Wait, was this about the drug or about social distancing?
Once the FDA approves a drug a Dr. can give it to anyone for any condition. Drug companies can only promote it for approved uses.
That’s ridiculous. 20 years of it not panning out is a great reason to be extremely skeptical right now and a good reason to think even cautious measured evaluation is cautiously flushing money down the toilet.
An MD can be sued for incorrectly prescribing drugs that cause damage to the patient or others.
Nonsense. A drug’s efficacy in treating condition X tells you nothing, jack, zero, about its efficacy treating condition Y. I have worked on drugs that produce remarkable responses in one form of cancer while having absolutely no clinical impact on other forms of cancer much more similar to the original cancer than COVID-19 is to influenza.
We don’t know. We includes you.
Well whaddya know. It turns out President Trump might have a financial interest in the drug’s use.
Trump holds “financial interest” in pharmaceutical company that produces hydroxychloroquine: NYT
This makes sense in normal times, but when there is a worldwide pandemic going on, we may need to make the best decision we can with limited data. So while that further study is occurring, what should we do? Assume an effectively infinite supply of hydroxychloroquine.
That’s a great question, and its thankfully above my pay grade, but I’ll give you my opinion. I would stop telling people that HCQ is going to save the country, as the President has been doing; I would also stop telling people that it’s useless garbage, as some others have been doing. I would direct interested patients to ongoing clinical trials, especially if they are: (1) in a group with high risk of death; and (2) not suffering from existing problems with heart rhythm. If clinical trials are not available to a given patient who fits criterion 1 and 2, I would leave it to the discretion of the individual physician whether or not to prescribe off-label.
I don’t know but I know you’re wrong. If this drug has been tried many times to treat various other viruses, including other corona viruses, over the course of decades then it’s a great indication that it won’t work this time.
I think the primary reason for skepticism is that even proven anti-virals don’t have the kind of dramatic curative effect that is being attributed to this drug. At best, they make the symptoms a little less severe and shorten the duration somewhat.
Not the “I was at death’s doorstep and I took this pill and 2 or 6 or 8 hours later I recovered almost completely” anecdotes. That is an extraordinary claim for an anti-viral and it requires a high level of proof.
Well, OK, so let me introduce you to necitumumab, a monoclonal antibody marketed by Eli Lilly and Company as “Portrazza.” Useful against a very wide variety of tumor types in vitro.
Add necitumumab to standard of care chemotherapy in patients with squamous non-small cell lung cancer, and it helps. Patients live longer. Their disease progresses more slowly. Necitumumab is approved by FDA for squamous NSCLC, and is considered a useful first-line option in this context.
Over the last decade+, necitumumab has also been administered to patients with other types of cancer. No significant efficacy has been detected in most of them. Most notably for the purposes of this conversation, it was not beneficial for patients with other forms of lung cancer, including non-squamous non-small cell tumors.
If you maintain that a drug’s ineffectiveness against one form of illness necessarily means it will be ineffective against other forms of that illness, you must account for necitumumab’s effectiveness against squamous but not non-squamous NSCLC. You must account for thousands of other drugs that work against one specific condition, and not against related others. Can you account for that?
You can’t. Know why? Because when it comes to HCQ vs. the current novel coronavirus (novel, meaning heretofore unstudied), you don’t know.
Yeah, great. Maybe Hydroxychloroquine cures cancer too! Can’t know til we try!
Well, if they test the drug against cancer cells in a lab - following development of a reasonable hypothesis for a mechanism of action - and it results in tumor growth inhibition, they surely will try it in patients. That’s… that’s how drug development works. You don’t understand, but you’re sure you do, which makes your posts a great illustration of my point.
So thanks!
Instead of baseless hope, there is apparently actual hope with a very old TB vaccine called Bacillus Calmette-Guerin vaccine, which is still used extensively in developing countries. Australia has launched trials with medical personnel using it and a placebo. It’s a very interesting read.
There’s also the question of whether we even need a “cure” for COVID.
No doubt it’s a huge-scale tragedy, but the fact is, most people who get COVID get better without any treatment.
The problem is people got infected on such a huge scale that our healthcare system is breaking because we can’t help the people who get severe or complicated cases. Also we don’t have adequate test coverage to know who even has COVID vs. the flu.
These are systemic problems that even a “miracle treatment” can’t touch. We need tests. We need contact tracing. We need to limit the spread. Most of all we need a MASS PRODUCED VACCINE.
Even if chloroquine works as advertised, it’s a tiny weak band-aid at best.
That’s fascinating. I’m curious why this isn’t given more widely. While I live in the US, and TB infections here are rare, they aren’t zero, and I do travel from time to time. While I’ve been vaccinated for typhoid and yellow fever as an adult, no one has ever offered me a TB vaccine. And if it has positive ‘off-target’ effects, so much the better.
There is a good chance that a vaccine simply won’t happen so prepare yourself. Band aids might be all we got.
Yes, we don’t know. But the odds are slim.
Take the anti-cancer drug Gleevec. It truly is a miracle drug. When it went to clinical trials 98% of the patients on the active drug got better really fast.
When I was doing cancer support, I spent a lot of time trying to convince patients not to throw away their money or remaining time with their families on onerous unproven treatments, many which were in early trials.
And everyone always said “What about Gleevac?” Look at how well that worked out for those early patients. And the only response I had for that was “ that kind of success hardly ever happens”. And in the two and a half years I did cancer support - I never saw an early clinical trial of a new compound that had any success whatsoever, much less the kind of success that Gleevec saw.
I’m not saying this new drug combination shouldn’t be carefully looked at. I’m just saying the fact that it failed against other similar viruses makes it a long shot.
And everyone should be skeptical of any doctors that are using Fox News as the conduit to publicize their results. They should be skeptical of pretty much anything that Dr. Oz hawks, ever. They should be skeptical of doctors that publish YouTube videos instead of journal articles. They should be aware that their is a huge nexus between the people promoting this and the people that promote colloidal silver and herbal cancer cures.
They should remember that promise of a miracle drug amid an epidemic is every con artist’s fevered wet dream.
See, what you’re failing to understand is that I’m not saying it’s impossible. I’m already aware Hydroxychloroquine doesn’t even treat all forms of malaria but is used in certain lupus cases. It’s a crazy world. You telling me “it’s possible!” isn’t really earth shattering. I’m saying it looks like a well trod but unsuccessful path.
But yes, I don’t know. That’s why I didn’t say I did.
Well, that’s the thing, isn’t it? There are a million things that could be tried for most diseases. Most aren’t. That’s because we truly don’t have the resources to test them all quickly, safely, or effectively.
We are selective precisely for this purpose. And that selection is based on a variety of factors, including past experience. In the case of hydroxycholoroquine, tests are being conducted but there’s also solid reason to believe it is not a ‘100% cure’ or a preventative, as some people have touted. Come to it, there’s reason to believe it may have limited impact as a treatment, much less a cure.
Realistic assessment and skepticism of a potential treatment is not mutually exclusive with also testing it but with realistic expectations and with due diligence in all testing protocols.
But that’s where the science and the public response are getting mixed up. The layperson doesn’t get science. They believe this will be like a Star Trek effort where by the end of the hour, a miracle cure is produced instead of the likely result, which is, at best, this will provide some relief maybe in some cases but also have a bevy of known side effects.
Beyond that, as, at best, a modestly effective treatment, we’re putting a lot of hope (and time and money) into something it when those resources may be better spent elsewhere. Maybe this particular drug is the best place to put a moonshot R&D effort, but I wouldn’t want to put money on that.