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Hydroxychloroquine - What Goes On?

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tgh

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These news medias only spread negativity and stress.. They do no good to the humanity except giving more stress and anxiety which are extremely bad for immunity.

Indeed : Ignorance is Bliss... :)
 

lovetravellingoz

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Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis

In this large multinational real-world analysis, we did not observe any benefit of hydroxychloroquine or chloroquine (when used alone or in combination with a macrolide) on in-hospital outcomes, when initiated early after diagnosis of COVID-19. Each of the drug regimens of chloroquine or hydroxychloroquine alone or in combination with a macrolide was associated with an increased hazard for clinically significant occurrence of ventricular arrhythmias and increased risk of in-hospital death with COVID-19.
....

We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents
..
96 032 patients
...

Interpretation
We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.







An analysis of 96,000 patients shows those treated with hydroxychloroquine were also more likely to suffer irregular heart rhythms

A study of 96,000 hospitalized coronavirus patients on six continents found that those who received an antimalarial drug promoted by President Trump as a “game changer” in the fight against the virus had a significantly higher risk of death compared with those who did not.

People treated with hydroxychloroquine, or the closely related drug chloroquine, were also more likely to develop a type of irregular heart rhythm, or arrhythmia, that can lead to sudden cardiac death, it concluded.

The study, published Friday in the medical journal Lancet is the largest analysis to date of the risks and benefits of treating covid-19 patients with antimalarial drugs. Like earlier smaller studies, it delivered disappointing news to a world eager for promising treatments for the novel coronavirus as the global death toll grows to more than 300,000. While doctors have refined how they treat the disease, they have yet to discover a magic bullet against a pathogen for which humans have no known immunity.


 

andye

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Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis

In this large multinational real-world analysis, we did not observe any benefit of hydroxychloroquine or chloroquine (when used alone or in combination with a macrolide) on in-hospital outcomes, when initiated early after diagnosis of COVID-19. Each of the drug regimens of chloroquine or hydroxychloroquine alone or in combination with a macrolide was associated with an increased hazard for clinically significant occurrence of ventricular arrhythmias and increased risk of in-hospital death with COVID-19.
....

We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents
..
96 032 patients
...

Interpretation
We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.







An analysis of 96,000 patients shows those treated with hydroxychloroquine were also more likely to suffer irregular heart rhythms

A study of 96,000 hospitalized coronavirus patients on six continents found that those who received an antimalarial drug promoted by President Trump as a “game changer” in the fight against the virus had a significantly higher risk of death compared with those who did not.

People treated with hydroxychloroquine, or the closely related drug chloroquine, were also more likely to develop a type of irregular heart rhythm, or arrhythmia, that can lead to sudden cardiac death, it concluded.

The study, published Friday in the medical journal Lancet is the largest analysis to date of the risks and benefits of treating covid-19 patients with antimalarial drugs. Like earlier smaller studies, it delivered disappointing news to a world eager for promising treatments for the novel coronavirus as the global death toll grows to more than 300,000. While doctors have refined how they treat the disease, they have yet to discover a magic bullet against a pathogen for which humans have no known immunity.


Note that this is not a randomised study
Although it reports adjustment for confounding varaiables, it is difficult to adjust with accuracy
You could certainly argue that sicker patients are more likely to be given drugs
It would be very surprising if there was a big positive effect of antimalarials though
 

drron

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Though the campaign against Hydroxychloroquine is not over.From the results the Use of Hydroxychloroquine with Azithromycin shouldn't continue as in the studies the use of either alone is just as effective with less risk of side effects.certainly the cardiac side effects were not unexpected as both drugs increase the risk of ventricular arrhythmias.In the 60 + years experience using hydroxychloroquine it has been found that at a dose of 400mg a day there is much reduced risk of heart complications and the virtual elimination of the most serious eye complications.Some of the studies had higher doses than 400mg per day..

