Stories
Slash Boxes
Comments

SoylentNews is people

posted by Fnord666 on Monday April 13 2020, @01:12AM   Printer-friendly

The Latest Hydroxychloroquine Data, As of April 11:

We have new data on hydroxychloroquine therapy to discuss. The numbers will not clear anything up.

The good news is that the HCQ/sulfasalazine comparison does not show any real differences in adverse events over one-month courses of treatment. I should note that sulfasalazine is not the most side-effect-free medication in the whole pharmacopeia, but it has not been associated with (for example) QT prolongation, which is one of the things you worry about with hydroxychloroquine. The paper concludes that short-term HCQ monotherapy does appear to be safe, but notes that long-term HCQ dosing is indeed tied to increased cardiovascular mortality.

The trouble comes in with the azithromycin combination. Like many antibiotics (although not amoxicillin), AZM is in fact tied to QT prolongation in some patients, so what happens when it's given along with HCQ, which has the same problem?

Worryingly, significant risks are identified for combination users of HCQ+AZM even in the short-term as proposed for COVID19 management, with a 15-20% increased risk of angina/chest pain and heart failure, and a two-fold risk of cardiovascular mortality in the first month of treatment.

That isn't good. I am very glad to hear that the Raoult group has observed no cardiac events in their studies so far, but I wonder how they have managed to be so fortunate, given these numbers.

Update: here is another new preprint from a multinational team lead out of Brazil. It enrolled 81 patients in a trial of high-dose hydroxychloroquine  (600 mg b.i.d. over ten days, total dose 12g) or low-dose (450mg b.i.d. on the first day, qd thereafter for the next four, total dose 2.7g). All patients also received azithromycin and ceftriaxone (a cephalosporin antibiotic). The high-dose patients showed more severe QT prolongation and there a trend toward higher lethality compared to the low dose. The overall fatality rate across both arms of the study was 13.5% (so far), which they say overlaps with the historical fatality rate of patients not receiving hydroxychloroquine. The authors actually had to stop recruiting patients for the high-dose arm of the study due to the cardiovascular events, but they're continuing to enroll people in the low-dose group to look at overall mortality. The paper mentions that HCQ has been mandated as the standard therapy in Brazil, so there is no way to run a non-HCQ control group, though.


Original Submission

 
This discussion has been archived. No new comments can be posted.
Display Options Threshold/Breakthrough Mark All as Read Mark All as Unread
The Fine Print: The following comments are owned by whoever posted them. We are not responsible for them in any way.
  • (Score: 2) by legont on Monday April 13 2020, @04:03AM (21 children)

    by legont (4179) on Monday April 13 2020, @04:03AM (#981821)

    Hydroxychloroquine was approved for medical use in the United States in 1955.[2] It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.[6] In 2017, it was the 128th most commonly prescribed medication in the United States, with more than five million prescriptions.[7][8]

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

    What the fuck is this "research" about?

    --
    "Wealth is the relentless enemy of understanding" - John Kenneth Galbraith.
    Starting Score:    1  point
    Karma-Bonus Modifier   +1  

    Total Score:   2  
  • (Score: 5, Insightful) by pipedwho on Monday April 13 2020, @04:24AM (20 children)

    by pipedwho (2032) on Monday April 13 2020, @04:24AM (#981822)

    Some speculation early on identified hydroxychloroquine as a treatment of COVID. The evidence is tenuous and no controlled studies have been run. But, for some reason it has avalanched as the go-to treatment, even if it actually does nothing. And not only may it have no benefit, it may have other serious side effects.

    The whole hydroxychloroquine thing is a classic example of how 'non-scientific' the medical establishment can be.

    • (Score: 2, Informative) by Anonymous Coward on Monday April 13 2020, @04:43AM (1 child)

      by Anonymous Coward on Monday April 13 2020, @04:43AM (#981828)

      How non-scientific the medical establishment is? No one would be talking about hydroxychloroquine, the same way they aren't talking about the other treatments under investigation, if Trump hadn't mentioned it repeatedly on TV.

      • (Score: 0) by Anonymous Coward on Monday April 13 2020, @07:13AM

        by Anonymous Coward on Monday April 13 2020, @07:13AM (#981869)

        Right. And any establishment that kowtows to Trump's gut feelings is un-scientific, in doing so.

    • (Score: 2) by captain normal on Monday April 13 2020, @04:53AM (3 children)

      by captain normal (2205) on Monday April 13 2020, @04:53AM (#981833)

      Snake Oil by any other name is still Snake Oil.

      --
      When life isn't going right, go left.
      • (Score: 0) by Anonymous Coward on Monday April 13 2020, @12:23PM (2 children)

        by Anonymous Coward on Monday April 13 2020, @12:23PM (#981921)

        Perhaps the authorities should do a clinical trial of snake oil.

        • (Score: 2) by HiThere on Monday April 13 2020, @02:54PM (1 child)

          by HiThere (866) Subscriber Badge on Monday April 13 2020, @02:54PM (#982006) Journal

          They actually have. This is a traditional Chinese medicine.

