Reply
 
Thread Tools Display Modes
  #51  
Old 04-06-2020, 03:37 PM
Locrian is online now
Guest
 
Join Date: Nov 2008
Location: Valley Village, CA
Posts: 4,653
I take 1,000 milligrams of metformin every day, so you'll have to find something else. Next!
  #52  
Old 04-06-2020, 03:37 PM
Little Nemo is offline
Charter Member
 
Join Date: Dec 1999
Location: Western New York
Posts: 86,197
nm

Last edited by Little Nemo; 04-06-2020 at 03:40 PM.
  #53  
Old 04-06-2020, 03:39 PM
Omar Little's Avatar
Omar Little is offline
Guest
 
Join Date: Apr 2000
Location: Within
Posts: 13,806
Gov. Cuomo stated today that use of hydroxychloroquine in New York hospitals is having "anecdotally" positive results.

https://thehill.com/homenews/state-w...ls-anecdotally
  #54  
Old 04-06-2020, 03:43 PM
slash2k is offline
Guest
 
Join Date: Feb 2014
Posts: 2,807
Quote:
Originally Posted by Do Not Taunt View Post
and there are decades of evidence on safety with people taking it for malaria prophylaxis, though that is no longer recommended due to malaria-resistance.
There are decades of evidence of the sort of the bad side effects that can happen.

Here, for example, is the current FDA label for Plaquenil, a brand name for hydroxychloroquine. Relevant sections include:

Quote:
Postmarketing cases of life-threatening and fatal cardiomyopathy have been reported with use of PLAQUENIL as well as with use of chloroquine.
Quote:
PLAQUENIL has been shown to cause severe hypoglycemia including loss of consciousness that could be life threatening in patients treated with or without antidiabetic medications.
Quote:
Antimalarial compounds should be used with caution in patients with hepatic disease or alcoholism or in conjunction with known hepatotoxic drugs. A reduction in dosage may be necessary in patients with hepatic or renal disease, as well as in those taking medicines known to affect these organs.
Quote:
Clinical studies of PLAQUENIL did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. However, this drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection and it may be useful to monitor renal function.
Quote:
The 4-aminoquinoline compounds are very rapidly and completely absorbed after ingestion, and in accidental overdosage, or rarely with lower doses in hypersensitive patients, toxic symptoms may occur within 30 minutes. The symptoms of overdosage may include headache, drowsiness, visual disturbances, cardiovascular collapse, convulsions, hypokalemia, rhythm and conduction disorders including QT prolongation, torsades de pointes, ventricular tachycardia and ventricular fibrillation, followed by sudden potentially fatal respiratory and cardiac arrest.
This is a drug that can work well in a lot of people, but it's not really a "safe" medication, in that when it goes wrong, it can go really wrong really quickly, and it can kill. Giving it to a lot of mostly elderly and already-ill patients, at a time when the health care system is already overwhelmed, may not be all that smart.
  #55  
Old 04-06-2020, 03:55 PM
Quint is offline
Charter Member
 
Join Date: Feb 2003
Posts: 929
Quote:
Originally Posted by monstro View Post
I say we all take forsythia. It's growing all over the place right now. WHAT DO WE HAVE TO LOSE, PEOPLE!!
Forsythia? I know that foxglove can be used to stop all symptoms of any kind for any condition in fairly short order. Someone should tell Trump!
  #56  
Old 04-06-2020, 04:01 PM
Elko is offline
Charter Member
 
Join Date: Oct 2003
Location: City of Pride & Purpose
Posts: 15
Quote:
Originally Posted by nelliebly View Post
Am I the only person on the SDMB who's been on hydroxychloroquine? I keep hoping someone else will chime in. I was on it for six years for lupus. I can state unequivocally that it does NOT prevent or cure viral infections. I had the flu while I was on it as well as a couple of colds.
Your are not, nelliebly. I've been taking it for around 15 years to keep my lupus in remission, and it's currently the only drug I take for lupus. Similar to you, I typically get about one cold a year, and every so often, a flu that must not be covered by a given year's vaccine.

I just happened to refill my prescription a couple of days before it really hit the news, and am not looking forward to what my pharmacist might tell me when I have to refill again.
  #57  
Old 04-06-2020, 04:03 PM
Damuri Ajashi is offline
Guest
 
Join Date: Jul 2006
Posts: 21,649
With all the shit Trump is throwing against the wall, something is bound to stick. Maybe this is it.

It doesn't mean he isn't full of shit.
  #58  
Old 04-06-2020, 04:12 PM
Sage Rat's Avatar
Sage Rat is offline
Member
 
Join Date: Mar 2004
Location: Howdy
Posts: 22,920
Quote:
Originally Posted by Do Not Taunt View Post
I'm also unwilling to accept that I don't need to have an opinion. I'm not saying I'm going to second-guess experts, but that a) I have natural curiosity and want to understand
That's good. But you are asking for a unicorn. If someone writes up a user-friendly version of the information, that doesn't mean that you'll understand it in a way that is reasonable, because you don't have the correct training or understanding of the topic. And any user-friendly version will, almost certainly, become just as misconstrued as the official version.

