10 votes

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial

7 comments

  1. [2]
    DanBC
    Link
    A seriously underpowered study, pushing a drug that's actually pretty heavy duty: https://twitter.com/GaetanBurgio/status/1241201751916568576 "In short, all this hype on the clinical trial is...

    A seriously underpowered study, pushing a drug that's actually pretty heavy duty: https://twitter.com/GaetanBurgio/status/1241201751916568576

    "In short, all this hype on the clinical trial is based on a open label, non randomized and underpowered clinical trial on HCQ treatment against #COVID19 with viral load as an outcome that was not properly measured in 2/3 of the control cohort !!!"

    These were hospital patients, closely monitored in ICU, having daily EKGs.

    https://twitter.com/KaschifAli/status/1241431390614433793?s=20

    https://twitter.com/CowboyDotard/status/1241779813930676227?s=20

    The real worry is that people obtain these meds illicitly; misdose them, and suffer permanent harm or die. We've seen people talk about other anti-malarials like mefloquine. We know from Gulf War veterans that there's a risk of psychosis from mefloquine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1564027/

    12 votes
    1. patience_limited
      Link Parent
      Yeah, the OP study is pretty haphazard. The Chinese case studies are uncontrolled as well; they were basically throwing the kitchen sink at patients to try and improve survival. The Washington...

      Yeah, the OP study is pretty haphazard. The Chinese case studies are uncontrolled as well; they were basically throwing the kitchen sink at patients to try and improve survival. The Washington Post story I linked below mentions that doctors are taking the drugs and prescribing them to their families for prophylaxis, without any evidence at all that they prevent infection - they're desperate.

      There are multiple large-scale studies of hydroxychloroquine and chloroquine for prophylaxis in progress. We should get answers quickly.

      Nonetheless, there's good evidence of efficacy in vitro for both hydroxychloroquine and chloroquine, and a moderately well-understood mechanism of action against SARS/MERS-family coronaviruses. CDC information on existing drug trials and evidence is here.

      Hydroxychloroquine (tradename Plaquenil in the U.S.) is a relatively safe drug that's been in wide use for over 60 years. If it's effective prophylaxis against SARS-CoV-2 infection, that's good news for the people who can tolerate it. From a sample size of one otherwise healthy person, I can advise the nausea and diarrhea during the first week of use are serious enough to be discomfiting, and might be health risks by themselves for people with other illnesses.

      5 votes
  2. patience_limited
    (edited )
    Link
    Now we just have to deal with the supply problem. It's not going to kill me and most other Plaquenil-using arthritis patients to go without it (the drug has an elimination half-life of 30+ days),...

    Now we just have to deal with the supply problem.

    It's not going to kill me and most other Plaquenil-using arthritis patients to go without it (the drug has an elimination half-life of 30+ days), but people with lupus can go into crisis and sustain life-threatening or fatal organ damage.

    Chloroquine is also effective (in vitro, anyway), but it's much more toxic and less available from anti-malarial dispensaries since most regions' malaria parasites are now resistant.

    Both hydroxychloroquine and azithromycin can cause fatal cardiac arrhythmias; prescribing them together is not recommended since this effect may be magnified. Maybe this is manageable in a hospital setting, but people shouldn't combine these drugs for self-treatment.

    8 votes
  3. [2]
    unknown user
    Link
    It says something about the situation when, in contrast to large, dozen-of-pages papers, this barely-two-page finding for a painfully-limited study is absolutely worth sharing.

    It says something about the situation when, in contrast to large, dozen-of-pages papers, this barely-two-page finding for a painfully-limited study is absolutely worth sharing.

    6 votes
    1. [2]
      Comment deleted by author
      Link Parent
      1. unknown user
        Link Parent
        I agree. That's why I said what I said. To elaborate a little: it says something about the situation that something that wouldn't pass the standards of scientific rigor of any self-respecting...

        I agree. That's why I said what I said.

        To elaborate a little: it says something about the situation that something that wouldn't pass the standards of scientific rigor of any self-respecting journal 6 months ago is today a vital piece of information that deserves being shared even in its incomplete form because the data it relays is just that important.

        3 votes
  4. [2]
    bleem
    Link
    https://www.huffpost.com/entry/trump-fauci-coronavirus-hloroquine-azithromycin_n_5e768e4fc5b6eab77949660d shrug maybe include this also
    3 votes