          The result is that there is a snake native to China whose oil does have inflammation suppressing properties. It's nothing spectacular. Aspirin is better at the job. And it's not just any old snake. (Can't remember my source for that, and it was years ago, possibly a decade or more.)

          --
          Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
    • (Score: 4, Insightful) by Anonymous Coward on Monday April 13 2020, @05:37AM (6 children)

      by Anonymous Coward on Monday April 13 2020, @05:37AM (#981843)

      Something many don't realize is how 'unscientific' medicine, in general, is. Countless number of drugs were developed for one purpose, found to be useless, but in the process seemed to show some other effect - and so they went that route with it. Viagra is probably the most famous example - it was being trialed as a drug for heart problems. It had negligible efficacy, but did a great job of getting everybody's dick hard. Prozac came from an allergy medicine that somehow seemed to also have an antidepressant effect, so forth and so on.

      The only thing that's changed with the droxy is this whole shit show of drug development is being made public due to our little pestilence.

      In general people would like to imagine we have a sophisticated system of medicine where we nail down what exactly some disease is doing and then produce a drug to micro-target those factors. In reality, it's more like we try a bunch of crap, see what works, and then retrofit explanations of the drug's method of operation. Again, psychotropics are an awesome example. What causes depression? It's one of those cases where those with no knowledge and those with a lot of knowledge would answer the same way - we've no clue. It's only those in the middle that might suggest a serotonin imbalance. That hypothesis again came from retrofitting the observation that SSRI's seemed to have an anti-depressant effect. Of course they also cause a gazillion other physiological changes as well, so nobody really knows what the exact mechanism in play is.

      Something to always consider before deciding to indulge in medication.

      • (Score: 0) by Anonymous Coward on Monday April 13 2020, @05:54AM

        by Anonymous Coward on Monday April 13 2020, @05:54AM (#981849)

        Biologics will fix everything.

      • (Score: 2, Insightful) by Anonymous Coward on Monday April 13 2020, @07:16AM (1 child)

        by Anonymous Coward on Monday April 13 2020, @07:16AM (#981870)

        What? Discovering something accidentally isn't unscientific. It's how hunches and accidental findings are investigated which can be un/scientific.

        Something many don't realize is how 'unscientific' medicine, in general, is.

        Something you don't seem to realize is what 'scientific' is.

        • (Score: 2) by nishi.b on Monday April 13 2020, @12:18PM

          by nishi.b (4243) on Monday April 13 2020, @12:18PM (#981918)

          I understood the grandparent's statement as something I noticed myself: it's only very recently that we are able to understand a disease mechanism and try to design a treatment for it from this knowledge : which protein allows binding into cells, which genetic sequence is the problem and so on. And yes, most medicine still consists in validating with the scientific method treatments that originated much more randomly than that.

      • (Score: 3, Interesting) by HiThere on Monday April 13 2020, @03:02PM (2 children)

        by HiThere (866) Subscriber Badge on Monday April 13 2020, @03:02PM (#982014) Journal

        That comment about Viagra is proof that you don't understand experimental science (which all other science is based on). You use theories to try something, but if it doesn't do what you expect, you notice what it does do. Then you adjust your theories to match the experimental results.

        Well, that's how it's supposed to happen. And I left out details, like replication, testing edge cases, validation, etc. And often different steps are done by different people, or even different teams.

        So. They predicted Viagra would be a heart drug, and found they were wrong, but noticed this other useful characteristic. The information presented doesn't allow me to determine what theory they used to predict it, or whether the theory was adjusted. But the steps presented are part of the experimental scientific method. So is Goodyear's discover of rubber vulcanization.

        The saying is "fortune favors the prepared mind". That's an oversimplification. But adventitious adoption of unexpected fortune is definitely a part of the scientific method.

        --
        Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
        • (Score: 3, Interesting) by DeathMonkey on Monday April 13 2020, @03:11PM

          by DeathMonkey (1380) on Monday April 13 2020, @03:11PM (#982022) Journal

          "The Most Exciting Phrase in Science Is Not ‘Eureka!’ But ‘That’s funny …’" - Isaac Asimov

        • (Score: 0) by Anonymous Coward on Monday April 13 2020, @05:19PM

          by Anonymous Coward on Monday April 13 2020, @05:19PM (#982085)

          The problem is that there is no adjustment because we still have no clue why or what things are doing - only that they seem to do at least one thing, and an unknown number of other things. The trials tell you that, ideally, you won't immediately die or suffer other substantial injury from taking the drug. Yet even that's kind of meh as the research itself tends to be of an abysmal quality. For instance this [nature.com] replication study is now rather famous. A team of researchers attempted to replicate 53 keystone preclinical studies in cancer. They were only able to successfully replicate 6 of them, 11%. That's even worse than the replication rate in social psychology studies (which are hovering in the low twenties). There's a major conflict of interest. While regulatory and other bodies do work to provide some degree of oversight, ultimately all testing and verification is carried out by the exact same companies that stand to make billions of dollars by having their drugs proven safe and effective, even if they're not. Lo and behold they tend to disproportionately find that their drugs are indeed safe and effective. The FDA does not independently validate or study anything - they simply affirm whether or not they believe the statements made by the company 'x treats y' are justified given the data the company shows to the FDA.