Think of it like a court trial. Whoever goes last has the advantage. When the jury decides, their version will be fresher in their memory, and the other side will never have a chance to rebut any points that they make Our courts want to favor the defendant, and so they get to go after the prosecution.

In a news article, they will generally want to provide a pros and cons list. That's the user-friendly version of presenting something. Should pros go first or cons? What if there are more cons but they are all fairly meaningless and very few pros, but all very important? How do you balance that so that even a person who can't tell between them can make an informed and reasonable judgement from the two?

Maybe you write a lot. And now, having written a lot, going into the whole history of organic chemistry, biology, and p-values, you have an article that is 99% university college instruction and 1% relevant to the topic at hand. Who actually reads that article all the way through? If someone has actually read that article, and understood it, do they still need the user-friendly version?

A user friendly presentation simply can't suffice if you're too far out in the weeds. If you want to understand something which is hard to understand, unless you're an expert, then all there is for it is to read up enough on the subject that you can parse a science journal and get something from it.

Quote:
b) it's part of being an informed citizen
No, as a citizen, your job is to elect people who you trust are able and willing to talk to experts and anyone who would be affected by an issue, and who would change their mind and their approach on the basis of what they heard in an evenhanded and balanced way.

Your job is not to become a backseat driver of the people you elect to government. If you want good government, spend your time making sure that the people you elect are dispassionate, care about people, hardworking, and are willing to sit there and power through spreadsheets or science journals, if necessary, to try and do their job.

Quote:
c) health experts' expertise doesn't extend to other realms. They can tell us the facts, the risks, and the likely outcomes, but they are not the people who get to decide if those risks are worth taking, or how to trade off economic pain against public health.
No, that's politicians, not you. And your politicians should say what I say, which is that they will want to see the math results that the CDC and FDA give them. But then to also compare that to what the drug manufacturers are saying about availability of the product, what hospitals are saying about their ability to store different medications, what stage of testing other countries might already be in and whether it makes more sense to give way on a few therapies, etc.

As the people who have been elected to govern - as opposed to you, the backseat driver - they have access to information like this that you do not. You will likely never have it and certainly you won't have the free time to properly go through it like the politicians do since you have some other job to do in life and you won't have access to the scientists, doctors, manufacturers, and diplomats to help you wade through it all.

You do not live in a democracy. You are not expected nor desired to be a part of your government except in the realm of finding honest, incorruptible, intelligent, and upstanding individuals to lay trust into. If you bring any opinion on actions and policy into the mix, you are simply trying to drive the car, by proxy, without being able to see the road, the mirrors, the dashboard, nor feel the vehicle under your feet. It is silly and counterproductive.

The country is and was expected to be a republic. The framers of the constitution viewed "democracy" as a bad word and reviled it greatly, based on how it had destroyed many nations in the past. You should do the same.

If you do not trust our leaders, that's because you know who you chose to vote for.
  #59  
Old 04-06-2020, 04:14 PM
Do Not Taunt is online now
Guest
 
Join Date: Apr 2006
Location: Seattle
Posts: 2,409
Quote:
Originally Posted by slash2k View Post
There are decades of evidence of the sort of the bad side effects that can happen.

Here, for example, is the current FDA label for Plaquenil, a brand name for hydroxychloroquine. Relevant sections include:

[...]


This is a drug that can work well in a lot of people, but it's not really a "safe" medication, in that when it goes wrong, it can go really wrong really quickly, and it can kill. Giving it to a lot of mostly elderly and already-ill patients, at a time when the health care system is already overwhelmed, may not be all that smart.
Thanks, good information. Still, side effects in some populations don't mean that we shouldn't be able to follow up with monitored tests in safer populations for COVID-19 uses. This has the potential to do a lot of good. Or be completely useless.
  #60  
Old 04-06-2020, 04:18 PM
Ann Hedonia's Avatar
Ann Hedonia is offline
Guest
 
Join Date: Apr 2009
Posts: 4,135
I have a question for any medical professionals that might be following this thread.

If this unproven therapy is broadly distributed, will there be any public health consequences due to the widespread use of Zithromax? Will it cause bacterial resistance? Will we lose it as an antibiotic?

One reason I’m asking is that there are people that are advocating its use as a preventative, which would mean a lot of people would be taking it at the same time. Is this wise?
  #61  
Old 04-06-2020, 04:19 PM
iamthewalrus(:3= is offline
Guest
 
Join Date: Jul 2000
Location: Santa Barbara, CA
Posts: 12,522
Novartis, a drug company that manufactures hydroxychloroquine, paid Michael Cohen $1.2m for "health care consulting" shortly after Trump was inaugurated.

