Hydroxychloroquine is useless

[Oxx]

Despite some individuals (most notably the President of the United States of America) having suggested that hydroxychloroquine is effective against the virus, despite only anecdotal evidence for this, it has now been demonstrated that it is ineffectual.  

 

"No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection" - Molina et al. (2020)

 

https://doi.org/10.1016/j.medmal.2020.03.006

[from the home of CC]

Yes, it doesn't look promising. What may help till a vaccine is here is convalescent antibody therapy. Survivors plasma is separated and low dosed into folks for the antibodies it contains. It has shown success in the past with other viruses. imo a magic bullet is not going to appear till trials are finished on vaccines though I understand why people are reaching for these types of straws..

[uhuh]

In my latest post I referred to this Paris study as the "French follow-up". The study design was better than the Marseille study. 

 

Another recent randomised study (not French),  also scientifically sound, found some efficacy, statistically significant. (Improvement with drugs in about 25 cases versus about 17 in the placebo group - treatment was begun early, when the patients were still doing ok)

All these studies are small.

[tonray]

I'm not sure it's effectiveness as a treatment has to do with it's anti-viral action. Just as it's use in LUPUS patients...it has an anti-inflammatory effect that may aid oin mitigating the lung and organ damage that is triggered by the immune response to the viral infection. More study certainly is needed but you cannot count out any treatment. For example...the only treatments being used currently are supportive and have no effect on the virus itself...this would be used in the same way. 

[uhuh]

Chloroquine/HCQ is being investigated because it has well known antiviral activity in vitro.

Nothing to do with antiinflammatory properties. 

[ThailandRyan]

You also have to remember that what may work for one person may not work for another, and is therefore trial and error.  However, for the masses I hope that they soon have some type of inoculation, as well as some type of prophylaxis to turn around those that have the virus currently as far as stopping the virus.    

[rabas]

One more data point. There are some issues with this study:

 

1. It was much smaller with just 9 patients completing the study.

2. 8 patients had  "significant co morbidities associated with poor outcomes".

3. They did not look for a decrease in viral load, the used PCR to detect its presence.

4. Their results only measured if it had disappeared or not after 5 days.

 

Yes it is a data point, but one of the weakest so far. Cholorquine will not treat comorbidities.

Edited April 6, 2020 by rabas

[tonray]

18 minutes ago, uhuh said:

Chloroquine/HCQ is being investigated because it has well known antiviral activity in vitro.

Nothing to do with antiinflammatory properties. 

It is commonly used in LUPUS and Malaria patients who clearly have no virus

 

https://en.wikipedia.org/wiki/Hydroxychloroquine

 

"

Medical use

Hydroxychloroquine is used to treat systemic lupus erythematosus, rheumatic disorders like rheumatoid arthritis, porphyria cutanea tarda, and Q fever, and certain types of malaria.^[2] It is considered the first line treatment for systemic lupus erythematosus.^[8] Certain types of malaria, resistant strains, and complicated cases require different or additional medication.^[2]

It is widely used to treat primary Sjögren syndrome, but has not been shown to be effective.^[9] Hydroxychloroquine is widely used in the treatment of post-Lyme arthritis. It may have both an anti-spirochaete activity and an anti-inflammatory activity, similar to the treatment of rheumatoid arthritis.^[10]"

Edited April 6, 2020 by tonray

[DrTuner]

22 minutes ago, from the home of CC said:

Yes, it doesn't look promising. What may help till a vaccine is here is convalescent antibody therapy. Survivors plasma is separated and low dosed into folks for the antibodies it contains. It has shown success in the past with other viruses. imo a magic bullet is not going to appear till trials are finished on vaccines though I understand why people are reaching for these types of straws..

Plasma hasn't proven all that effective, these people are using computer simulations to modify antibodies from SARS-CoV epidemic in 2003, might be more effective and is in test phase: 

 

[from the home of CC]

6 minutes ago, DrTuner said:

Plasma hasn't proven all that effective, these people are using computer simulations to modify antibodies from SARS-CoV epidemic in 2003, might be more effective and is in test phase: 

 

It is not a cure all but possibly will give time to patients to allow them to live long enough to produce their own antibodies.  

https://www.latimes.com/science/story/2020-04-02/blood-centers-begin-collecting-coronavirus-antibodies-from-covid-19-survivors

 

The kicker is that this can be tried now. The world can't afford to wait out researchers without at least trying something that has worked before..

