Hydroxychloroquine - What Goes On?

Renato1

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I like watching Fox News.

Last Monday, on his radio show, Hannity interviewed a Doctor in a New York hotspot. Doctor said, he treated 350 patients of his and 150 in another area with hydroxychloroquine, antibiotics and zinc sulfate . At that time, he had had none going to hospital and none dead.

Next day Hannity had another New York doctor on who was also treating his patients with hydroxychloroquine - he was more coy about citing facts and figures, but said his results from using the anti-malaria drug on patients were positive.

On Saturday, Tucker Carlson had another doctor on describing the nightmare in New York hospitals. The Doctor then stated that he was using the anti-malaria drug as a prophylactic.

And New York Governor Cuomo was procuring 750,000 doses of the malaria drug chloroquine; 70,000 doses of its derivative, hydroxychloroquine; and 10,000 doses of the antibiotic Zithromax.

After President Trump expressed optimism over the results that French doctors had gotten with the drugs, and he had ordered the FDA to fast track testing of hydroxychloroquine, the Governors of Nevada and Michigan then passed orders preventing their doctors from using hydroxychloroquine on their patients,

These reports sort of raised a lot of questions to me like -
Would it not be a simple statistical test to see if, on contracting the virus, the population of people currently taking the drug for Lupus and arthritis have a significantly lower hospitalisation and death rate than the general population?

Would it not be a simple statistical test to compare the hundreds already treated with the drugs after contracting the virus, to an equivalent number of people who contracted the virus a few weeks prior who weren't treated?

What's up with those State Governors banning its use? and

Is the drug useless, or are New Yorkers and people here and in other countries now dying needlessly?

Then, on The Bolt Report tonight, he reported that New York health workers are now on the anti-malaria drug.
And that France and Italy now allows it to be used in some cases.
And that our health workers will be starting a trial in three weeks.

So, is this some kind of Right Wing Conspiracy in presenting the information above?
Or, does a partial cure fo rthe epidemic exist, but it doesn't work for the public ......but it is good for health workers? (Kind of reminds me of our Face Mask discussion)

Any thoughts?
Regards,
Renato
 
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Ahhh, I wondered when this would be quoted..

I read this several days ago, and it is DISINFORMATION at its WORST.
It is written in a style to make it sound scientific, but is any but. It is made to sucker in non critical thinkers into believing this is a scientific study.

Well Isochronous since you brought it up, let's have a read and critique of it.

Firstly it is "hcqtrial.com" - there aren't many research trials that have their own .com domain. I wonder who paid for it?

Who is the author? - not stated
What are their affiliations? - not stated
Where do they work? - not stated
Who pays them? - not stated
Who funded the trial? - not stated

- so its essentially graffiti on the wall..

I'll just comment of some the more interesting quotes from the "trial".
"Entire countries made different decisions regarding treatment with HCQ, essentially assigning themself to the treatment or control group." - Assigning themselves??? Then that is not randomised. 🤔
"Since randomization was done at a coarse country level, we adjust for differences between countries and analyze confounding factors." - huh?? - it is not possible to do this..

"Many countries either adopted or declined early treatment with HCQ, forming a large country-randomized controlled trial with 2.0 billion people in the treatment group and 663 million in the control group." - refer to wikipedia, numnuts..

Image


" The treatment group has a 79.1% lower death rate." - then it would easily be observable in any trial then - but this has not been reproduced in any of the RCTs performed.

"Since the sample sizes are very large, p < 0.0001," - that's right the populations are not the same. Thats all that says. There is an assumption that the reason they are not the same is purely HCQ, but obviously the health care systems in the first and third world countries are different.

They use multiple "adjustments" but do not state what and how, so this can not be verified. Real scientific.🙄

Straight for wikipedia - A randomized controlled trial (or randomized control trial; RCT) is a type of scientific (often medical) experiment that aims to reduce certain sources of bias when testing the effectiveness of new treatments; this is accomplished by randomly allocating subjects to two or more groups, treating them differently, and then comparing them with respect to a measured response. One group—the experimental group—receives the intervention being assessed, while the other—usually called the control group—receives an alternative treatment, such as a placebo or no intervention.

Essentially this is DISINFORMATION, made on purpose to confuse and to foster dissent. Anyone with a scientific background can see this. It is no wonder why the USA is doing so poorly with Americans quoting stuff like this.

TM
 
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Just for completeness, two randomised trials looking at the use of HCQ in PreExposure Prophylaxis (PrEP).

One out of Philadelphia published in JAMA, and one from Minneapolis in preprint.

Verdict - No clinical benefit and not protective againts SARS-CoV2.

TM
 

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Just for completeness, two randomised trials looking at the use of HCQ in PreExposure Prophylaxis (PrEP).

One out of Philadelphia published in JAMA, and one from Minneapolis in preprint.

Verdict - No clinical benefit and not protective againts SARS-CoV2.

TM

Two questions. In the JAMA trial it was terminated early. At 8 weeks because they could not get their sample size.

In the second trial, the dosage was just 400 mg once or twice weekly.

Having been on HCQ for four years now, my experience is that it took 3 months before I felt any benefit from being on it (for SLE and APS) and my dosage is 400 mg a day. So I am receiving over a week, 2800 mg compared with just 400 in the second study.