What a mystery. We may never get to the bottom of why the huckster in chief is touting this drug.
  #62  
Old 04-06-2020, 04:23 PM
Do Not Taunt is online now
Guest
 
Join Date: Apr 2006
Location: Seattle
Posts: 2,409
Quote:
Originally Posted by Sage Rat View Post
If you do not trust our leaders, that's because you know who you chose to vote for.
Well, I don't trust our leaders, at least at the federal level, and that's primarily because of who other people chose to vote for. But that's neither here nor there. I do live in a democracy, though not in a direct democracy, and my decisions on who to vote for are based on my understanding of facts. If I thought, for example, that tax cuts on the rich paid for themselves in economic growth, I might vote differently. But I don't believe that, because despite not being an economist, I am literate and can understand economic ideas and data to a sufficient depth to make voting decisions based on them. I can also make decisions about who I think is most competent to the lead the nation in a pandemic emergency, given appropriate factual data. I could not do so - nor could anyone else - in the absence of such data. Which is not to say that some folks in my democracy vote without understanding facts or doing critical thinking, but I choose not to operate that way.
  #63  
Old 04-06-2020, 04:35 PM
Dr_Paprika is offline
Member
 
Join Date: Oct 2000
Location: South of Toronto, Canada
Posts: 4,520
Zithromax has 3 potential ways it could help. It reduces bacterial infection in patients susceptible to this, it has anti-inflammatory action, and it acts on the ribosomal RNA viruses use to produce proteins (though how much this helps in coronavirus is unclear, maybe not too much).

There is some risk of increasing resistance. However, in isolated patients the risk of mutated viruses spreading may be less. I hope they reserve this moonshot for sicker patients.

Is it wise? Given over 60% of all antibiotics are given to animals (for food production), which is terribly dangerous for developing resistance; given a huge percentage of antibiotics are given for usually viral conditions like sinusitis, given a propensity to use antibiotics which are too strong rather than the weakest effective one... frankly, I think it’s a drop in the bucket.
__________________
"A noble spirit embiggens the smallest man"
  #64  
Old 04-06-2020, 04:37 PM
Bijou Drains is offline
Guest
 
Join Date: Sep 2008
Posts: 12,038
Not too surprised by this , from twitter

Ohio lawmaker
@RepGalonski
says she is making a criminal referral today to the International Criminal Court for Trump to be charged with crimes against humanity over his hydroxychloroquine promotion.
  #65  
Old 04-06-2020, 04:55 PM
Omar Little's Avatar
Omar Little is offline
Guest
 
Join Date: Apr 2000
Location: Within
Posts: 13,806
Quote:
Originally Posted by Bijou Drains View Post
crimes against humanity
Is this one of those new party pack games?
  #66  
Old 04-06-2020, 05:09 PM
Chefguy's Avatar
Chefguy is offline
Charter Member
 
Join Date: Jun 2003
Location: Portlandia
Posts: 44,077
Quote:
Originally Posted by iamthewalrus(:3= View Post
Novartis, a drug company that manufactures hydroxychloroquine, paid Michael Cohen $1.2m for "health care consulting" shortly after Trump was inaugurated.

What a mystery. We may never get to the bottom of why the huckster in chief is touting this drug.
Even more worrisome is that Ghouliani is touting it as well. If that fucking know-nothing troll is pimping for it, I know to stay miles away from it. I'm betting he has an investment stake in it.
  #67  
Old 04-06-2020, 05:44 PM
Jim Peebles is offline
Guest
 
Join Date: Jul 2017
Posts: 672
"A Democratic state representative from Detroit is crediting hydroxychloroquine — and Republican President Donald Trump who touted the drug — for saving her in her battle with the coronavirus."

https://www.freep.com/story/news/loc...mp/2955430001/
  #68  
Old 04-06-2020, 06:01 PM
Sage Rat's Avatar
Sage Rat is offline
Member
 
Join Date: Mar 2004
Location: Howdy
Posts: 22,920
Quote:
Originally Posted by Jim Peebles View Post
"A Democratic state representative from Detroit is crediting hydroxychloroquine — and Republican President Donald Trump who touted the drug — for saving her in her battle with the coronavirus."

https://www.freep.com/story/news/loc...mp/2955430001/
http://chicagoheadacheclinic.com/the...colds-and-flu/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3133578/

Believe does not equal reality. It can be helpful through some rather convoluted means but you may as well just use sugar. It's cheaper and gives some calories.

Last edited by Sage Rat; 04-06-2020 at 06:04 PM.
  #69  
Old 04-06-2020, 09:05 PM
UltraVires is offline
Guest
 
Join Date: Jul 2007
Location: Bridgeport, WV, US
Posts: 17,400
AFAIK, Trump has never said that this thing was a cure. He has never said that it is scientifically helpful. He said that he was "hopeful" after hearing anecdotal evidence, and Dr. Fauci agreed that there was anecdotal evidence that it was helpful, but scientifically, that is not enough and it need trials. Trump never said for people to run out and take it or ask their doctors to prescribe it.

I fear this is another symptom of Trump derangement syndrome. If Trump said that there was no medicine out there that might be able to help, I fear that some of his same critics would say that he was being too doom and gloom in this time of panic and should reassure Americans that there are some medicines that have shown anecdotal evidence to be helpful and to stay positive.
  #70  
Old 04-06-2020, 09:19 PM
slash2k is offline
Guest
 
Join Date: Feb 2014
Posts: 2,807
Quote:
Originally Posted by UltraVires View Post
AFAIK, Trump has never said that this thing was a cure. He has never said that it is scientifically helpful. He said that he was "hopeful" after hearing anecdotal evidence, and Dr. Fauci agreed that there was anecdotal evidence that it was helpful, but scientifically, that is not enough and it need trials. Trump never said for people to run out and take it or ask their doctors to prescribe it.

