# Early hydroxychloroquine associated with survival **URL:** \ **Category:** The Quarantine Zone\ **Tags:** covid-quarantine\ **Created:** [May 5, 2020, 4:59pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192 "2020-05-05T16:59:15Z")\ **Posts on this page:** 18\ **Page:** 4
**Author:** ![AK84](https://avatars.discourse-cdn.com/v4/letter/a/85e7bf/32.png) [@AK84](https://boards.straightdope.com/u/AK84)\ **Post date:** [May 22, 2020, 8:11pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/61 "2020-05-22T20:11:40Z")
> [@What\_Exit](#): > > Yay sound bites vs. studies. Very convincing wall of words. There are plenty of studies supporting HCQ use as well.:smack: The “sound bites (sic)” that you state are a “convincing wall of text” are actual scientist who are explaining why its not a silver bullet and probably not useless either.Including those who have carried out studies or are using it the drug clinically. :rolleyes: > **[Hydroxychloroquine Dosage Guide + Max Dose, Adjustments - Drugs.com](https://www.drugs.com/dosage/hydroxychloroquine.html#Usual_Adult_Dose_for_Malaria)** > > Detailed Hydroxychloroquine dosage information for adults and children. Includes dosages for Rheumatoid Arthritis, Systemic Lupus Erythematosus, Malaria Prophylaxis and more; plus renal, liver and dialysis adjustments. > [@Ann Hedonia](#): > > The proven safety profile is for the dosages used for rheumatic illnesses. Unfortunately, and this seems to be the catch, the anti-viral effects don’t kick in at that concentration, they require a much higher dosage. The recommended dosages for COVID patients were considerably higher than that for rheumatic diseases. While the exact dosage is not yet clear, what you say is wrong. [HCQ is recommended for Lupus, Arthritis, Malaria and Malaria prophylaxis.](https://www.drugs.com/dosage/hydroxychloroquine.html) The dose for COVID19 is > [@](#): > > 800 mg salt (620 mg base) orally on day 1, followed by 400 mg salt (310 mg base) orally once a day > Total duration of therapy: 4 to 7 days, based on clinical evaluation WHich is not much higher than that for malaria. > [@](#): > > 800 mg salt (620 mg base) orally as an initial dose, followed by 400 mg salt (310 mg base) at 6, 24, and 48 hours after the initial dose > Total dose: 2000 mg salt (1550 mg base) ---
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [May 22, 2020, 9:59pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/62 "2020-05-22T21:59:47Z")
I know I’ve been really vocal on the subject. My opinions on the subject have nothing to do with my politics or my feelings towards President Trump. It’s been an interest of mine since 2004, when my boyfriend was diagnosed with Stage 4 pancreatic cancer. The doctor gave him a 5% chance of living one year, we took at as a challenge. We stopped working with the first couple of doctors that recommended standard treatment while getting our affairs in order. We found out there were a lot of treatments out there and we became convinced that all we had to do was find the right one. We saw an article in the Wall Street Journal about a new and innovative test. The reason chemo wasn’t curative was that most people didn’t pick the right one. All we had to do was test the various chemotherapies against a tumor sample. We managed to find the doctor that developed the test and got him to take us as a patient. It didn’t work, he died and over the next several months my head cleared and I was able to see through the bullshit. At the time I was active in several online cancer groups. I saw people make the same mistakes we did and I began helping people realistically analyze experimental and innovative medical treatments. When the world first began raving about Hydroxychloroquine, I was skeptical. I did a little basic research. I found a long history of the drug being studied as an anti-viral without much success. I found no theory that explained why this drug that was ineffective against flu and other SARS viruses might work against COVID. I realized there would be a basic issues with dosages. I was not impressed at all with the early unreviewed studies that showed promise, because I had seen so many similar documents regarding dubious cancer treatments. Some of these unreviewed papers remind me of sovereign citizen lawsuits, they are sometimes convincing because they look so real. Viruses are, in general, a particularly intractable pharmaceutical issue. At any given moment, there are hundreds of researchers looking for compounds that are effective against viruses inside the human body. It’s a tough problem and the successes have been minor. In that atmosphere difficult to believe that there’s a quick and easy cure unless you buy into the idea that “this is