As well there are now several reports of hydroxychloroquine with zinc gives better results-note these are no trials.But one from NY.
"The study looked at the records of 932 COVID-19 patients treated at local hospitals with hydroxychloroquine and azithromycin.
More than 400 of them were also given 100 milligrams of zinc daily.
Researchers said the patients given zinc were one and a half times more likely to recover, decreasing their need for intensive care."


And evidence why zinc may be effective with hydroxychloroquine.

As well better results when Hydroxychloroquine is used as prophylaxis.

Now taking it as prophylaxis doesn't mean you won't get Covid but it seems to reduce the chances.A large trial underway now in Detroit.ironically being run by Cardiologists.

It is also being used in countries such as Algeria and Honduras as treatment of mild cases.The reports are they are less likely to go on to severe disease and ventilation-which is what those countries wanted due to not having the facilities for managing many such cases.Again not official trials.
 

drron

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Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis

In this large multinational real-world analysis, we did not observe any benefit of hydroxychloroquine or chloroquine (when used alone or in combination with a macrolide) on in-hospital outcomes, when initiated early after diagnosis of COVID-19. Each of the drug regimens of chloroquine or hydroxychloroquine alone or in combination with a macrolide was associated with an increased hazard for clinically significant occurrence of ventricular arrhythmias and increased risk of in-hospital death with COVID-19.
....

We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents
..
96 032 patients
...

Interpretation
We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.







An analysis of 96,000 patients shows those treated with hydroxychloroquine were also more likely to suffer irregular heart rhythms

A study of 96,000 hospitalized coronavirus patients on six continents found that those who received an antimalarial drug promoted by President Trump as a “game changer” in the fight against the virus had a significantly higher risk of death compared with those who did not.

People treated with hydroxychloroquine, or the closely related drug chloroquine, were also more likely to develop a type of irregular heart rhythm, or arrhythmia, that can lead to sudden cardiac death, it concluded.

The study, published Friday in the medical journal Lancet is the largest analysis to date of the risks and benefits of treating covid-19 patients with antimalarial drugs. Like earlier smaller studies, it delivered disappointing news to a world eager for promising treatments for the novel coronavirus as the global death toll grows to more than 300,000. While doctors have refined how they treat the disease, they have yet to discover a magic bullet against a pathogen for which humans have no known immunity.


This article is now being queried.It seems totally unreliable.here is one of the reasons.
"5. Data from Australia are not compatible with government reports (too many cases for just five hospitals, more in-hospital deaths than had occurred in the entire country during the study period). Surgisphere (the data company) have since stated this was an error of classification of one hospital from Asia. This indicates the need for further error checking throughout the database. "
So more people have died of using hydroxychloroquine for treating Covid than have died in the whole of Australia for covid.
 

RooFlyer

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Medical journal has concerns about data behind key hydroxychloroquine study (ABC)

Edit - just realised this is the same thing as drron posted on. Behind the play, I and the ABC are ...

Well, well, well. A Lancet publication, no less. 'Peer reviewed' no less (I've posted a number of times how "peer reviewed" is used by many to imply "this is correct" or "you can't challenge this" - a review by peers who simply agree with your theory or perspective isn't much of a review. Some editors will choose reviewers with a fair idea beforehand of whether they will pan or pass an article submitted to them. I have had a number of first hand experiences in the scientific press :) ).

Anyway ... hold the press on hydroxychloroquine

Original bolding:

A UK medical journal that published an influential article that found hydroxychloroquine increased the risk of death in COVID-19 patients says it has concerns about the data behind the study.

The observational study published in The Lancet in late May looked at 96,000 hospitalised COVID-19 patients who were treated with the malaria drug that US President Donald Trump claims he takes and has urged others to use.

Several clinical trials were put on hold after the study was published.

The study, using data provided by healthcare data analytics firm Surgisphere, was not a traditional clinical trial that would have compared hydroxychloroquine to a placebo or other medicine.

Today, the journal said "serious scientific questions" had been brought to its attention about the validity of the data behind the study.

