacity.

Several early studies failed to show benefit.  Not everything is a media conspiracy.  Science is an evolutionary process.


That said, this study is interesting, but there's more to look at here than just HCQ.  Specifically, this study isn't truly looking at the effects of AZM + HCQ in isolation:

Steroids were given to 78.9% of the HCQ group, 74.3% of the HCQ+AZM group, but only 35.7% of the control group.  Thus, the groups were clearly not being treated the same in other ways besides whether or not they got HCQ.  There are already studies showing that certain steroids can significantly cut covid mortality:

https://www.statnews.com/2020/06/16/major-study-finds-common-steroid-reduces-deaths-among-patients-with-severe-covid-19/

Also noteworthy is that the HCQ-only patients were in the best shape at the start - they had the lowest mean mSOFA (a screening for organ failure) score, which is one measure of overall patient duress.

Based on this, it's impossible to say how much of the total effect can be attributed to HCQ itself.  Not dismissing the study, but there's clearly more work to be done to hone in on what the optimal treatment protocol for Covid is, and in isolating the impacts of individual components. Remdesevir has shown measurable benefits too, as has dexamethasone.  Clearly *something* about the treatment group led to better outcomes in the above study, but there were more differences between the groups besides just HCQ.  Understanding all of that is the key to developing the best possible treatment protocols.  The optimal treatment protocol will probably eventually involve multiple drugs - though it's not clear which combination is best at this point.

Conclusion:

Quote
In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact.


For the sake of accuracy, there's absolutely nothing in this study to suggest that azithromycin did anything useful.  The AZM+HCQ group fared worse than the group with HCQ alone(although they were also objectively sicker), and there's no statistical difference in mortality rates between the control group and AZM alone.

Not a media conspiracy. More a failure of scientific journals to do peer reviews.

https://www.washingtonpost.com/health/2020/06/04/researchers-retract-study-that-found-big-risks-using-hydroxychloroquine-treat-covid-19/

https://www.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine

Essentially a small company made up a study, then medical journals printed it and the media didn't ask questions.

Just bureaucracy being bureaucracy.
Title: Re: Would you take Hydroxychloroquine?
Post by: bacchi on July 03, 2020, 11:38:35 AM
Incredible. It seems the only reason the media was so against hydroxychloroquine is because Trump was publicly optimistic about it - likely because he was briefed on it being used in non-clinical capacity.

The reason people were against it is because Trump was pushing for it without any proof that it worked.

Unless you're suggesting that he knew the results of this study months before the results were released. Now that would be incredible.
Title: Re: Would you take Hydroxychloroquine?
Post by: caffeine on July 03, 2020, 12:28:35 PM
Incredible. It seems the only reason the media was so against hydroxychloroquine is because Trump was publicly optimistic about it - likely because he was briefed on it being used in non-clinical capacity.

The reason people were against it is because Trump was pushing for it without any proof that it worked.

Unless you're suggesting that he knew the results of this study months before the results were released. Now that would be incredible.

Trump's enthusiasm for the drugs was based on a French study of 20 patients in March that showed the drugs might work against the virus. He was obviously briefed on it and was publicly hoping it was going to work. He probably shouldn't have mentioned it.

I would also take the positive study with a grain of salt. The UK tested with 11,000 people and concluded it was of no help.

https://www.recoverytrial.net/news/statement-from-the-chief-investigators-of-the-randomised-evaluation-of-covid-19-therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19

The "incredible" more of a statement on the news media promoting every story/study to declare something controversial to generate stories about a politician they dislike (obviously). The study I linked and the CNN article are oddly missing from the front page. It's buried.

I frequent CNN. This was a front page news article:

https://www.cnn.com/2020/05/22/health/hydroxychloroquine-coronavirus-lancet-study/index.html

It's from this debunked study:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

It seems in the public interest to update that study was retracted in a likewise public way - they never did.

A peer reviewed study with a large n was published and the article is made and buried. Why no front page?
Title: Re: Would you take Hydroxychloroquine?
Post by: MudPuppy on July 03, 2020, 12:30:27 PM
It was on every front page... yesterday
Title: Re: Would you take Hydroxychloroquine?
Post by: caffeine on July 03, 2020, 12:53:46 PM
It was on every front page... yesterday

I must have missed it

https://www.nytimes.com/issue/todayspaper/2020/07/02/todays-new-york-times

https://web.archive.org/web/20200702164001/https://www.cnn.com/

Fox News (who has a massive incentive to publish an article on the subject to push the "Fake News" narrative) just published theirs 6 hours ago. And it's on the front page.

https://www.foxnews.com/politics/hydroxychloroquine-helped-save-coronavirus-study
Title: Re: Would you take Hydroxychloroquine?
Post by: js82 on July 03, 2020, 01:01:53 PM

Not a media conspiracy. More a failure of scientific journals to do peer reviews.

https://www.washingtonpost.com/health/2020/06/04/researchers-retract-study-that-found-big-risks-using-hydroxychloroquine-treat-covid-19/

https://www.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine

Essentially a small company made up a study, then medical journals printed it and the media didn't ask questions.

Just bureaucracy being bureaucracy.

I was referring more to the multiple "no evidence of benefit or harm" studies that came out on the initial wave of HCQ studies, than the Surgisphere debacle.

That said, the Surgisphere thing was beyond awful.  As a scientist(in another field) who read the study, my initial reaction upon reading it was something along the lines of "something doesn't seem right here" - some of the numbers they published were simply so far out of line with other available data that it didn't make sense - if Surgisphere's numbers were real, we'd have seen signs of it in other studies.  It should have raised a few eyebrows with reviewers prior to publication - the data patterns were that strange.  It bothers me that the data patterns were enough to strike me as odd after a quick read, and yet it wasn't thoroughly investigated by the journal(which presumably has people whose job it is to review these kinds of articles) before publication.