something that THEY don’t want you to know about”, and that slides into conspiracy theory territory. Lastly, it’s always tricky studying treatments for illnesses that most people recover from naturally. You’re always going to get lots of anecdotes about the guy that took the drug and got better in the next day or so and you can’t give them too much weight. I don’t think it’s like leeches or prayer. But I do think it’s kicking around in that large gray area that sits between science and pseudoscience, you know - that place where Dr. Oz lives. That molecule may even provide a starting point for a drug that works, maybe they can make a synthetic with a stronger anti-viral effect and less toxicity. But I find the fact that it was so heavily promoted and distributed with virtually no evidence horrifying. And I know that no matter how many negative studies come in, their will be people that will always believe. They gave too much or too little or too early or too late. I’m not going to go into the politics of the drug here, except to say that the right wing advocacy of the drug is deep and disturbing and the only reason we even know the drug exists. ---
**Author:** ![slash2k](https://avatars.discourse-cdn.com/v4/letter/s/439d5e/32.png) [@slash2k](https://boards.straightdope.com/u/slash2k)\ **Post date:** [May 22, 2020, 10:16pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/63 "2020-05-22T22:16:27Z")
> [@AK84](#): > > While the exact dosage is not yet clear, what you say is wrong. > > [HCQ is recommended for Lupus, Arthritis, Malaria and Malaria prophylaxis.](https://www.drugs.com/dosage/hydroxychloroquine.html) > > The dose for COVID19 is > > WHich is not much higher than that for malaria. Other sources give somewhat higher dosages. For example, [this study](https://pubmed.ncbi.nlm.nih.gov/32344449/) reports > [@](#): > > In an exposure driven post-exposure prophylaxis setting, 800 mg loading dose followed in 6 hours by 600 mg, then 600 mg daily for 4 more days achieved daily troughs above EC50 in \>50% subjects. These doses are higher than recommended for malaria chemoprophylaxis, and clinical trials are needed to establish safety and efficacy. That dose is 3800mg, or nearly twice what is recommended for malaria prophylaxis. ---
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [May 22, 2020, 10:40pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/64 "2020-05-22T22:40:02Z")
I had been looking at the actual dosages used in the various trials - some which exceeded the doses in the EUA, which erred on the side of safety. Both links in post 61 go to the information for malaria prophylaxis, which is based on WEEKLY dosing, not daily dosing. But dosing is a problem when it comes to effectiveness, and the various studies have been attempting to split the baby. This source talks about the effective serum concentration, or how much of the drug needs to get into the bloodstream in order to be effective. And that number is way higher -4.5x to 17x - than the effective serum concentration for lupus and similar diseases. > **[Covid-19: VA Study Points to Increased Mortality with Hydroxychloroquine -...](https://www.physiciansweekly.com/covid-19-va-study-points-to-increased-mortality-with-hydroxychloroquine/)** > > Standard supportive care bested either HC alone or combined with azithromycin The much-touted hydroxychloroquine (HC) for treatment of patients with Covid-19, combined with or without azithromycin (AZ), not only may not help mitigate the virus’... And it’s worth noting that a study of patients taking the drug for lupus and other disorders got COVID at pretty much the same rate and severity as a similar group not on the medication. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [May 23, 2020, 4:25am UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/65 "2020-05-23T04:25:28Z")
> [@DinoR](#): > > The FDA emergency approval for Remdesivir "allows the drug to be given to patients with COVID-19 only if they are severely ill … That’s odd, since my understanding is that remdesivir is like tamiflu, it’s supposed to work best if you take it after exposure but before you get sick, and becomes less and less useful the further the disease progresses. > [@Ann\_Hedonia](#): > > … > I don’t think it’s like leeches or prayer… Hey, my dad literally cured a guy via blood-letting. Leeches would have worked fine, although needles were used. My dad diagnosed the man as having [hemochromatosis](https://www.mayoclinic.org/diseases-conditions/hemochromatosis/symptoms-causes/syc-20351443). But I agree with your broader point. I’m just being picky. ---