[DrTuner]

1 minute ago, from the home of CC said:

The kicker is that this can be tried now. The world can't afford to wait out researchers without at least trying something that has worked before..

That's true. Better than nothing. And all the more reason to roll out massive testing for antibodies, so those that have recovered may donate. I haven't heard anything about the PTT/MIT/etc fast tests being used, they should be in production by now.

[ChouDoufu]

45 minutes ago, Oxx said:

Despite some individuals (most notably the President of the United States of America) having suggested that hydroxychloroquine is effective against the virus, despite only anecdotal evidence for this, it has now been demonstrated that it is ineffectual.  

 

"No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection" - Molina et al. (2020)

 

https://doi.org/10.1016/j.medmal.2020.03.006

i think (not being a doctor) the thread title is incorrect, and your understanding of the study title may be as well.

 

there have been studies showing a correlation between use of hyd+azi being effective in treatment, so there is some evidence.  this was one study among many attempting to confirm it.

 

this study used a very small sample so the value of any findings would be limited.  the extract even stated further investigation would be required for a definitive answer.

 

as the study title stated, THIS trial found no evidence, not that there was no evidence showing the combination of drugs to be promising.  as they stated, other studies have suggested efficacy.

 

this study did not demonstrate the drug to be ineffectual; it was unable to demonstrate the drug to be effectual.  that's my understanding.

[scubascuba3]

Strange, i read case studies from Belgium and France and it seemed successful, but it doesn't matter really anyway as we can't get hold of any

[CGW]

Seems to me folks don't want there to be a "natural" aid to help fight & recover, Vit C, Zinc, Lysine and any thing else that is natural is deemed useless as is the body's immune system! Stopping people taking the sun especially in the West is ludicrous!

People will only be happy when "Big Pharma" save the day, strange times..........................

What on earth has happened to the world that we now have to rely on "others" to save us! Are we no longer able to live in a "natural" world? ????

End times? 

[Kelsall]

Hogwash.  The OP says it is useless, then bashes Trump, then says it has been demonstrated to be ineffectual.

 

If you read the study, it talks about severe COVID-19 infection and says more research should be done to provide a definitive answer.

 

Use of the drug should be done early on, before severe infection.

 

Still, quite a stealthy Trump bashing and the OP is to be commended for that. LOL.  BTW Cuomo has said it should be tried.

[UbonThani]

His trial was flawed. Tamiflu didnt do much after 48 hrs. It had to be used early. Same with these other drugs. Early treatment will show best results.

 

Plus these drugs can provide a pathway for Zinc to enter cells and fight it.

 

[DrTuner]

1 hour ago, from the home of CC said:

It is not a cure all but possibly will give time to patients to allow them to live long enough to produce their own antibodies.  

https://www.latimes.com/science/story/2020-04-02/blood-centers-begin-collecting-coronavirus-antibodies-from-covid-19-survivors

 

The kicker is that this can be tried now. The world can't afford to wait out researchers without at least trying something that has worked before..

More studies I bumped into about using plasma: https://jamanetwork.com/journals/jama/fullarticle/2763983

 

Quote

These preliminary findings raise the possibility that convalescent plasma transfusion may be helpful in the treatment of critically ill patients with COVID-19 and ARDS, but this approach requires evaluation in randomized clinical trials.

 

Edited April 6, 2020 by DrTuner

[Sheryl]

2 hours ago, ChouDoufu said:

i think (not being a doctor) the thread title is incorrect, and your understanding of the study title may be as well.

 

there have been studies showing a correlation between use of hyd+azi being effective in treatment, so there is some evidence.  this was one study among many attempting to confirm it.

 

this study used a very small sample so the value of any findings would be limited.  the extract even stated further investigation would be required for a definitive answer.