So just anecdotally I would have been very surprised if either study yielded any positive results.
 
Two questions. In the JAMA trial it was terminated early. At 8 weeks because they could not get their sample size.

In the second trial, the dosage was just 400 mg once or twice weekly.

Having been on HCQ for four years now, my experience is that it took 3 months before I felt any benefit from being on it (for SLE and APS) and my dosage is 400 mg a day. So I am receiving over a week, 2800 mg compared with just 400 in the second study.

So just anecdotally I would have been very surprised if either study yielded any positive results.
The JAMA trial was stopped for futility. This generally means there was no important difference between the experimental and control groups. It’s nothing to do with stopping because you can’t enrol enough participants.
 
The JAMA trial was stopped for futility. This generally means there was no important difference between the experimental and control groups. It’s nothing to do with stopping because you can’t enrol enough participants.
Thanks for clarifying. I interpreted this statement incorrectly.
"The trial was terminated early for futility before reaching a planned enrollment of 200 participants".

However my thoughts about the expected time of impact still remain. When I started taking it the rheumatologist said not to expect much change for three months as it takes that long to have an impact. And on various FB groups of those people taking it, patients reinforce the same message. It takes some time to be effective. So the early termination surprises me.
 
Thanks for clarifying. I interpreted this statement incorrectly.
"The trial was terminated early for futility before reaching a planned enrollment of 200 participants".

However my thoughts about the expected time of impact still remain. When I started taking it the rheumatologist said not to expect much change for three months as it takes that long to have an impact. And on various FB groups of those people taking it, patients reinforce the same message. It takes some time to be effective. So the early termination surprises me.
You are taking it for treatment for a chronic disease. This trial is looking at preventing HCW contracting COVID-19.
I don’t think the two are remotely comparable.
 
I think the Australian study will be interesting when it is released but we just haven't had the case load needed to fully examine its utility.

If HCQ takes some time to modify the immune system then I don't think eight weeks really tested it out.
 
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HCQ is used as a DMARD (disease modifying anti rheumatic drug). It subtly modifies your immune system, so it is not as active against your own body by decreasing cytokine activation. The effects take time, because the observable effects are that of immune activation and inflammation. Just as it takes some time for symptoms and signs to appear, it will take time for them to dissipate. Even with ultra high dose steroi_s used in haematologic crises, the effects can take time (days).

The proposed effects of HCQ in SARS-CoV2 are thought to be multifactorial, including increasing endosomal pH and interferes with the glycosylation of cellular receptor of SARS-CoV, so that it cannot bind to the angiotensin-converting enzyme 2 (ACE2) expressed in lung, heart, kidney and intestine. This is purely dependant on concentration, and does not take weeks to exert an effect. The in-vitro studies would suggest an protective effect within hours.

The same drug can used in different ways, through differing pathways and therefore differing timelines. An analogy would be ammonium nitrate takes weeks to months to have observable effects as a fertiliser on plants, and milliseconds to observable effects as an explosive.

TM
 
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This trial is looking at preventing HCW contracting COVID-19.
looking upthread I don't believe it was ever about preventing the contraction of COVID-19. It was more to do with the possibility of alleviating the detrimental effects of COVID-19 should it be contracted while undergoing a controlled course of Hydroxychloroquine.
 
The dosage for Malaria prophylaxis is 400mg per week hence the dosage chosen in the trials quoted.It is not being used for immunosuppression in this circumstance.

Now the malaria parasite and the Covid virus certainly are very different organisms so is weekly dosage appropriate.
However another trial using a short course of plaquenil was also stopped for futility.But of the 113 who developed symptoms after close contact with a Covid case only 16 had a confirmed positive test.Why the rest weren't tested when part of a trial seems unusual to me.

Another study from the University of Minnesota basically had the same results.

So little going for post exposure use of Plaquenil.

The ongoing trials though are for pre exposure use to prevent infection.This is what the Australian study is looking at.Large trials still ongoing in India.Important as plaquenil is a cheap drug and if it did prove useful it would be good for poorer countries.Unlikely to ever be used for anything related to Covid in developed nations.
 
looking upthread I don't believe it was ever about preventing the contraction of COVID-19. It was more to do with the possibility of alleviating the detrimental effects of COVID-19 should it be contracted while undergoing a controlled course of Hydroxychloroquine.
No that’s not correct. The study I’m referring to was about preventing the transmission of Covid-19 to HCW taking HCQ. Nothing to do with the affects of contracting it.
 
looking upthread I don't believe it was ever about preventing the contraction of COVID-19. It was more to do with the possibility of alleviating the detrimental effects of COVID-19 should it be contracted while undergoing a controlled course of Hydroxychloroquine.
No that’s not correct. The study I’m referring to was about preventing the transmission of Covid-19 to HCW taking HCQ. Nothing to do with the affects of contracting it.
It is not a case of being correct. In the light of day I realised my intent would have been better serviced by using the word 'always' in place of 'ever'.

There are many areas for which studies can be undertaken. Certainly I was indicating the study you were referring to was for a different purpose when compared with other studies mentioned in this thread relating to the effectiveness of it's use as a treatment in combination with other treatments after contraction. i.e. This thread is not solely about research on if it's use could help prevent the contracting of COVID. There is reference to this upthread as early as post 20.
 
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