It should be more incumbent on the scientific journals to review articles to make sure things like this don't make it through without proper review.  The media that most of the lay public consumes is not equipped to dig deep enough into scientific studies to identify flaws(or signs of data falsification) like this - the scientific community needs to take the time to make sure what they're broadcasting to the rest of the world is good science, before they broadcast it.
Title: Re: Would you take Hydroxychloroquine?
Post by: Tyler durden on July 03, 2020, 01:39:22 PM
Yes, because science.


https://www.henryford.com/news/2020/07/hydro-treatment-study
Title: Re: Would you take Hydroxychloroquine?
Post by: bacchi on July 03, 2020, 01:49:05 PM
Incredible. It seems the only reason the media was so against hydroxychloroquine is because Trump was publicly optimistic about it - likely because he was briefed on it being used in non-clinical capacity.

The reason people were against it is because Trump was pushing for it without any proof that it worked.

Unless you're suggesting that he knew the results of this study months before the results were released. Now that would be incredible.

Trump's enthusiasm for the drugs was based on a French study of 20 patients in March that showed the drugs might work against the virus. He was obviously briefed on it and was publicly hoping it was going to work. He probably shouldn't have mentioned it.

Yep.

Maybe he should've left cures to the agency and scientists who know how to deal this type of situation.

It does beg the question...why did he keep doubling down, even after the French study was critiqued from California to France and multiple other studies showed no effect, at best?
Title: Re: Would you take Hydroxychloroquine?
Post by: caffeine on July 03, 2020, 02:10:12 PM
Incredible. It seems the only reason the media was so against hydroxychloroquine is because Trump was publicly optimistic about it - likely because he was briefed on it being used in non-clinical capacity.

The reason people were against it is because Trump was pushing for it without any proof that it worked.

Unless you're suggesting that he knew the results of this study months before the results were released. Now that would be incredible.

Trump's enthusiasm for the drugs was based on a French study of 20 patients in March that showed the drugs might work against the virus. He was obviously briefed on it and was publicly hoping it was going to work. He probably shouldn't have mentioned it.

Yep.

Maybe he should've left cures to the agency and scientists who know how to deal this type of situation.

It does beg the question...why did he keep doubling down, even after the French study was critiqued from California to France and multiple other studies showed no effect, at best?

Trump reminds me of my grandfather (just in stubbornness). Shoots from the hip and can't admit he's wrong. His first comments on the drug sounded like optimism and not validation. After the press bashed him, he sorta doubled/tripled down that it worked just to spite his opponents.

We should only be so fortunate that hydroxychloroquine doesn't kill - and may in fact be helpful based on the latest study. If it wasn't the case, then I imagine a lot of resources were probably wasted because of the weight of what a sitting US President speculated.

In politics, rarely a politician will admit they're wrong - but they also rarely put themselves in such a position such as the efficacy of a drug during a global pandemic.
Title: Re: Would you take Hydroxychloroquine?
Post by: hops on July 03, 2020, 03:34:14 PM
The continued politicization of this drug is just bizarre. The Henry Ford press release seems to have roundly underwhelmed many experts, while the usual snake oil salespeople and armchair doctors on social media are crowing and screaming about conspiracies.
Title: Re: Would you take Hydroxychloroquine?
Post by: LWYRUP on July 03, 2020, 04:22:32 PM
I have not read this thread.

I would take it based on my doctor's advice.  I would not take it if my doctor did not advise it.

I would assume my doctor was far more competent in these matters than me.  If I doubted that, I would just get a second opinion from another qualified professional.

The idea that there are "red team" drugs and "blue team" drugs is disheartening.  I hope to God my doctor ignores this bullshit.
Title: Re: Would you take Hydroxychloroquine?
Post by: hops on July 04, 2020, 11:31:45 AM
I would assume my doctor was far more competent in these matters than me. If I doubted that, I would just get a second opinion from another qualified professional.

The idea that there are "red team" drugs and "blue team" drugs is disheartening.  I hope to God my doctor ignores this bullshit.

You probably don't have much to worry about. While cable news and the Internet "both sides" everything to death, that's not how science works or how medicine is practiced. The most anti-Trump doctors in the world would've been over the moon if hydroxychloroquine had been a wonder drug, regardless of what Laura Ingraham or Twitter randos think.
Title: Re: Would you take Hydroxychloroquine?
Post by: scottish on July 05, 2020, 07:04:35 AM
The WHO announced that hydroxychloroquine doesn't help and they are discontinuing further trials.

https://www.theglobeandmail.com/world/article-who-halts-hydroxychloroquine-hiv-drugs-in-covid-trials-after-failure-3/ (https://www.theglobeandmail.com/world/article-who-halts-hydroxychloroquine-hiv-drugs-in-covid-trials-after-failure-3/)
Title: Re: Would you take Hydroxychloroquine?
Post by: BussoV6 on July 07, 2020, 02:41:32 AM
At least it was a "less stupid" suggestion than injecting detergents and sunlight. Give the man some credit!
Title: Re: Would you take Hydroxychloroquine?
Post by: Travis on July 07, 2020, 06:00:14 AM
This girl's family appears to have hit as many COVID bingo squares as possible.
-Church gathering
-Hydroxychloroquine and another antibiotic as a preventative measure (generally not how antibiotics are supposed to be used)
-Anti-mask
-Tried to home remedy or use barely tested treatments
-Followed ICU doc's advice at the last minute and then blame the docs

https://www.washingtonpost.com/nation/2020/07/07/florida-carsyn-davis-coronavirus/ (https://www.washingtonpost.com/nation/2020/07/07/florida-carsyn-davis-coronavirus/)