Unfortunately, I think the media is setting up Trump for a big win on Hydroxychloroquine.

Do_Not_Taunt · April 7, 2020, 5:52pm

I’ve heard it can cause patients on dialysis to grow new kidneys.

Sage_Rat · April 7, 2020, 5:52pm

That is fair, but what if there are 20 other drugs that are more promising, you need a minimum study size of 1000 patients per drug, and you can only give the drug to someone who is in or approaching the need for critical care (e.g. about 5% of all people who contract the illness)?

Should we boost this one because the President decided that it’s amazing - for unknown reasons - and drop one of the lower of the better 20? Or should we just test the 20 - on the basis that the President is a daytime TV show host not a doctor - because that’s all we can get enough test patients for?

Colibri · April 7, 2020, 5:57pm

Moved to Politics and Elections.

Colibri
Quarantine Zone Moderator

drad_dog · April 7, 2020, 6:08pm

turnop is seeking to personally benefit from the drug. So there’s that.

Czarcasm · April 7, 2020, 6:11pm

See posts #88 and #106.

Great_Antibob · April 7, 2020, 6:16pm

Well, the Humpback whale population has rebounded, so maybe they actually do have a point?

CarnalK · April 7, 2020, 6:30pm

Does anyone know the numbers on how many people get the various side effects of hydroxychloroquine?

nearwildheaven · April 7, 2020, 6:48pm

And meanwhile, people who need it for autoimmune diseases can’t get it. :mad:

KidCharlemagne · April 7, 2020, 7:25pm

Are you implying that about me or the media?

KidCharlemagne · April 7, 2020, 7:37pm

This was just casual talk between friends regarding his clinical experience. He’s comparing recovery rates before and after he began using Plaquenil. He’s not exactly putting it up for peer review. But when many scientifically-minded people develop an intuition that a drug is working when they know full well the tendency of the human mind to see patterns where there are none, I’m listening. I can’t expect the others in this thread to trust my judgement on the judgment of these doctors which is why I didn’t want this to be about the efficacy of Plaquenil (though I certainly understand why it went there).

Euphonious_Polemic · April 7, 2020, 7:38pm

Corn husks, I tell ya! CORN HUSKS ALL OVER YOUR FACE!

What do you have to lose?

Akaj · April 7, 2020, 7:43pm

It’s human nature for people to want magic bullet solutions to frightening, complex problems. It’s the job of a leader to discourage magic bullet thinking.

Instead we have a president who not only does the opposite, but may trying to profit from it.

But it won’t matter, because – as we’ve seen countless times – if something goes well, 35% of the country will give Trump the credit for it, and if it goes badly they’ll blame Democrats. So they’ll proclaim Trump a hero for promoting a drug that helps three people beat COVID-19, and blame Democrats for denying it to the teemiing millions.

KidCharlemagne · April 7, 2020, 7:45pm

I find the miraculous recovery anecdotes suspect as well, but as far as overall success rates, I wouldn’t be surprised if a drug that blocked penetration of host cells was significantly more successful than one that inhibited enzymes involved in replication (like most antivirals).

KidCharlemagne · April 7, 2020, 7:56pm

storyteller0910:

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.

Just FYI, there was research on Chloroquine Phosphate that showed results before Plaquenil got involved. You can’t see hard numbers but there was a study in China that used 100 patients that seemed to convince everyone there to make it standard treatment.

https://www.jstage.jst.go.jp/article/bst/advpub/0/advpub_2020.01047/_pdf

Thus far, results from more than 100 patients have demonstrated that chloroquine phosphate is superior to the control treatment in inhibiting the exacerbation of pneumonia, improving lung imaging findings, promoting a virus- negative conversion, and shortening the disease course according to the news briefing. Severe adverse reactions to chloroquine phosphate were not noted in the aforementioned patients. Given these findings, a conference was held on February 15, 2020; participants including experts from government and regulatory authorities and organizers of clinical trials reached an agreement that chloroquine phosphate has potent activity against COVID-19. The drug is recommended for inclusion in the next version of the Guidelines for the Prevention, Diagnosis, and Treatment of Pneumonia Caused by COVID-19 issued by the National Health Commission of the People’s Republic of China.