I fear this is another symptom of Trump derangement syndrome. If Trump said that there was no medicine out there that might be able to help, I fear that some of his same critics would say that he was being too doom and gloom in this time of panic and should reassure Americans that there are some medicines that have shown anecdotal evidence to be helpful and to stay positive.
He said, "What do you have to lose?"

Well, what you have to lose, potentially, is your life. Some of the documented (rare, but known and documented) side effects of hydroxychloroquine are fatal, but he hasn't mentioned that little detail. In fact, he explicitly stated, "But the nice part is, it’s been around for a long time, so we know that if it — if things don’t go as planned, it’s not going to kill anybody." (cite, although he has said substantially the same thing on other occasions.) This is false, wrong, incorrect, and a lie: if things go wrong, it CAN KILL YOU.
  #71  
Old 04-06-2020, 09:19 PM
running coach's Avatar
running coach is offline
Arms of Steel, Leg of Jello
Charter Member
 
Join Date: Nov 2000
Location: Riding my handcycle
Posts: 38,244
Quote:
Originally Posted by UltraVires View Post
AFAIK, Trump has never said that this thing was a cure. He has never said that it is scientifically helpful. He said that he was "hopeful" after hearing anecdotal evidence, and Dr. Fauci agreed that there was anecdotal evidence that it was helpful, but scientifically, that is not enough and it need trials. Trump never said for people to run out and take it or ask their doctors to prescribe it.

I fear this is another symptom of Trump derangement syndrome. If Trump said that there was no medicine out there that might be able to help, I fear that some of his same critics would say that he was being too doom and gloom in this time of panic and should reassure Americans that there are some medicines that have shown anecdotal evidence to be helpful and to stay positive.

Trump keeps touting a decades-old malaria pill as a coronavirus 'game changer', undercutting his top infectious-disease expert

Quote:
"HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine," Trump said in a series of tweets on Saturday. "Hopefully they will BOTH be put in use IMMEDIATELY. PEOPLE ARE DYING, MOVE FAST," he continued.

At a briefing on Thursday, Trump said chloroquine and hydroxychloroquine had been approved by the Food and Drug Administration to treat the coronavirus. But shortly after, FDA Commissioner Stephen Hahn contradicted Trump, saying that the FDA would need to determine that in a clinical trial. The drug has not been approved for COVID-19 patients.
What the fuck do you think he was trying to imply? Anyone who isn't educated in playing word games will think he's saying it's a cure.
  #72  
Old 04-06-2020, 09:28 PM
UltraVires is offline
Guest
 
Join Date: Jul 2007
Location: Bridgeport, WV, US
Posts: 17,400
It's a good thing then that Donald Trump is not writing my prescriptions. If I cannot trust my doctor not to prescribe something for me that's going to kill me then I have bigger problems. It is a politician putting a positive spin on something.

He said "a real chance" not run out and take it illegally or beg your doctor to give it to you.
  #73  
Old 04-06-2020, 09:32 PM
running coach's Avatar
running coach is offline
Arms of Steel, Leg of Jello
Charter Member
 
Join Date: Nov 2000
Location: Riding my handcycle
Posts: 38,244
Quote:
Originally Posted by UltraVires View Post
It's a good thing then that Donald Trump is not writing my prescriptions. If I cannot trust my doctor not to prescribe something for me that's going to kill me then I have bigger problems. It is a politician putting a positive spin on something.

He said "a real chance" not run out and take it illegally or beg your doctor to give it to you.
You don't read quotes, do you? He said it was approved by the FDA as a treatment. As far as the average layman is concerned, that's the same thing and you damn well know it.
  #74  
Old 04-06-2020, 09:41 PM
asahi's Avatar
asahi is offline
Guest
 
Join Date: Aug 2015
Location: On your computer screen
Posts: 13,225
Quote:
Originally Posted by FlikTheBlue View Post
I'm not so sure about that. Short of actually being one of those dead, I think Trump's base will tune out even the deaths of their neighbors and family.
I think we can all agree that, what, 28% of Trump voters will support him if he runs around naked and shits on the White House lawn. But maybe the "persuadables" might get it.
  #75  
Old 04-06-2020, 09:54 PM
UltraVires is offline
Guest
 
Join Date: Jul 2007
Location: Bridgeport, WV, US
Posts: 17,400
Quote:
Originally Posted by running coach View Post
You don't read quotes, do you? He said it was approved by the FDA as a treatment. As far as the average layman is concerned, that's the same thing and you damn well know it.
Clearly he screwed up big time on that one and there is no getting around it. But even saying that the FDA approved it does not mean anything. Oxycodone is FDA approved for pain, but that doesn't mean that because of these middle aged aches and pains that I have I can demand a doctor prescribe it for me. My doctor uses his professional judgment in what to prescribe for my condition. No doctor, AFAIK, says that the President said it was okay and hands me a bowl full of pills.
  #76  
Old 04-06-2020, 10:02 PM
scr4 is offline
Guest
 
