The anti malarial drugs
- Thread starter 1Tripoda
- Start date
Doctors are still prescribing this drug combo because it works. Cuomo asked for more hydroxy because it works. In this study the drug was only given to people that were already critical and most on ventilators. Hydroxy is extremely effective when administered early.
There may be other drugs that turn out to be more effective but this combo has done much good.
But yeah we know you hate Trump.
That drives every “right” and every “wrong” in this country. Whether you support Trump or hate him ... he could cure cancer and half of the country would blame him for a food shortage caused by overpopulation. Or he could level Wuhan with nukes but it’d be ok that innocent civilians died because we shut down the lab that unleashed the virus upon the world.
Was this study peer reviewed? What were their comments?
Was there a placebo group? A group that received no treatment? What were their outcomes?
Describe the control group.
If this is a valid scientific study then it’s going to define all of those things.
Was there a placebo group? A group that received no treatment? What were their outcomes?
Describe the control group.
If this is a valid scientific study then it’s going to define all of those things.
From what I understand it was just a pick and choose questionnaire that very easily could have manipulated the data to fit their agenda. The idea that this reporter said it didn't help anyone, and may have even killed some people shows me everything I need to know. Even a full study with a placebo, who have some people on the placebo, will have a positive outcome for some of them. I will stand by trusting the field testing that has occurred in several countries including France and the US, while it will not be able to determine any side effects, and will not be 100% accurate, most people can't wait for 1-2 years for a typical full blown study to be completed.
Proof that it works beyond a small number of people? Proof that it is universally effective or are you just clinging to your security blanket?
Keep digging your hole.
https://www.cnn.com/2020/04/08/health/drug-hydroxychloroquine-french-study/index.html
https://www.cnn.com/2020/04/15/health/new-french-study-hydroxychloroquine/index.html
"A drug that's been touted by President Donald Trump as a "game changer" didn't help hospitalized patients with coronavirus and was associated with heart complications, according to a new study.
"This provides evidence that hydroxychloroquine does not apparently treat patients with Covid 19," said Dr. Paul Offit, an infectious disease specialist at Children's Hospital of Philadelphia. "Even worse, there were side effects caused by the drug -- heart toxicities that required it be discontinued."
"A drug that's been touted by President Donald Trump as a "game changer" didn't help hospitalized patients with coronavirus and was associated with heart complications, according to a new study.
"This provides evidence that hydroxychloroquine does not apparently treat patients with Covid 19," said Dr. Paul Offit, an infectious disease specialist at Children's Hospital of Philadelphia. "Even worse, there were side effects caused by the drug -- heart toxicities that required it be discontinued."
https://www.theguardian.com/world/2...quine-coronavirus-scientific-studies-research
With endorsements from a controversial French physician, Fox News and Donald Trump, hydroxychloroquine – an old anti-malarial drug that is today more commonly used to treat lupus – has received a disproportionate amount of attention as a potential treatment for Covid-19.
It has also become another partisan political wedge issue in the US: conservative politicians and media figures have hyped studies that support the theory that the drug is a potential treatment. And on Wednesday, Rick Bright, the head of a US government agency charged with investing in treatments and responses for pandemics, said he was forced out of his job over his resistance to the administration’s “misguided directives” promoting “broad use” of the drug, which he said “clearly lack scientific merit”.
The hype around hydroxychloroquine is irresponsible, but the hope is understandable. There is as yet no drug that has been shown to be effective against the coronavirus, which has killed more than 180,000 people worldwide.
The limited evidence around hydroxychloroquine so far has come in a steady stream of scientific studies, often as soon as they are posted online as “preprints” – ie before they have gone through the rigorous vetting process known as peer review. None of the studies that have been released meet the gold standard for demonstrating a drug’s effectiveness – a large-scale, double-blinded randomized controlled trial (RCT), though multiple trials of that kind are under way.
While the world awaits those results, here’s a guide to some of the studies released thus far:
In vitro v in vivo
In early February, the journal Cell Research published a letter to the editor by Chinese scientists reporting the results of their experiments looking at whether existing drugs might be effective against the coronavirus. The scientists tested five drugs in vitro – meaning on cells infected with the virus in a laboratory rather than in humans – and found promising results for two: remdesivir and chloroquine. (Chloroquine is a close relative to hydroxychloroquine, which is considered safer.)