 

as the study title stated, THIS trial found no evidence, not that there was no evidence showing the combination of drugs to be promising.  as they stated, other studies have suggested efficacy.

 

this study did not demonstrate the drug to be ineffectual; it was unable to demonstrate the drug to be effectual.  that's my understanding.

 

the thread title is the title of the paper.

 

The study's actual conclusion was:

 

"In summary, despite a reported antiviral activity of chloroquine against COVID-19 in vitro, we
found no evidence of a strong antiviral activity or clinical benefit of the combination of
hydroxychloroquine and azithromycin for the treatment of our hospitalized patients with
severe COVID-19. Ongoing randomized clinical trials with hydroxychloroquine should provide
a definitive answer regarding the alleged efficacy of this combination and will assess its safety."

 

(bold is mine).

 

All the studies to date have been very small and lacked a control group. The evidence so far is at best very mixed but proper studies are underway which will give a clear answer.

 

It is certainly premature at best (and dangerously inaccurate at worst) to advertise or promote this as a treatment now.

[Kelsall]

31 minutes ago, Sheryl said:

 

the thread title is the title of the paper.

 

The study's actual conclusion was:

 

"In summary, despite a reported antiviral activity of chloroquine against COVID-19 in vitro, we
found no evidence of a strong antiviral activity or clinical benefit of the combination of
hydroxychloroquine and azithromycin for the treatment of our hospitalized patients with
severe COVID-19. Ongoing randomized clinical trials with hydroxychloroquine should provide
a definitive answer regarding the alleged efficacy of this combination and will assess its safety."

 

(bold is mine).

 

All the studies to date have been very small and lacked a control group. The evidence so far is at best very mixed but proper studies are underway which will give a clear answer.

 

It is certainly premature at best (and dangerously inaccurate at worst) to advertise or promote this as a treatment now.

The title of the paper is "No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection"

 

The thread title is "Hydroxychloroquine is useless"

 

The last sentence is "Ongoing randomized clinical trials with hydroxychloroquine should provide a definitive answer regarding the alleged efficacy of this combination and will assess its safety. " which indicates more trials need to be done.   We cannot say at this time "Hydroxychloroquine is useless"

Edited April 6, 2020 by Kelsall

[Sheryl]

Yes, I agree. It is premature to say either way.

[idiot farang]

23 minutes ago, Sheryl said:

 

the thread title is the title of the paper.

 

The study's actual conclusion was:

 

"In summary, despite a reported antiviral activity of chloroquine against COVID-19 in vitro, we
found no evidence of a strong antiviral activity or clinical benefit of the combination of
hydroxychloroquine and azithromycin for the treatment of our hospitalized patients with
severe COVID-19. Ongoing randomized clinical trials with hydroxychloroquine should provide
a definitive answer regarding the alleged efficacy of this combination and will assess its safety."

 

(bold is mine).

 

All the studies to date have been very small and lacked a control group. The evidence so far is at best very mixed but proper studies are underway which will give a clear answer.

 

It is certainly premature at best (and dangerously inaccurate at worst) to advertise or promote this as a treatment now.

Sincere question for you...

 

Given the dearth of alternate therapies, and given the decades of low risk profile of both drugs... if you were in a higher risk group (older, underlying conditions, etc) AND you were positive for the coronavirus, would you not take it?

 

From my reading, if you are in the group that decline quickly, waiting is (literally) a deadly choice. Alternatively, taking these 2 drugs is decidedly NOT a deadly choice. Several treating doctors have noted the the efficacy of the drug combo is much greater with early treatment. Anecdotal, sure. But time isn't on your side to wait for trials if you're in the situation I've laid out.

 

I genuinely cannot see where, confronted with such a reality, the phrase "what have you got to lose" is incorrect or reckless.

 

If the 2 drugs were very dangerous... ok, there is at least an argument. But we're talking about drugs with decades of use by billions of people. When there is no known cure and you're in a high risk group, it seems the decision to withhold (or even advise against their use) is irresponsible.