Join Date: Aug 1999
Location: Alabama
Posts: 16,594
Quote:
Originally Posted by KidCharlemagne View Post
I’m just kind of bummed that I think ultimately Trump is gonna look like he alone led the fight against the evil Dems in getting the panacea into the hands of the people.
It just saddens me that people are more worried about scoring political points than about saving lives.
  #77  
Old 04-06-2020, 10:23 PM
nearwildheaven is online now
Guest
 
Join Date: Apr 2013
Posts: 14,214
Quote:
Originally Posted by Musicat View Post
A good con artist can put a spin on everything and anything to pretend the outcome is in his favor. A really good con artist can fool most of the people most of the time. These are both attributes Trump has shown he has in abundance. For his base (the conned), he will always look good, and come out of this smelling like a rose. For rational thinkers, not so much.
I spoke to my parents earlier this evening. (They're doing OK, so far.) My dad said he had just finished watching Hannity interview Dr. Oz, "and he thinks this is a great thing."

So, in other words, it probably isn't.
  #78  
Old 04-06-2020, 11:23 PM
epbrown01 is offline
Guest
 
Join Date: Oct 2012
Posts: 3,937
Quote:
Originally Posted by scr4 View Post
It just saddens me that people are more worried about scoring political points than about saving lives.
In the president's case, it seems more about getting the stock market back in shape before the election.
  #79  
Old 04-07-2020, 12:26 AM
elucidator is offline
Charter Member
 
Join Date: Mar 2000
Location: Further
Posts: 60,681
If corona disappears entirely on Easter, and Il Douche is credited for it, I will seriously re-examine my disdain for Satanism
  #80  
Old 04-07-2020, 01:36 AM
RioRico is offline
Suspended
 
Join Date: Sep 2019
Location: beyond cell service
Posts: 3,193
Quote:
Originally Posted by elucidator View Post
If corona disappears entirely on Easter, and Il Douche is credited for it, I will seriously re-examine my disdain for Satanism
Worry not. Cerveza Corona may be out of production but pentagrams probably won't see increased demand... unless eye of newt is an effective treatment.
  #81  
Old 04-07-2020, 02:14 AM
slash2k is offline
Guest
 
Join Date: Feb 2014
Posts: 2,807
The International Society of Antimicrobial Chemotherapy (in whose journal the French study was published) have issued a statement that says in part "the article does not meet the Society’s expected standard, especially relating to the lack of better explanations of the inclusion criteria and the triage of patients to ensure patient safety."
  #82  
Old 04-07-2020, 07:40 AM
Ashtura is offline
Guest
 
Join Date: Aug 2003
Location: Delaware, USA
Posts: 2,969
Quote:
Even if the narrative is only half-true, it would be dynamite in terms of revving up his political base.
His political base doesn't need revving up. They will be plenty revved up already. An extra enthusiastic vote is still just a vote. The question is peeling away swing voters and centrist democrats. Nobody is going to be talking about Hydroxychoroquine in November, especially if it is just some mediocre thing. If it was a miracle drug that would be known by now. This is gonna be steamrolled by literally dozens of other things between now and November.

What, imo, would push him over the top, and looks might happen, is they are continually pushing the projected death tolls down by the 10s of thousands as the days go by. Considering the initial Imperial College projections for US deaths were in the millions, if this get pushed down to flu-like numbers (say, 80Kish), which looks possible and is hopefully true from a non-partisan standpoint, he's going to be able to put that down as a win no matter how democrats spin it.
  #83  
Old 04-07-2020, 08:16 AM
RickJay is offline
Charter Jays Fan
Moderator
 
Join Date: Jun 2000
Location: Oakville, Canada
Posts: 43,045
Quote:
Originally Posted by slash2k View Post
The International Society of Antimicrobial Chemotherapy (in whose journal the French study was published) have issued a statement that says in part "the article does not meet the Society’s expected standard, especially relating to the lack of better explanations of the inclusion criteria and the triage of patients to ensure patient safety."
In the world of drug research, to criticize a study for its failure to ensure patient safety is about the worst thing you can say about it.
__________________
Providing useless posts since 1999!
  #84  
Old 04-07-2020, 08:43 AM
Alley Dweller's Avatar
Alley Dweller is online now
Guest
 
Join Date: Feb 2011
Posts: 4,641
Quote:
Originally Posted by slash2k View Post
The International Society of Antimicrobial Chemotherapy (in whose journal the French study was published) have issued a statement that says in part "the article does not meet the Society’s expected standard, especially relating to the lack of better explanations of the inclusion criteria and the triage of patients to ensure patient safety."
Let's say the study did recklessly endanger patients' lives. But if the drug still worked are we supposed to ignore that information? I mean sure, punish the experimenters for their allegedly irresponsible acts, but why punish the rest of us?
  #85  
Old 04-07-2020, 09:34 AM
slash2k is offline
Guest
 
Join Date: Feb 2014
Posts: 2,807
Quote:
Originally Posted by Alley Dweller View Post
Let's say the study did recklessly endanger patients' lives. But if the drug still worked are we supposed to ignore that information? I mean sure, punish the experimenters for their allegedly irresponsible acts, but why punish the rest of us?
Not necessarily, but the part about "lack of better explanations of the inclusion criteria" means that the journal's board is suspicious that the data showing it worked was manipulated, and that the study didn't really demonstrate it working in the first place. If the experimenters were playing fast and loose with both the ethics and the data, yes, you should ignore the information because you can't trust the information.
  #86  
Old 04-07-2020, 09:55 AM
Zyada is offline
Guest
 