**Author:** ![USCDiver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/uscdiver/32/354_2.png) [@USCDiver](https://boards.straightdope.com/u/USCDiver)\ **Post date:** [May 23, 2020, 2:06pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/66 "2020-05-23T14:06:17Z")
> [@puzzlegal](#): > > Hey, my dad literally cured a guy via blood-letting. Leeches would have worked fine, although needles were used. My dad diagnosed the man as having [hemochromatosis](https://www.mayoclinic.org/diseases-conditions/hemochromatosis/symptoms-causes/syc-20351443). > > But I agree with your broader point. I’m just being picky. If we are going to be picky, one does “cure” hemochromatosis (at least not the hereditary kind). ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [May 23, 2020, 6:12pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/67 "2020-05-23T18:12:05Z")
Fair enough. He cured the man’s symptoms, but yes, the guy had to have his blood drawn regularly to stay healthy. The guy had been sick for a while, though, and was so grateful to finally be healthy that he invited my father and his little children onto his fishing boat in Boston harbor for a day. I have never been so bored in my life! Although I did eat the best flounder I’ve ever had that evening, with the added relish of having caught it myself. ---
**Author:** ![AK84](https://avatars.discourse-cdn.com/v4/letter/a/85e7bf/32.png) [@AK84](https://boards.straightdope.com/u/AK84)\ **Post date:** [May 29, 2020, 7:55pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/68 "2020-05-29T19:55:00Z")
And now serious questions raised about the _Lancet_ study. > **[Scientists Question Validity of Major Hydroxychloroquine Study (Published 2020)](https://www.nytimes.com/2020/05/29/health/coronavirus-hydroxychloroquine.html)** > > Experts demanded verification of data and methods used in a study of drugs to treat Covid-19. The study suggested the drugs might have increased deaths. ---
**Author:** ![echoreply](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/echoreply/32/3641_2.png) [@echoreply](https://boards.straightdope.com/u/echoreply)\ **Post date:** [June 3, 2020, 10:18pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/69 "2020-06-03T22:18:22Z")
> [@AK84](#): > > And now serious questions raised about the _Lancet_ study. > [https://www.nytimes.com/2020/05/29/health/virus-hydroxychloroquine-lancet.html](https://www.nytimes.com/2020/05/29/health/virus-hydroxychloroquine-lancet.html) Indeed, it looks like many of these early studies used data from a single company, Surgisphere, which is [being brought into question](https://www.sciencemag.org/news/2020/06/mysterious-company-s-coronavirus-papers-top-medical-journals-may-be-unraveling). The data they provided seems odd. It isn’t clear if somethings are just simple mistakes, for example labeling one category as “Australia”, when it should have been “Australasia,” or there are bigger problems. Additionally, the raw data is a secret, so not available for reviewers to replicate the results. The studies using the data showed that hydroxychloroquine might be dangerous, which meant that several randomized trials were halted. Now we’re in the position of not knowing what to believe, or what evidence to accept. The politicization of hyrdroxychloroquine makes things even more difficult. I think the meta critique of all this is that peer review is around for a reason. Taking time for careful review of results by third party experts can in the end save time, embarrassment, and possibly lives. Rushing important results to press has a place, but not at the expense of getting it wrong. Or maybe these studies are fine, and a bit more work will show that the problems are just inconsequential mistakes, like the Australia/Australasia problem, and the secret data is due to HIPAA and other concerns and is not nefarious at all. ---
**Author:** ![Snowboarder\_Bo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowboarder_bo/32/229_2.png) [@Snowboarder\_Bo](https://boards.straightdope.com/u/Snowboarder_Bo)\ **Post date:** [June 4, 2020, 1:25am UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/70 "2020-06-04T01:25:12Z")
[Malaria drug fails to prevent COVID-19 in a rigorous study](https://apnews.com/acdfd2d1fda245315a164225d15d360c) > [@](#): > > Results published Wednesday by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus. The drug did not seem to cause serious harm, though – about 40% on it had side effects, mostly mild stomach problems. > > “We were disappointed. We would have liked for this to work,” said the study leader, Dr. David Boulware, an infectious disease specialist at the University of Minnesota. “But our objective was to answer the question and to conduct a high-quality study,” because the evidence on the drug so far has been inconclusive, he said. ---