... 150 doctors signed an open letter to the journal calling the article's conclusions into question and asking The Lancet to publish the peer review comments.
 
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drron

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An encouraging report of a drug used for a lymphoma and chronic lymphocytic leukaemia having a good response used in Sick Covid 19 patients.only a small study though.
 

ethernet

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Which of the 3 strains by four categories, then by age groups?
It is accepted there are 3 strains I think we know HCQ is no good for severe/ICU levels, and at that level immnosuppression is the go. Why do a study before a risk/reward cost benefit analysis has been done? In nursing homes - that seems reasonable.

We know the health system does not want to pay for mass preventative treatment, and doctors know medication compliance is also a problem - both antibiotics and anti-malarials. High value individuals - no harm in that. WHO has a vested interest in keeping down genuine malaria deaths in dirt poor countries.

I think a better question to ask is does HCQ extend non-positive transmissions/ impact on testing. I think they knoiw the answer to that one.
 

Pushka

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Which of the 3 strains by four categories, then by age groups?
It is accepted there are 3 strains I think we know HCQ is no good for severe/ICU levels, and at that level immnosuppression is the go. Why do a study before a risk/reward cost benefit analysis has been done? In nursing homes - that seems reasonable.

We know the health system does not want to pay for mass preventative treatment, and doctors know medication compliance is also a problem - both antibiotics and anti-malarials. High value individuals - no harm in that. WHO has a vested interest in keeping down genuine malaria deaths in dirt poor countries.

I think a better question to ask is does HCQ extend non-positive transmissions/ impact on testing. I think they knoiw the answer to that one.
I think it might actually assist in reducing the immune response if given as prophylaxis and not as an active treatment where it's too late to take effect. Takes about 2 months for auto immune issues.
 

serfty

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New peer reviewed study published by the International Journal of Infectious Diseases:


According to a protocol-based treatment algorithm, among hospitalized patients, use of hydroxychloroquine alone and in combination with azithromycin was associated with a significant reduction in-hospital mortality compared to not receiving hydroxychloroquine.
...

Conclusions and Relevance
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.
 

teammongo

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New peer reviewed study published by the International Journal of Infectious Diseases:

Just my 2 cents..
That study is, to put it politely, rubbish..
There was a disproportionate amount of cardiovascular disease (a known risk factor) in the neither drug group.
They also found that obesity was protective (contrary to other studies).
They also quote a decrease in hazard ratio of 60-70% with both treatments. Quite simply, this is impossible. Penicillin's effectiveness is a risk reduction of 30% in a pre-antibiotic world. I think we can all agree that penicillin works....
This study is an observational trial, and it demonstrates the weaknesses of this style of study.

They should be used to develop randomised controlled trials.
Thankfully this has been done.

HCQ is ineffective at post exposure prophylaxis.
University of Minnesota, Randomised Controlled - 821 subjects. No protective effect.
Catalona, Spain. Cluster, Randomised - 2314 subjects. No protective effect.

HCQ+- Azithromycin is ineffective for mild moderate disease.
Sao Palo. Multicentre, randomised, controlled - 667 hospitalised patients. No Effect.

HCQ is ineffective for hospitalised patients (Recovery trial).
United Kingdom. Multicentre, randomised, controlled - 4716 patients. Largest study to date.
"hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death."
Chief Invesitigator is Dr Peter Horby - a British medical doctor, epidemiologist, and Professor of Emerging Infectious Diseases and Global Health at the University of Oxford and Chair of the UK government's New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG).

There will always be differening results from smaller trials, but the strongest evidence we have to date is that it does not work, and may actually be harmful.

Dr. Anthony Fauci said that all the “valid” scientific data shows hydroxychloroquine isn’t effective in treating Covid-19.

As a US colleague once told me - "Hope is not a treatment option.."

TM
 

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trippin_the_rift

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Isn't it weird that a drug that is on the WHO 'essential drugs list' for the past 50 years, that has had countless studies over decades of safe use -- is now considered dangerous by the media?