Join Date: Apr 1999
Location: Foat Wuth!
Posts: 5,542
Quote:
Originally Posted by monstro View Post
I say we all take forsythia. It's growing all over the place right now. WHAT DO WE HAVE TO LOSE, PEOPLE!!
I think this is most effective if coreopsis has set in
  #87  
Old 04-07-2020, 10:00 AM
Chefguy's Avatar
Chefguy is offline
Charter Member
 
Join Date: Jun 2003
Location: Portlandia
Posts: 44,077
Quote:
Originally Posted by UltraVires View Post
It's a good thing then that Donald Trump is not writing my prescriptions. If I cannot trust my doctor not to prescribe something for me that's going to kill me then I have bigger problems. It is a politician putting a positive spin on something.

He said "a real chance" not run out and take it illegally or beg your doctor to give it to you.
And yet the government is stockpiling tens of millions of doses of the stuff. Gee, I wonder who is benefiting financially from that. . .
  #88  
Old 04-07-2020, 10:19 AM
Czarcasm's Avatar
Czarcasm is online now
Charter Member
Charter Member
 
Join Date: Apr 1999
Location: Portland, OR
Posts: 64,030
Quote:
Originally Posted by Chefguy View Post
And yet the government is stockpiling tens of millions of doses of the stuff. Gee, I wonder who is benefiting financially from that. . .
Perhaps someone high up in the chain of command that holds stock in the company that produces Plaquenil(the brand name version)?
  #89  
Old 04-07-2020, 10:19 AM
monstro is offline
Guest
 
Join Date: Mar 2002
Location: Richmond, VA
Posts: 21,699
It's no wonder to me why Trump has gone all in on hydroxychloroquine. If he's wrong, that would mean we the tax-payer has bought 29 million pills of uselessness. So he can't be wrong.

Lord, please don't let him be wrong!
  #90  
Old 04-07-2020, 10:31 AM
mandala's Avatar
mandala is offline
Guest
 
Join Date: Sep 2012
Location: Diamond City, Zeta Prime
Posts: 657
India agrees to release Chloroquine stocks, fearing US retaliation
This is a mighty victory for America. You all ought to be grateful to the Chief.
Just don't blame us if the pills don't work against Covid.
__________________
I think, therefore I am... I think
  #91  
Old 04-07-2020, 10:34 AM
HMS Irruncible is offline
Guest
 
Join Date: Nov 2004
Posts: 9,350
Quote:
Originally Posted by Ann Hedonia View Post
But Hydroxychloroquine isn’t even an anti-viral.
I'm not an expert on anti-virals, but according to wikipedia there have been 5 studies suggesting that chloroquine has antiviral properties, with mechanisms that make sense to me.

I'm not for a moment suggesting chloroquine is an effective treatment for this virus, or most viruses, and I agree Trump has been irresponsibly acting like a snake-oil salesman on this, but it appears incorrect to categorically say that chloroquine has no antiviral properties.

Also for the record, the antiviral mechanism of chloroquine has absolutely nothing to do with how it works as an anti-malarial. Coronavirus has no broad relationship with malaria or anti-malarial drugs.
  #92  
Old 04-07-2020, 10:36 AM
steronz is online now
Guest
 
Join Date: Feb 2007
Location: Oh-hiya-Maude
Posts: 5,443
Quote:
Originally Posted by UltraVires View Post
[Trump] has never said that it is scientifically helpful.
Quote:
Originally Posted by UltraVires View Post
Clearly he screwed up big time on that one and there is no getting around it.
Does the FDA approve things that aren't "scientifically helpful?" Will you admit that falsely saying that it was FDA approved was the same thing as saying that it's scientifically helpful?
  #93  
Old 04-07-2020, 10:39 AM
KidCharlemagne is offline
Guest
 
Join Date: Apr 2001
Posts: 5,514
Quote:
Originally Posted by Ann Hedonia View Post
Drug companies HAVE been looking at this drug as a potential anti-viral. For years and years. It has been consistently found to be ineffective.

Even the “positive” results are contradictory. That YouTube video* posted by a Jim Peebles, contradicts a bunch of the other allegedly positive results. That doctor claims the treatment ( that other doctors claimed success with) is totally ineffective unless you add another magic ingredient- in this case, zinc.

Which contradicts most of the other anecdotes.