**Author:** ![crowmanyclouds](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/crowmanyclouds/32/19884_2.png) [@crowmanyclouds](https://boards.straightdope.com/u/crowmanyclouds)\ **Post date:** [June 4, 2020, 1:34am UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/71 "2020-06-04T01:34:29Z")
Clearly they didn’t give the [DEL][COLOR=“Black”]lab rats[/DEL][/COLOR] patients enough zinc. CMC fnord! ---
**Author:** ![Francis\_Vaughan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/francis_vaughan/32/3093_2.png) [@Francis\_Vaughan](https://boards.straightdope.com/u/Francis_Vaughan)\ **Post date:** [June 4, 2020, 11:40am UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/72 "2020-06-04T11:40:03Z")
I was going to do a bit of Internet digging, but this guy beat me to it. [https://www.medicineuncensored.com/a-study-out-of-thin-air](https://www.medicineuncensored.com/a-study-out-of-thin-air) The whois entry for the company is almost totally redacted as well. Basically it reeks. ---
**Author:** ![JohnM](https://avatars.discourse-cdn.com/v4/letter/j/848f3c/32.png) [@JohnM](https://boards.straightdope.com/u/JohnM)\ **Post date:** [June 4, 2020, 3:53pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/73 "2020-06-04T15:53:50Z")
> [@Francis\_Vaughan](#): > > I was going to do a bit of Internet digging, but this guy beat me to it. > [https://www.medicineuncensored.com/a-study-out-of-thin-air](https://www.medicineuncensored.com/a-study-out-of-thin-air) > > The whois entry for the company is almost totally redacted as well. > > Basically it reeks. But the “this guy” you’re referring to is not a virologist, epidemiologist, pulmonologist or any other relevant specialty. He is an [ophthalmologist](https://www.doximity.com/pub/james-todaro-md). He is also about the furthest thing possible from an uninterested party, as he is one of the two “tech bros” who hyped hydroxychloroquine early on. According to [Esquire](https://www.esquire.com/uk/life/a32284282/hydroxychloroquine-donald-trump-coronavirus-cure-didier-raoult/): > [@](#): > > On 18 March, two days before the study was published in the _International Journal of Antimicrobial Agents_, a New York lawyer and blockchain entrepreneur named Gregory Rigano hailed the results during an appearance on Fox News. Rigano, and a doctor-turned-bitcoin-investor named James Todaro, had already appointed themselves as Silicon Valley’s chief hydroxychloroquine hype-men, co-authoring a widely shared Google Doc that made the case for the drug. I know that everybody wants there to be an effective treatment for this virus, but wishing doesn’t make it so and other than being seized on and promoted by Trump, why are we even still talking about hydroxychloroquine when the evidence for its usefulness ranges from thin to nonexistant? ---
**Author:** ![Great\_Antibob](https://avatars.discourse-cdn.com/v4/letter/g/e47c2d/32.png) [@Great\_Antibob](https://boards.straightdope.com/u/Great_Antibob)\ **Post date:** [June 4, 2020, 4:15pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/74 "2020-06-04T16:15:15Z")
Bad science is bad science. Even if the conclusions end up being broadly correct. The example we want to set for scientists and students and everybody else is that it’s been done the right way, no matter the result. At this point, we all know hydroxychloroquine is unlikely to be of much use with COVID-19. But that doesn’t mean supporting a sham study simply because it draws that conclusion. That’s motivated reasoning of the sort we should never accept. Bad science is not fought with more bad science. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 4, 2020, 4:35pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/75 "2020-06-04T16:35:56Z")
> [@JohnM](#): > > But the “this guy” you’re referring to is not a virologist, epidemiologist, pulmonologist or any other relevant specialty. He is an [ophthalmologist](https://www.doximity.com/pub/james-todaro-md). > > He is also about the furthest thing possible from an uninterested party, as he is one of the two “tech bros” who hyped hydroxychloroquine early on. According to [Esquire](https://www.esquire.com/uk/life/a32284282/hydroxychloroquine-donald-trump-coronavirus-cure-didier-raoult/): I wouldn’t trust a partisan. But, if his information checks out then it checks out. Truth is truth, regardless of who says it. From his assessment, the non-partisan take would be that it’s a small start-up whose business offering is to know all the things. His argument is that no one can do that - let alone with the manpower and youngness of the company - and so it’s clearly a scam. The question would be why Lancet took the company’s information on good faith and whether they did proper vetting. It’s not inherently impossible for a