Also, note that the doctors coming forward with 100% 'cure rate' are treating with HCQ + Azithromycin + Zinc.
I don't see Zinc mentioned in any of the above studies. Did I miss something?
 

teammongo

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Isn't it weird that a drug that is on the WHO 'essential drugs list' for the past 50 years, that has had countless studies over decades of safe use -- is now considered dangerous by the media?

Also, note that the doctors coming forward with 100% 'cure rate' are treating with HCQ + Azithromycin + Zinc.
I don't see Zinc mentioned in any of the above studies. Did I miss something?
Its not weird at all. Just because it's on the essential drugs list does not mean it is safe. There are many, many drugs on that list which will cause severe problems if used off label. An example of this is the drug streptokinase. If you received this drug without a firm indication it will definitely shorten your journey to the final destination!

Also yes, HCQ has been used safely for many years - for both malaria and now for inflammatory rheumatic disorders (this is the indication listed in the WHO list). But that is because the benefits outweigh the risks. When there is no benefit, all you get is the risks.

An example of a safe class of drugs is anti-hypertensives. Approximatley 15% of the adult australian population (over 2 million) are on anti-hypertensives. They save more people than they kill - by decreasing strokes, heart attacks and heart failure. But if you get sick, really sick with septic shock, anti-hypertensives will definitely shorten your hospital stay and increase your chances of leaving the hospital horizontally. So a treatment may be safe in the community, but not safe when you get very sick.

The studies do not cover zinc. There are trials in progress looking at this. I cannot comment as there is no hard evidence yet.

It is not the media that is the problem, it is the anti-vaxer mindset. Refusing to accept the best evidence, instead choosing to believe it is part of a bigger conspiracy. There is no conspiracy. We are working feverishly for effective treatments and vaccines. HCQ was promising, but multiple rigorous trials have not reproduced those initial amazing observations.

Public monies should be invested into things that been shown to work, not squandered on dreams and hopes.

TM
 
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drron

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But the evidence is that there are better drugs than HCQ in severe Covid infections.Absolutely I accept that.There are also reasonably cheap drugs such as steroids that are more effective.Though some preliminary reports that in some patients steroids worsen the outcomes.

Interesting and it does make some sense that if markers of inflammation are low steroids may not be effective.

As to HCQ being a dangerous drug there are well established guidelines for it's use.A dosage of 400mg or less has been shown to have a much lower incidence of severe adverse effects.Periodic ECGs also can show up those patients who have QT elongation and hence should discontinue the drug.

Interesting that you should mention antihypertensives being safe.I well remember a derivative of the calcium channel blockers,mibefradil,being introduced and being passed by the FDA and introduced into Australia.A year later withdrawn because of severe side effects that were not noticed in the trials.
There are unlikely to be such surprises for HCQ.

But there is another side to the HCQ story and Covid.Not so relevant to advanced and rich nations but very important for poorer countries.India is not a very rich country and has a lot of poor citizens.It is also one of the major producers of HCQ at a low cost.It makes sense for them to use HCQ for prophylaxis.The original studies in SARS after all showed that Chloroquine and HCQ altered the ACE-2 receptor thus limiting the introduction of the virus to the cells.
They began a trial for Health Care workers to use it for prophylaxis.The early results were encouraging with less infections in those taking HCQ than those not.So they expanded the number of those taking it for prophylaxis.
The problem is,just like for vaccines,the results will take a very much longer time to be sufficiently robust to see whether this is a real effect.

So it is not helpful to demonise the drug, as is common,nor submit bad possibly fraudulent results for publication as with the withdrawn articles from the Lancet and NEJM.
 

Pushka

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HCQ takes several weeks to have any impact on the immune system for rheumatic illness so it never made much sense to me that it would work within that time period needed for covid patients. As a prophylaxis, possibly it does have an impact where the covid patient is ill from the cytokine expression of covid but it doesnt seem that all patients experience that anyway. It does reduce inflammation. Slowly.
 

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