Here’s an example of an earlier study, properly conducted, that showed that it is completely ineffective in preventing flu. Not a YouTube video.
https://www.ncbi.nlm.nih.gov/pubmed/21550310
Given CP and Hydroxychloroquine’s suspected mechanism of action (preventing glycosylation at the ACE-2 receptor), they’re lack of efficacy with flu is meaningless. I don’t know where you’re getting the idea there is no evidence. There are a number of controlled studies, however small and flawed, that show efficacy. The studies that show no efficacy are embarrassingly bad. Doctors everywhere are prescribing it. Frontline healthcare workers in NYC are using it prophylactically. My friend who is head of infectious diseases at St Michaels in Newark, who is Spockian in his dispassionate analysis, says it’s an unequivocal success (as do most of his colleagues) in his clinic, and the lack of success other Drs see is likely a result of waiting until it’s too late (which is very clear in the study I referenced in the OP). None of this is to say that the drug works, but your insistence that it doesn’t is as ungrounded in science as your criticisms of the pro case.
  #94  
Old 04-07-2020, 10:39 AM
Zyada is offline
Guest
 
Join Date: Apr 1999
Location: Foat Wuth!
Posts: 5,542
Quote:
Originally Posted by UltraVires View Post
Clearly he screwed up big time on that one and there is no getting around it. But even saying that the FDA approved it does not mean anything. Oxycodone is FDA approved for pain, but that doesn't mean that because of these middle aged aches and pains that I have I can demand a doctor prescribe it for me. My doctor uses his professional judgment in what to prescribe for my condition. No doctor, AFAIK, says that the President said it was okay and hands me a bowl full of pills.

And advertising drugs doesn't work to increase drug sales, which is why we never see those even though it's legal.
  #95  
Old 04-07-2020, 10:42 AM
HMS Irruncible is offline
Guest
 
Join Date: Nov 2004
Posts: 9,350
Quote:
Originally Posted by KidCharlemagne View Post
I’m not here to debate the research studies at this point. I’m just kind of bummed that I think ultimately Trump is gonna look like he alone led the fight against the evil Dems in getting the panacea into the hands of the people.
It's important to note here that the outcome has nothing to do with whether chloroquine works. Even if it proves to be an utter failure, Trump supporters will claim that the media is suppressing information on chloroquine successes. They will direct us to YouTube videos of one person claimed they were cured by chloroquine.

The media's error was not how they covered chloroquine. The media's error is engaging with Trump at all. He's a parasite that feeds off their attention, and they need to stop giving it to him. They shouldn't cover his medical or scientific opinions any more than they would any other failed real-estate investor or corrupt politician.
  #96  
Old 04-07-2020, 10:51 AM
slash2k is offline
Guest
 
Join Date: Feb 2014
Posts: 2,807
Quote:
Originally Posted by KidCharlemagne View Post
My friend who is head of infectious diseases at St Michaels in Newark, who is Spockian in his dispassionate analysis, says it’s an unequivocal success (as do most of his colleagues) in his clinic, and the lack of success other Drs see is likely a result of waiting until it’s too late (which is very clear in the study I referenced in the OP).
How is he establishing unequivocal success? If he's giving it to many patients early in the disease process, well, most people with mild to moderate cases are going to recover anyway, so how is he establishing who is recovering BECAUSE of it, versus who is recovering COINCIDENTAL with it?

If this stuff works, then that's great news, but let's make sure we are measuring what we think we are measuring.
  #97  
Old 04-07-2020, 10:55 AM
Ann Hedonia's Avatar
Ann Hedonia is offline
Guest
 
Join Date: Apr 2009
Posts: 4,135
Quote:
Originally Posted by HMS Irruncible View Post
I'm not an expert on anti-virals, but according to wikipedia there have been 5 studies suggesting that chloroquine has antiviral properties, with mechanisms that make sense to me.

I'm not for a moment suggesting chloroquine is an effective treatment for this virus, or most viruses, and I agree Trump has been irresponsibly acting like a snake-oil salesman on this, but it appears incorrect to categorically say that chloroquine has no antiviral properties.

Also for the record, the antiviral mechanism of chloroquine has absolutely nothing to do with how it works as an anti-malarial. Coronavirus has no broad relationship with malaria or anti-malarial drugs.
It does have some anti-viral effects. It will kill off most viruses in a test tube or Petri dish (in vitro). But it has never been shown to be effective in vivo -inside a living organism. This is a trajectory frequently seen with early “promising” research that doesn’t pan out.

My issue with the press coverage of these drugs is they are making it sound like a new idea. They are not mentioning that these drugs have been tested as treatments for similar viruses - like the flu - for many years and they have never been proven to be effective as a treatment for any viral infection in humans.

I apologize if I wasn’t clear about this when I claimed the drug has never been shown to be an effective anti-viral. I meant effective as medicine for viral infections in living beings, not that the substance had no anti-viral properties whatsoever.
  #98  
Old 04-07-2020, 11:01 AM
asahi's Avatar
asahi is offline
Guest
 
Join Date: Aug 2015
Location: On your computer screen
Posts: 13,225
I think what may happen - I say 'may' b/c we just don't have enough evidence - is that we may see exactly what we're seeing and hearing about now: success that is inconsistent across the population but perhaps effective in isolated situations. If this were adhering to the usual FDA process, the combination probably wouldn't pass muster, which is what the Dr. Faucis of the world are arguing. But when you're desperate, in individuals cases, it could prove to be beneficial.