          I am not criticizing the methodology, aside from playing fast and loose with clinical studies, because there probably is not that much more we can do given our extremely limited understanding of human physiology. The only thing I emphasize here is how wrong most people's interpretation of medical 'science' is, and see at as something far more idealized than it is. It still remains more in the domain of the social and other pseudosciences than actual sciences, simply because we don't even have much of a foundation upon which to build. It's simply throwing darts, mostly blind, and seeing what sticks. And indeed I strongly suspect that in the future substantial chunks of our modern pharmacology, undoubtedly including the vast majority of psychotropics, will be looked back upon similarly to how we now view lobotomies, even though lobotomies rose to prominence and normalization through the exact same methodologies we use today.

          I suspect if more people understood exactly how those pills they're popping came to be, they might give it a moment's consideration as opposed to the current situation where people often practically demand a variety of different pills after visiting the doctor. This is made much worse in the US since we are one of the only two countries in the world that still allows direct to consumer pharmaceutical advertising which is just grossly unethical.

    • (Score: 2) by legont on Monday April 13 2020, @01:12PM (6 children)

      by legont (4179) on Monday April 13 2020, @01:12PM (#981933)

      It is already PROVEN DECADES AGO that it is SAFE medicine. Specifically, old people take it all the time and in most places all over the world it is available OVER THE COUNTER.
      The only danger here is that Trump fucks some democrats over it. Democrats use this as a political tool and kill people in the process, as 80% people on ventilators die in NYC.

      --
      "Wealth is the relentless enemy of understanding" - John Kenneth Galbraith.
      • (Score: 2) by HiThere on Monday April 13 2020, @03:09PM

        by HiThere (866) Subscriber Badge on Monday April 13 2020, @03:09PM (#982021) Journal

        Yahhh....it's been proven so safe that you can't buy quinine water over the counter for gin and tonic in the US.

        Sorry, just because most people can take small amounts of something without problems doesn't mean that it's safe at any dosage. And the recommended dose of quinine derived drug (several different ones are being tested IIUC) is close to the level where it causes heart problems in lots of people. Short term use *MAY* be ok for *MOST* people at those levels. But safe? Well........no. Or at least it depends on what you're comparing it against. (Safe compared to malaria? Possibly. Of course, it doesn't work that well against malaria any more.)

        --
        Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
      • (Score: 2) by DeathMonkey on Monday April 13 2020, @03:53PM (4 children)

        by DeathMonkey (1380) on Monday April 13 2020, @03:53PM (#982039) Journal

        It is already PROVEN DECADES AGO that it is SAFE medicine.

        It was proven decades ago to have very dangerous side effects. And this new data confirms them.

        FTA: Worryingly, significant risks are identified for combination users of HCQ+AZM even in the short-term as proposed for COVID19 management, with a 15-20% increased risk of angina/chest pain and heart failure, and a two-fold risk of cardiovascular mortality in the first month of treatment.

        Democrats use this as a political tool and kill people in the process

        Democrats are asking that people listen to scientists. Once they determine it's safe and effective we'll be happy.

        Meanwhile, it's jumping the gun and listening to the President instead of the experts that's getting people killed:
        Husband and wife poison themselves trying to self-medicate with chloroquine [livescience.com]
        Man Dies After Taking Chloroquine for Coronavirus [webmd.com]

        Remember a time when the President DIDN'T spread dangerous misinformation?

        • (Score: 2) by legont on Monday April 13 2020, @04:49PM (3 children)

          by legont (4179) on Monday April 13 2020, @04:49PM (#982070)

          This is democrat political horse shit, sorry. The drug is used to treat arthritis which is lifetime condition for seniors and has mortality way below covid for them.
          Regardless, my doctor whom I trust, tried and failed to get it for herself. She also told me that the whole supply of the drug is taken by hospitals. Yes, the drug may not help, but given the death rate there is nothing wrong with using it. Democrats, just fuck off - the blood will be on your hands.

          --
          "Wealth is the relentless enemy of understanding" - John Kenneth Galbraith.
          • (Score: 2) by DeathMonkey on Monday April 13 2020, @05:06PM (2 children)

            by DeathMonkey (1380) on Monday April 13 2020, @05:06PM (#982078) Journal

            This is democrat political horse shit, sorry.

            You mean the DIRECT QUOTE I took from the article we're discussing?

            • (Score: 2) by legont on Monday April 13 2020, @05:28PM (1 child)

              by legont (4179) on Monday April 13 2020, @05:28PM (#982090)

              Yes, I am pissed off about the article. Sorry, did not mean any personal offense.

              --
              "Wealth is the relentless enemy of understanding" - John Kenneth Galbraith.
              • (Score: 0) by Anonymous Coward on Monday April 13 2020, @07:43PM

                by Anonymous Coward on Monday April 13 2020, @07:43PM (#982186)

                So, conservative shit-fit? There's a treatment for that!