Early hydroxychloroquine associated with survival

The Quarantine Zone
61

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:

While the exact dosage is not yet clear, what you say is wrong.

HCQ is recommended for Lupus, Arthritis, Malaria and Malaria prophylaxis.

The dose for COVID19 is

WHich is not much higher than that for malaria.

62

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.

63

Other sources give somewhat higher dosages. For example, this study reports

That dose is 3800mg, or nearly twice what is recommended for malaria prophylaxis.

64

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.

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.

65

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.

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.

But I agree with your broader point. I’m just being picky.

66

If we are going to be picky, one does “cure” hemochromatosis (at least not the hereditary kind).

67

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.

68

And now serious questions raised about the Lancet study.

69

Indeed, it looks like many of these early studies used data from a single company, Surgisphere, which is being brought into question. 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.

70

Malaria drug fails to prevent COVID-19 in a rigorous study

71

Clearly they didn’t give the [DEL][COLOR=“Black”]lab rats[/DEL][/COLOR] patients enough zinc.

CMC fnord!

72

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

The whois entry for the company is almost totally redacted as well.

Basically it reeks.

73

But the “this guy” you’re referring to is not a virologist, epidemiologist, pulmonologist or any other relevant specialty. He is an ophthalmologist.

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:

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?

74

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.

75

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.

76

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.”

77

Malaria drug didn’t help virus patients, big UK study finds

78

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).