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This study shows that when it is taken after the disease has advanced enough that patients are in the hospital that it is no help in this situation either.
I gather what you are trying to argue is that hydroxychloroquine might be effective when we get to the nebulous area of when it is not being taken to prevent occurrence of symptoms, but it hasn't advanced to the point where the patient ends up in the hospital? How do you define these parameters? When exactly is the appropriate time to take this medicine? When is it too late? Shouldn't it lessen symptoms if taken prophylatically when a person actually becomes sick? The study I have quoted above states the patients had "mild to moderate symptoms".
I find it more logical that the medication isn't useful in treating coronavirus.
This study is pretty easy to pick apart: basically everybody got better by day 15 whether they were treated or not.-- The study wasn't sensitive enough to differentiate small differences in study groups.
If you "eyeball" the three graphs in Figure 2, you get the impression that the two treated groups got better a little faster than the control (untreated) group-- but apparently it wasn't statistically significant.
A bigger problem with the study is that it doesn't address the problem of pt age: we know younger pts get better at a very high rate whether treated or not, so you need a huge study (1500 pts & 1500 controls) to find small differences. (We could argue that if the differences are that small, it's not a real, clinically important difference anyway.)
What we need is a good study in the over- 65 age group...the only group with high complication/death rate.
Theoretically, any anti-inflammatory agent (like glucocorticosteroids, NSAIDS or HCQ) should work in those pts who exhibit the "cytokine storm" phenomenon. Those are the guys who get terribly sick and probably die....In the others (most of the cases) it probably doesn't have enough of an effect to be measured.
It seems there are three sides to this argument-- the fearful ones ("This is so bad I'll try anything.")...the idioelogical obstructionists ("The President wants to try it, so we must oppose it.").. . and the scientists ("There's no good evidence against it and some in favor of it. Let's keep studying it.")
The only drugs proven to work are remdesivir and the corticosteroid dexamethasone. For some reason, a large number of Americans believe Trump over medical professionals. Amazing how one many can unearth so many conspiracies. Like a supernatural being or something...
This study is pretty easy to pick apart: basically everybody got better by day 15 whether they were treated or not.-- The study wasn't sensitive enough to differentiate small differences in study groups.
If you "eyeball" the three graphs in Figure 2, you get the impression that the two treated groups got better a little faster than the control (untreated) group-- but apparently it wasn't statistically significant.
A bigger problem with the study is that it doesn't address the problem of pt age: we know younger pts get better at a very high rate whether treated or not, so you need a huge study (1500 pts & 1500 controls) to find small differences. (We could argue that if the differences are that small, it's not a real, clinically important difference anyway.)
What we need is a good study in the over- 65 age group...the only group with high complication/death rate.
Theoretically, any anti-inflammatory agent (like glucocorticosteroids, NSAIDS or HCQ) should work in those pts who exhibit the "cytokine storm" phenomenon. Those are the guys who get terribly sick and probably die....In the others (most of the cases) it probably doesn't have enough of an effect to be measured.
It seems there are three sides to this argument-- the fearful ones ("This is so bad I'll try anything.")...the idioelogical obstructionists ("The President wants to try it, so we must oppose it.").. . and the scientists ("There's no good evidence against it and some in favor of it. Let's keep studying it.")
And the 4th side...scientists who have seen enough to realize further study of this useless treatment is futile and a waste of time and resources that could actually be spent on more fruitful avenues of research and treatment...
And the 4th side...scientists who have seen enough to realize further study of this useless treatment is futile and a waste of time and resources that could actually be spent on more fruitful avenues of research and treatment...
Another well thought out and researched position I see...
"The disproportionate focus on treatment with HCQ, in addition to the lack of a strong scientific rationale for its use and the risk of its potentially harmful effects, has major opportunity costs. In a recent analysis of COVID-19 clinical trials, one in every six studies of treatments against SARSCoV-2 was designed to study HCQ or chloroquine. We understand the desperation of many to see an effective treatment for COVID-19 emerge that will stop the pandemic in its tracks or slow its relentless spread in the US. But investing our resources in HCQ after multiple studies have not shown it to be effective for COVID-19 has serious implications for more than just individual patients. The continuing advocacy on behalf of HCQ distracts us from advancing the science on COVID-19 and seeking more effective interventions in a time when more than 1000 people are dying per day of this disease." https://medium.com/@gregggonsalves/s...9-47d0dee7b2b0
Hydroxychloroquine can cause a potentially lethal heart arrhythmia.
Yeah, especially when they give 2,400 mg of HCQ in 24 hrs to critically ill patients, instead of the recommended 500 mg in 24 hours to mildly ill & pre symptomatic patients.
Yeah, especially when they give 2,400 mg of HCQ in 24 hrs to critically ill patients, instead of the recommended 500 mg in 24 hours to mildly ill & pre symptomatic patients.
And the 4th side...scientists who have seen enough to realize further study of this useless treatment is futile and a waste of time and resources that could actually be spent on more fruitful avenues of research and treatment...
Those would be the close-minded "scientists".:...As I said, we have some evidence it works and that needs to be explained.
Sure, we could devote that money to research other treatments....Got any suggestions for which of the drugs listed in the 5000 page PDR or any of the hundreds of experimental compounds currently in the research pipeline or any common household chemicals available that have never been tested yet?...Pick one. Let's try it.....Talk about a shot in the dark.
We've been seeking treatments for viruses for 80 yrs-- since they were first discovered. Precious little to show for it. What makes you think we'll miraculously come up with something that works for this one in just a few weeks or month?
Tamiflu-- Great!...Flu without treatment lasts 240 hrs (10days)... Take $100 worth of Tamiflu and the average course is shortened to 228 hrs (9.5 days)..no change in mortality rate.
Tamiflu and other antivirals shorten the duration of flu 1-2 days (there's a range), but more importantly, almost halves the incidence of risk getting respiratory involvement.
There's obviously something wrong with the study when the prophylaxis agent hydroxychloroquine and the antibiotic azithromycin taken together result in worse results than just taking the hcq alone. The survival rate should have been higher.
Quote:
Overall crude mortality rates were 18.1% in the entire cohort, 13.5% in the hydroxychloroquine alone group, 20.1% among those receiving hydroxychloroquine plus azithromycin, 22.4% among the azithromycin alone group, and 26.4% for neither drug," the team wrote in a report published in the International Journal of Infectious Diseases.
I think the state of patient's health was not well understood and might explain the inconsistencies.
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