small company to do impressive work assembling data - if all the traditional businesses in the medical space have been slow to keep up with technology and the company hired some amazing people. Google took over the Internet with just a handful of people. But I would lean towards doubting the company, at the moment. The Lancet should publish their verification process. That they haven’t leads me to expect that they’re in doubt as well, and are currently researching the matter in-depth. Best is to wait for them. And while I am not a doctor, I would advise against hydroxychloroquine. It’s a medicine intended for those with malaria. Malaria is most commonly found in people who have been out wandering in the swamps - which is to say, young athletic men. While it has largely been a safe medicine for everyone receiving it, everyone receiving it is a widely different type of person than the type who will have deathly Coronavirus. Most anti-malarials are dangerous. The safest among them is quite plausibly dangerous for an older person with other medical complications. ---
**Author:** ![Iggy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iggy/32/3364_2.png) [@Iggy](https://boards.straightdope.com/u/Iggy)\ **Post date:** [June 5, 2020, 6:44am UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/76 "2020-06-05T06:44:03Z")
The Lancet provided a statement from the authors formally retracting the study. Questions about the data provided by Surgisphere led to the retraction. Authors stated “we can no longer vouch for the veracity of the primary data sources.” > **[Retraction—Hydroxychloroquine or chloroquine with or without a macrolide for...](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31324-6/fulltext)** > > After publication of our Lancet Article,1 several concerns were raised with respect > to the veracity of the data and analyses conducted by Surgisphere Corporation and > its founder and our co-author, Sapan Desai, in our publication. We launched an... ---
**Author:** ![Snowboarder\_Bo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowboarder_bo/32/229_2.png) [@Snowboarder\_Bo](https://boards.straightdope.com/u/Snowboarder_Bo)\ **Post date:** [June 5, 2020, 8:38pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/77 "2020-06-05T20:38:48Z")
[Malaria drug didn’t help virus patients, big UK study finds](https://apnews.com/2e04ef1d5c3aef7a92c4a0739782f876) > [@](#): > > Leaders of a large study in the United Kingdom that is rigorously testing the malaria drug hydroxychloroquine and other medicines for hospitalized COVID-19 patients say they will stop putting people on the drug because it’s clear it isn’t helping. > > Results released Friday from 1,542 patients showed the drug did not reduce deaths, time in the hospital or other factors. After 28 days, 25.7% on hydroxychloroquine had died versus 23.5% given usual care – a difference so small it could have occurred by chance. > > The results “convincingly rule out any meaningful mortality benefit,” study leaders at the University of Oxford said in a statement. > [@](#): > > More than 11,000 patients in England, Scotland, Wales and Northern Ireland were randomly assigned to get either standard of care or that plus one of these treatments: hydroxychloroquine, the HIV combo drug lopinavir-ritonavir, the antibiotic azithromycin, the steroid dexamethasone, the anti-inflammatory drug tocilizumab, or plasma from people who have recovered from COVID-19 that contains antibodies to fight the virus. > > Independent monitors met Thursday night to review results so far and recommended ending the hydroxychloroquine part of the study because results from 80% of participants suggested continuing was futile. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [June 6, 2020, 4:41am UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/78 "2020-06-06T04:41:18Z")
> [@Iggy](#): > > The Lancet provided a statement from the authors formally retracting the study. Questions about the data provided by Surgisphere led to the retraction. > > Authors stated “we can no longer vouch for the veracity of the primary data sources.” > > [https://www.thelancet.com/lancet/article/s0140673620313246](https://www.thelancet.com/lancet/article/s0140673620313246) To be more specific, Surgisphere says that they can’t share their raw data due to contractual restrictions. Doesn’t sound very likely, for something this important and when we’re talking about a bunch of hospitals. But I guess we won’t truly know until we get a better study to see if they get similar results (though, at this point, I don’t think there’s going to be any remaining push to research the topic). [Previous page](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192.md?page=3)