Caveats: There is a big difference between a drug showing promise in a laboratory and working in patients. Scientists have gotten similarly promising results with hydroxychloroquine against various viruses in past in vitro studies, including against the first Sars, but have yet to show its effectiveness against any virus in RCTs.
The controversial French study
Much of the media hype around hydroxychloroquine stems from a French study of the drug which purported to show significant reduction in viral load for patients treated with a combination of HCQ and azithromycin, a common antibiotic. The study was a clinical trial, meaning it involved actual patients, and underwent peer review before publication in the International Journal of Antimicrobial Agents (IJAA).
Caveats: There are numerous problems with this study’s design and the way its results were reported. The researchers downplayed the clinical outcomes – ie whether or not the patient improved, got worse or died – and instead based their analysis on measuring how long a patient was shedding the virus – ie whether the researchers were able to detect its presence from a nasal swab. All of the four patients with clear bad outcomes (three went to the ICU and one died) received the HCQ but were excluded from the viral shedding analysis. The researchers said that the remaining patients who received the drug shed virus for a shorter duration. This opened the door for people promoting the drug to mischaracterize their results and say they showed a “100% cure rate”.
The professional association affiliated with the IJAA has said the article “does not meet the society’s expected standard”, and the publisher has initiated additional independent peer review.
Meanwhile, the group of French scientists has continued to publish preprints reporting results on their continued use of hydroxychloroquine and azithromycin on patients in Marseille, without any control group.
A small Chinese clinical trial
In early April, Chinese scientists published a study looking at 62 patients with mild cases of Covid-19. Unlike the French trial, the study was randomized and the treatment and control groups were comparable. The study found a statistically significant difference in the time it took the two groups to recover, with patients who received HCQ showing shorter periods of fever and cough.
Caveats: The number of patients involved was very small, and the researchers did not include any patients with severe or critical illness. This paper has not yet been peer-reviewed. The study authors concluded that their results “partially confirmed” the potential of HCQ as a treatment, but they said large-scale trials were still needed, as well as basic research to understand the mechanism by which the drug is affecting people.
A retrospective analysis of patient data from France
While awaiting the results of large-scale clinical trials, some scientists have performed retrospective analyses of real-life patients to emulate a clinical trial. This works by selecting a cohort of patients who received the drug and an equivalent cohort who did not and then comparing their outcomes. In a French retrospective analysis posted as a preprint in mid-April, researchers found “no evidence” that HCQ was an effective treatment when comparing 84 patients who received the drug and 97 who did not.
Caveats: Retrospective analyses are not a substitute for RCTs. One clear confounding factor is that researchers do not know why physicians decided to treat some patients with HCQ and others not. The paper has also not yet been peer-reviewed.
Red flags in an aborted Brazilian trial
While hydroxychloroquine is considered safe for its approved uses, it does have side-effects, including increasing the risk of heart arrhythmias in some people. In mid-April, a group of researchers in Brazil posted a preprint revealing that they had called a halt to a clinical trial of hydroxychloroquine at high doses after they observed high rates of arrhythmias and a large number of deaths. The researchers “strongly recommended” that physicians no longer use the high dose of the drug.
Caveats: The Brazilian trial was designed to compare the efficacy of two different doses of hydroxychloroquine, and it did not include a control group that only received a placebo. Researchers found the higher dose, which they chose because it was recommended by Chinese authorities, to be unsafe, but they are continuing to test the efficacy of a lower dose. Their paper has not yet been peer-reviewed.
A retrospective analysis of US veterans
Similarly to the French retrospective analysis, researchers in the US looked at the outcomes for 368 patients who were treated for Covid-19 in the country’s Veterans Health Administration hospitals. The patients were broken into three groups: those who received HCQ, those who received HCQ and azithromycin, and those who did not receive HCQ. They found that HCQ, with or without azithromycin, did not reduce a patient’s need for a ventilator or reduce the risk of death. They also found that those who received HCQ alone had a higher risk of death than those who did not.
Caveats: The analysis was limited to male patients. As with the French retrospective analysis, this study is not a substitute for RCTs. One major confounding factor is that the patients who received HCQ were more severely ill. The researchers say that they accounted for this in their statistical analysis and still found a higher mortality rate for those receiving HCQ. The study has not yet been peer-reviewed.