If this is an accurate summation of the situation then the best Trump could do is point out that this might work in a few cases and that production will be ramped up to make sure there's an adequate supply of it, but he should really avoid hyping this up as a cure, as it seems highly unlikely that this will help cure a majority of cases that end up in ICU care.
  #99  
Old 04-07-2020, 11:17 AM
storyteller0910 is offline
Guest
 
Join Date: Aug 2001
Location: New Jersey (it's not as bad as they tell you)
Posts: 4,443
I think the hydrochloroquine data are being mis-represented in every conceivable direction right now, and it’s bad. I guess the real truth – nobody knows anything yet, pro or con – just doesn’t satisfy?

I mean, chloroquine is active against the novel coronavirus responsible for COVID-19 in vitro (Wang et al. Cell Research 2020;30:269-271 and elsewhere). It’s obviously true that this doesn’t necessarily translate to clinical benefit – the drug has shown in vitro antiviral activity in a number of instances over the last 20 years and it hasn’t ever panned out clinically – but it’s irresponsible to characterize this as some kind of out-of-thin-air thing. The nonclinical research absolutely justifies (cautious, measured) evaluation of the drug in infected patients, especially given the seriousness of the outbreak.

OK, so the clinical study that started all this is a French study, which was published in March (Gautret et al. Int J Antimicrob Agents 2020;20 March (E-pub ahead of print). A total of 42 patients met entry criteria (basically, age >12 and documented infection with SARS-CoV-2); 26 were treated with HCQ and 16 were not (there’s a bit of added complexity here because some patients received HCQ+azithromycin and some received HCQ only, but I’m going to ignore this for now). Of these 42, 6 – all HCQ patients- were lost to follow-up because treatment was stopped early – three due to transfer to ICU, one due to death, one due to toxicity, and one patient whose disease resolved quickly who was released from the hospital. The authors chose to consider results only from the 20 HCQ patients who received a full course of treatment. This is obviously a poor and self-serving choice – if a patient died on the drug or had to stop taking it due to toxicity, you can’t just throw those results away! – but we’ll come back to that later.

OK, so we’re left with 20 patients who received a full course of HCQ and 16 patients who received best available care. Ay Day 3, 10 of 20 (50%) of the former and 1/16 (6.3%) of the latter were negative for infection. The corresponding figures at Day 6 were 14 of 20 (70.0%) and 2 of 16 (12.5%), respectively. Of note, 6/6 patients treated with HCQ+azithromycin were negative for infection by Day 5.

That looks great! But! There’s still those 6 patients HCQ who were excluded from the analysis. To be as conservative as possible, let’s consider all six would have been treatment failures. This results in a response rate at Day 6 of 53.8% (14 of 26 HCQ-treated patients) - still much better than the 12.5% seen with the control.

That’s still good! But! Of those 12 control patients, who did not received HCQ, FIVE did not have their viral loads tested at all on Day 6 (many patients on both arms did not have actual viral loads reported, just simple “positive” or “negative” results, which is its own kind of problem but let’s let that go for today). So – again, being as conservative as possible – let’s assume that all five of those control patients would have been negative for the virus on Day 6. This would have meant that 7/12 control patients were negative on Day 6; that’s 58.3% - a better percentage than associated with HCQ when those missing 6 patients are considered!

Now, of course it’s exceedingly unlikely that all five control patients without Day 6 results were actually negative. Three of those five had been positive on Day 5, and none had ever had a non-positive result. And at least 1 of the 6 “missing” HCQ patients probably can be considered a positive outcome. So in the end the actual figures probably favor HCQ (and especially, favor HCQ+azithromycin). But not by as enormous a margin as has been reported.

So why did I go into so much detail here, probably boring most of you out of the thread? Because interpretation of this study is complicated. It’s not as simple as “good study” versus “bad study,” and saying that there is no evidence whatsoever that HCQ may be active against this idea is almost as irresponsible as calling it a miracle cure. We don’t know. This drug might help and it might not, but we don’t know. The evidence meets the standard for further study, and that is the most conclusive thing anyone can say; don’t trust anyone who goes further than that in either direction, because, and I can’t say this often enough, they don’t know.

----

P.S. Just to show that there’s weird science going on everywhere right now, Chinese researchers just reported that HCQ did not produce any benefit versus control in a 30-patient trial. Except that the majority of the patients in the control arm received other experimental treatments (mostly antivirals!), so the value of the results is questionable here, too.
  #100  
Old 04-07-2020, 11:26 AM
SayTwo is offline
Guest
 
Join Date: Oct 2005
Posts: 146
Quote:
Originally Posted by slash2k View Post
How is he establishing unequivocal success? If he's giving it to many patients early in the disease process, well, most people with mild to moderate cases are going to recover anyway, so how is he establishing who is recovering BECAUSE of it, versus who is recovering COINCIDENTAL with it?

If this stuff works, then that's great news, but let's make sure we are measuring what we think we are measuring.
Wait, was this about the drug or about social distancing?
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 11:52 PM.

Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2020, vBulletin Solutions, Inc.

Send questions for Cecil Adams to: cecil@straightdope.com

Send comments about this website to: webmaster@straightdope.com

Terms of Use / Privacy Policy

Advertise on the Straight Dope!
(Your direct line to thousands of the smartest, hippest people on the planet, plus a few total dipsticks.)

Copyright © 2019 STM Reader, LLC.

 
Copyright © 2017