Ann_Hedonia · April 7, 2020, 8:09pm

I’d be easier to convince if this drug that blocks penetration of host cells had worked against other viruses with similar host cells. Of if there was a theory as to why it could stop the replication of COVID cells when it failed to stop the replication of flu cells.

And I’d be even easier to convince if the evidence came through reputable sources instead of doctors calling into Fox News. I’d give more weight to a properly peer reviewed article published in a medical journal than a YouTube video.

Dr Oz’s history of promoting unproven therapies will cause me to be suspicious of anything he promotes, ever. Including his promotion of Donald Trump.

Donald Trump is truly in his element when he’s literally selling snake oil. He knows how to do this and he’s even pulling over people that should know better than to believe anything that comes out of that man’s mouth.

This whole thing is completely ridiculous, the ultimate conclusion of Trumpism. This is one half step away from colloidal silver / shark cartilage /emu oil level quackery - just wrapped in white coats and garnished with some flawed reports.

And the right wing eats up this crap. I’ve tried to figure out why, then I realized I was overthinking it. It’s simply that most conservatives are really really stupid.

HMS_Irruncible · April 7, 2020, 8:48pm

You mean those yellow-flower shrubs growing everywhere? Did I miss an inside joke?

HMS_Irruncible · April 7, 2020, 8:56pm

I think this is a little unfair. I don’t see conservatives as being abjectly stupid.

I do see that they seem to have zero mental defenses against being baited by supposed “insider information, so secret that the experts don’t even know about it!!!”. I guess they’re so allergic to feeling powerless and clueless that they instinctively reach for these comfort objects from familiar personalities.

KidCharlemagne · April 7, 2020, 9:41pm

Ann_Hedonia:

I’d be easier to convince if this drug that blocks penetration of host cells had worked against other viruses with similar host cells. Of if there was a theory as to why it could stop the replication of COVID cells when it failed to stop the replication of flu cells.

And I’d be even easier to convince if the evidence came through reputable sources instead of doctors calling into Fox News. I’d give more weight to a properly peer reviewed article published in a medical journal than a YouTube video.

Dr Oz’s history of promoting unproven therapies will cause me to be suspicious of anything he promotes, ever. Including his promotion of Donald Trump.

Donald Trump is truly in his element when he’s literally selling snake oil. He knows how to do this and he’s even pulling over people that should know better than to believe anything that comes out of that man’s mouth.

This whole thing is completely ridiculous, the ultimate conclusion of Trumpism. This is one half step away from colloidal silver / shark cartilage /emu oil level quackery - just wrapped in white coats and garnished with some flawed reports.

And the right wing eats up this crap. I’ve tried to figure out why, then I realized I was overthinking it. It’s simply that most conservatives are really really stupid.

You seem to really be ignoring that there is some data. Real data. Not perfect. Did you see the studies on Chloroquine Phosphate that I linked too? 10 Hospitals, 100 patients, enough data to convince doctors in China to make it standard treatment. This isn’t remotely quackery unless 72% of drs in Spain and front line doctors taking it prophylacticly in NYC are all quacks. And the reason CP and Plaquenil haven’t worked in other viruses is because the “novel” aspect of this virus is that it attaches to ACE-2 which is why is gets deep into the alveoli.

I have just as much contempt for Trump and the right as you do but I don’t let it affect my judgement.

CarnalK · April 7, 2020, 9:48pm

My dad was a doctor and smoked cigarettes from ages 15-65. Maybe cigarettes aren’t so bad.

Nobody should care if doctors are taking it proactively. We should be caring whether it seems effective. So tell me, are Spanish doctors getting infected less with a 72% adoption of this treatment? (not that I buy that without a cite)

iamthewalrus_3 · April 7, 2020, 9:48pm

Wow what are the odds.