US government recommendations
A panel of experts put together by the National Institute of Allergy and Infectious Diseases, the agency led by Dr Anthony Fauci, released treatment guidelines for Covid-19 on 21 April. The panel said that there was insufficient data to “recommend either for or against” hydroxychloroquine or chloroquine. However, the panel recommended against the use of hydroxychloroquine with azithromycin due to the risk of cardiac arrhythmia.
With endorsements from a controversial French physician, Fox News and Donald Trump, hydroxychloroquine – an old anti-malarial drug that is today more commonly used to treat lupus – has received a disproportionate amount of attention as a potential treatment for Covid-19.
It has also become another partisan political wedge issue in the US: conservative politicians and media figures have hyped studies that support the theory that the drug is a potential treatment. And on Wednesday, Rick Bright, the head of a US government agency charged with investing in treatments and responses for pandemics, said he was forced out of his job over his resistance to the administration’s “misguided directives” promoting “broad use” of the drug, which he said “clearly lack scientific merit”.
The hype around hydroxychloroquine is irresponsible, but the hope is understandable. There is as yet no drug that has been shown to be effective against the coronavirus, which has killed more than 180,000 people worldwide.
The limited evidence around hydroxychloroquine so far has come in a steady stream of scientific studies, often as soon as they are posted online as “preprints” – ie before they have gone through the rigorous vetting process known as peer review. None of the studies that have been released meet the gold standard for demonstrating a drug’s effectiveness – a large-scale, double-blinded randomized controlled trial (RCT), though multiple trials of that kind are under way.
While the world awaits those results, here’s a guide to some of the studies released thus far:
In vitro v in vivo
In early February, the journal Cell Research published a letter to the editor by Chinese scientists reporting the results of their experiments looking at whether existing drugs might be effective against the coronavirus. The scientists tested five drugs in vitro – meaning on cells infected with the virus in a laboratory rather than in humans – and found promising results for two: remdesivir and chloroquine. (Chloroquine is a close relative to hydroxychloroquine, which is considered safer.)
Caveats: There is a big difference between a drug showing promise in a laboratory and working in patients. Scientists have gotten similarly promising results with hydroxychloroquine against various viruses in past in vitro studies, including against the first Sars, but have yet to show its effectiveness against any virus in RCTs.
The controversial French study
Much of the media hype around hydroxychloroquine stems from a French study of the drug which purported to show significant reduction in viral load for patients treated with a combination of HCQ and azithromycin, a common antibiotic. The study was a clinical trial, meaning it involved actual patients, and underwent peer review before publication in the International Journal of Antimicrobial Agents (IJAA).
Caveats: There are numerous problems with this study’s design and the way its results were reported. The researchers downplayed the clinical outcomes – ie whether or not the patient improved, got worse or died – and instead based their analysis on measuring how long a patient was shedding the virus – ie whether the researchers were able to detect its presence from a nasal swab. All of the four patients with clear bad outcomes (three went to the ICU and one died) received the HCQ but were excluded from the viral shedding analysis. The researchers said that the remaining patients who received the drug shed virus for a shorter duration. This opened the door for people promoting the drug to mischaracterize their results and say they showed a “100% cure rate”.
The professional association affiliated with the IJAA has said the article “does not meet the society’s expected standard”, and the publisher has initiated additional independent peer review.
Meanwhile, the group of French scientists has continued to publish preprints reporting results on their continued use of hydroxychloroquine and azithromycin on patients in Marseille, without any control group.
A small Chinese clinical trial
In early April, Chinese scientists published a study looking at 62 patients with mild cases of Covid-19. Unlike the French trial, the study was randomized and the treatment and control groups were comparable. The study found a statistically significant difference in the time it took the two groups to recover, with patients who received HCQ showing shorter periods of fever and cough.
Caveats: The number of patients involved was very small, and the researchers did not include any patients with severe or critical illness. This paper has not yet been peer-reviewed. The study authors concluded that their results “partially confirmed” the potential of HCQ as a treatment, but they said large-scale trials were still needed, as well as basic research to understand the mechanism by which the drug is affecting people.
