Hydroxychloroquine study "does not meet the Society's expected standard."

“5 times the normal dosage”. This is a new treatment. You are advocating giving it en masse after only minimal testing.
How do you - or how does anyone else - know what the “normal” dosage is?

Typically, the results of whatever studies lead doctors to believe that the drug was an effective treatment also give them some clue as to what an effective dose might be. Then there are a series of clinical trials ( you know, those tests that everyone is now convinced are nothing but red tape ) to determine the minimum effective dosage and how much wiggle room there is between that and the lethal dose. Many treatments fail early testing not because they are ineffective, but because there is little or no variance between the effective dose and the lethal dose.

Yes, when they use Hydroxychloroquine as a treatment against COVID they do use much higher doses than they do when using it for an autoimmune disease treatment. They are not doing this because they want the testing to fail.

They are doing this because even in a test tube, the observed anti-viral effects only occur when the drug reaches much higher concentrations - between 4.5 and 17 times than the concentrations that make the drug effective against autoimmune diseases.

Itvlooks like the Brazilian study was using the lowest possible dosage that could be expected to be effective, 5x the dose for autoimmune diseases. You are right that at this dose the side effects could be expected to be more severe. But there is absolutely no theoretical reason to suspect that the drug would’ve have any effect against COVID at the lower dosages.

This is why it is dangerous to push the widespread use of untested drugs. While the VA study can’t be used to draw conclusions because of the lack of a randomized control group - the anecdotal evidence drawn from that study would be that the drug killed a whole bunch of people that would’ve survived otherwise.

I read something disturbing in a link promoting another last ditch treatment.

https://www.sciencemag.org/news/2020/04/new-york-clinical-trial-quietly-tests-heartburn-remedy-against-coronavirus#

It said that Hydroxychloroquine had become the New “standard of care” in NY City, so much that they couldn’t find a test group for this new treatment, they had to test the drug in combination with Hydroxychloroquine.

Then when I go online and look at the death numbers next to the numbers of diagnosed cases and see how much higher that percentage is in NY…well, I hope someone REALLY looks hard at this. It looks to me like these untested “treatments“ could be killing people.

It’s a bit strong to say conclusions can’t be drawn from the VA study. They didn’t use a randomized control group, which would be the gold standard, but it did use propensity scores to match the treatment group to untreated subjects. Assuming they did their statistics correctly, that’s similar to using a matched control group, but after the fact.
For every patient in the control group, they find one (or more) subjects that didn’t receive treatment who are similar on sex, age, obesity, hypertension, ethnicity, smoking status, and whatever else they can think of. I haven’t looked closely at the study to know what exactly they matched on. If they did not do propensity scoring in a reasonable way, then that is what peer review is for. They’ll either have to go back and fix the problems, or moderate the conclusions to reflect the lack of a good control sample.

I was mostly just trying to be fair. I have slammed the studies that promoted Hydroxychloroquine because of the lack of a proper control group, (as well as for multiple other reasons). So now that we have this other study that indicates that the drug may be actively harmful I feel that it’s only fair to mention that it suffers from a lot of the same problems.

I’m totally horrified by this and I really hope someone does some hard analysis of all these New York City trials. The rate of deaths among diagnosed cases is way higher in NYC than it is in other places and I’m now wondering if that can be tied to the Hydroxychloroquine experiment.

Note: I know Hydroxychloroquine is not supposed to be capitalized. My iPad does not know this and comes up in caps in the suggestion box. And I really don’t like typing the word out from scratch every time just so it begins with a lower case “h”, so I use the suggestion.

I spoke to him last night. He said he was feeling better and didn’t plan to see the doctor.

There’s now a thread here about people who are being given Pepcid (famotidine) by IV at 9 times the standard dose, because that might help them. I’ll also believe that when I see it.

And if you’re fussy about capitalization, you can refer to hydroxychloroquine by its brand name, Plaquenil.

they keep talking about blood clots. If there is a link to high levels of Hydroxychloroquine and heart beat irregularities that might be an issue. Afib can generate clots in the heart and there are only 3 places those clots can go if they dislodge, the head, the lungs, or the legs. If this is what is happening then any person with health issues would be well served to have their heart scanned with an ultrasound and if necessary put on blood thinners at the onset. It’s very easy to have afib episodes and never know it. This won’t alleviate lung problems associated with the virus but that is a separate issue.

Science Based Medicine has a detailed article about the whole debacle.

Ah, the wonderful world of adults.

FDA revokes emergency use of hydroxychloroquine

Told ya so.

Told ya so.