[law ling]

Topic should read "... useless in severe infections" - it remains to be seen if it is useful earlier on in the infection cycle, and in combination with other drugs.

 

And who's racing to find a vaccine?  - if it's big-pharma, they'll only be interested in the trillions of dollats they'll make from a vaccine - and will happily put out "reports" that existing drugs are "useless" ( as per the OP).

[Russell17au]

3 minutes ago, idiot farang said:

Sincere question for you...

 

Given the dearth of alternate therapies, and given the decades of low risk profile of both drugs... if you were in a higher risk group (older, underlying conditions, etc) AND you were positive for the coronavirus, would you not take it?

 

From my reading, if you are in the group that decline quickly, waiting is (literally) a deadly choice. Alternatively, taking these 2 drugs is decidedly NOT a deadly choice. Several treating doctors have noted the the efficacy of the drug combo is much greater with early treatment. Anecdotal, sure. But time isn't on your side to wait for trials if you're in the situation I've laid out.

 

I genuinely cannot see where, confronted with such a reality, the phrase "what have you got to lose" is incorrect or reckless.

 

If the 2 drugs were very dangerous... ok, there is at least an argument. But we're talking about drugs with decades of use by billions of people. When there is no known cure and you're in a high risk group, it seems the decision to withhold (or even advise against their use) is irresponsible.

I understand your position but these are not the only 2 drugs out there being looked at. There is a current drug available that in the laboratory has killed this virus within 48 hours and it is being prepaid for the clinical test now. The drug, Ivermectin is being tested by Monash University in Australia and so far their tests have shown that the coronavirus dies within 48 hours in the laboratory test.

https://www.monash.edu/discovery-institute/news-and-events/news/2020-articles/Lab-experiments-show-anti-parasitic-drug,-Ivermectin,-eliminates-SARS-CoV-2-in-cells-in-48-hours

So now there are becoming more and more possibilities that this virus might be defeated.

[timendres]

3 minutes ago, law ling said:

And who's racing to find a vaccine?  - if it's big-pharma, they'll only be interested in the trillions of dollats they'll make from a vaccine - and will happily put out "reports" that existing drugs are "useless" ( as per the OP).

Please feel free to discover the vaccine on your own.

[spidermike007]

3 hours ago, uhuh said:

In my latest post I referred to this Paris study as the "French follow-up". The study design was better than the Marseille study. 

 

Another recent randomised study (not French),  also scientifically sound, found some efficacy, statistically significant. (Improvement with drugs in about 25 cases versus about 17 in the placebo group - treatment was begun early, when the patients were still doing ok)

All these studies are small.

So, if you got infected, we're over 60, and ended up with serious pulmonary issues, would you take your doctor's advice and just roll the dice? I would not. I have both hydro and the suggested antibiotic at home. Enough for my wife and I. And it will be used if necessary. I prefer a few small studies with success, than nothing at all. Some prefer no hope. That is not the way I roll. 

[JHolmesJr]

2 hours ago, Kelsall said:

Use of the drug should be done early on, before severe infection.

 

I will not be at all surprised if that sly old dog Trump is on this regimen already.

That's how he's able to stand on that podium without a mask and swat away

idiots like Acosta with alarming alacrity.

 

Mind you he's had a lot of practice.

[Toosetinmyways]

The other problem is that the only place that has the stocks that Trump wants is India and Modi has already said no deal. 

[JHolmesJr]

1 minute ago, Toosetinmyways said:

The other problem is that the only place that has the stocks that Trump wants is India and Modi has already said no deal. 

 

The next time Modi asks for an increase in H1B quotas for his army of economic refugees, the answer will also be 'no deal'.

[idiot farang]

1 hour ago, JHolmesJr said:

That's how he's able to stand on that podium without a mask and swat away

idiots like Acosta with alarming alacrity.

+1 simply for using "alacrity".

[dabhand]

1 hour ago, Toosetinmyways said:

The other problem is that the only place that has the stocks that Trump wants is India and Modi has already said no deal. 

Not too fast. Maybe another 'perfect' phone call from Trump?

 

https://www.bbc.com/news/world-asia-india-52180660