A retrospective analysis of patient data from France
While awaiting the results of large-scale clinical trials, some scientists have performed retrospective analyses of real-life patients to emulate a clinical trial. This works by selecting a cohort of patients who received the drug and an equivalent cohort who did not and then comparing their outcomes. In a French retrospective analysis posted as a preprint in mid-April, researchers found “no evidence” that HCQ was an effective treatment when comparing 84 patients who received the drug and 97 who did not.
Caveats: Retrospective analyses are not a substitute for RCTs. One clear confounding factor is that researchers do not know why physicians decided to treat some patients with HCQ and others not. The paper has also not yet been peer-reviewed.
Red flags in an aborted Brazilian trial
While hydroxychloroquine is considered safe for its approved uses, it does have side-effects, including increasing the risk of heart arrhythmias in some people. In mid-April, a group of researchers in Brazil posted a preprint revealing that they had called a halt to a clinical trial of hydroxychloroquine at high doses after they observed high rates of arrhythmias and a large number of deaths. The researchers “strongly recommended” that physicians no longer use the high dose of the drug.
Caveats: The Brazilian trial was designed to compare the efficacy of two different doses of hydroxychloroquine, and it did not include a control group that only received a placebo. Researchers found the higher dose, which they chose because it was recommended by Chinese authorities, to be unsafe, but they are continuing to test the efficacy of a lower dose. Their paper has not yet been peer-reviewed.
A retrospective analysis of US veterans
Similarly to the French retrospective analysis, researchers in the US looked at the outcomes for 368 patients who were treated for Covid-19 in the country’s Veterans Health Administration hospitals. The patients were broken into three groups: those who received HCQ, those who received HCQ and azithromycin, and those who did not receive HCQ. They found that HCQ, with or without azithromycin, did not reduce a patient’s need for a ventilator or reduce the risk of death. They also found that those who received HCQ alone had a higher risk of death than those who did not.
Caveats: The analysis was limited to male patients. As with the French retrospective analysis, this study is not a substitute for RCTs. One major confounding factor is that the patients who received HCQ were more severely ill. The researchers say that they accounted for this in their statistical analysis and still found a higher mortality rate for those receiving HCQ. The study has not yet been peer-reviewed.
US government recommendations
A panel of experts put together by the National Institute of Allergy and Infectious Diseases, the agency led by Dr Anthony Fauci, released treatment guidelines for Covid-19 on 21 April. The panel said that there was insufficient data to “recommend either for or against” hydroxychloroquine or chloroquine. However, the panel recommended against the use of hydroxychloroquine with azithromycin due to the risk of cardiac arrhythmia.
There is no “Caveat” portion of a scientific publication/study. I’ve read many of them and ZERO have included a section on “caveats.” Also, none have given narratives where they cite a President’s endorsement. If I missed a scientific study that did so, please link one directly from the AMA or other reputable agencies.
I’m not endorsing or refuting it, I’m just telling my experiences with reading studies.
I’m not endorsing or refuting it, I’m just telling my experiences with reading studies.
I glimpsed over your post with caveat after caveat.
I’m not arguing efficacy since that’s not my discipline of medicine.
I rarely click on links, let alone any posted from a political website.
A politician speaking on a political website; I stand corrected!
The medical community MUST accept that!
The medical community MUST accept that!
I am digging a hole Rebel "I kiss CNN ass" Soldat? Beyond a most likely degree in poly Sci, what degrees do you have that make you an expert in anything? I may be digging a hole, but at least I have the scientific degrees to know how to best design and proceed with digging of said hole!
Nothing worse than a world expert that has zero world experience, only readings.
Whats up with continuing a debate about a drug the president now backs away from talking about? Haven’t you heard we’ve moved on to shooting up bleach? Powerful scientists are already doing a powerful study on whether this will work in areas where there are cancer causing windmills.
Nobody knows if it’s effective.
Some hope it is (for political purposes), some root against it (for political purposes).
I hope we find a good option, that gets approved, very soon.
Some hope it is (for political purposes), some root against it (for political purposes).
I hope we find a good option, that gets approved, very soon.
DPRK state media announces the eternal strength of Supreme Leader Kim Jong-un and the total truthiness of the Ministry of Propaganda.
