Chloroquine and Hydroxychloroquine as treatments for Covid-19

Discussion in 'Epidemics (including Covid-19, not Long Covid)' started by Samuel, Mar 11, 2020.

  1. Barry

    Barry Senior Member (Voting Rights)

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    I'm not qualified to know know if Hydroxychloroquine is beneficial for Covid 19, nor if it might be harmful.

    To really know if Hydroxychloroquine is beneficial for Covid 19, harmful, or of no effect at all, then you would presumably have to test it against a control group having near-identical Covid-19 life expectancy.

    It occurred to me when listening to the news a day or two back, that the people most likely to risk an unproven treatment are probably those whose Covid 19 outlook is already bleak anyway - it's human nature. So those taking the treatment would likely be more likely to die anyway. I imagine that prevailing conditions mean no such controlled studies are feasible in the short term at the moment, so we may be on the same old bandwagon of correlation rather than causation.

    I'd hate anyone to think I'm trying to make a case for Hydroxychloroquine as a Covid 19 treatment, because like I say, I'm not in the least qualified. But we are a science based forum and need to be unbiased, and spot any bias if it is there.
     
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  2. Trish

    Trish Moderator Staff Member

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    Last edited: Jun 6, 2020
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  3. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    I found this interesting and jaw-dropping (if true) :

    Code:
    https://threader.app/thread/1271829781563219969
    Code:
    https://twitter.com/Twittlebit_adis/status/1271829836454035458
    Same thread in the above two links - one directly from Twitter and one from Thread Reader App - read whichever one you are most comfortable with.

    Allegedly, doctors in Oxford testing HCQ were confusing hydrochloroquine with hydroxyquinolones and dramatically overdosed their sick patients.

    The source of this info is the newspaper France Soir which is apparently a French equivalent of some of the UK tabloids. And so whether this is true? I have absolutely no idea.
     
  4. Cheshire

    Cheshire Moderator Staff Member

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    France Soir has become a very, very bad newspaper, full of the worst conspiracy theories.
    One of the researchers involved in the trial answered a very reliable science journalist and denied what was said in the France Soir interview

    Google translate:
    Peter Horby formally denies this interpretation and affirms that France Soir badly reported the words of his colleague (which the French media disputes): "There is absolutely no confusion here between hydroxychloroquine and hydroxyquinoline, unlike what France Soir reports. The confusion comes from an interview with France Soir which reports the term "amoebic dysentery" instead of "amoebic hepatic abscess" (AHA), a pathology for which chloroquine has been used as treatment in the past, at comparable doses to the ones we used in Recovery with the HCQ. ”

    https://www.liberation.fr/checknews...fois-la-dose-d-hydroxychloroquine-aut_1790733
     
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  5. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    Thanks @Cheshire

    I'm glad that it turned out to be just a silly story!
     
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  6. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    I thought this (very long) article was very good and was worth the effort.

    Title : Hydroxychloroquine: A Morality Tale

    Link : https://www.tabletmag.com/sections/science/articles/hydroxychloroquine-morality-tale

     
  7. Cheshire

    Cheshire Moderator Staff Member

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    A parody paper was published by two Swiss researchers in a predatory journal which published an appalling article defending the use of hydroxychloroquine in COVID, to prove that there is no peer review in this type of journal and that (really) anything can be published if you pay.
    The level of absurdity reached by this article is unbelievable and it should have been be obvious to anybody reading it that it was a joke, but it got published (and retracted the following day).
    Here are two articles in English about the whole story.

    Journal accepts fake story about scooters and hydroxychloroquine
    Elisabeth Bik

    https://scienceintegritydigest.com/...-story-about-scooters-and-hydroxychloroquine/

    Hydroxychloroquine, push-scooters, and COVID-19: A journal gets stung, and swiftly retracts
    Retractionwatch

    https://retractionwatch.com/2020/08...19-a-journal-gets-stung-and-swiftly-retracts/
     
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  8. hinterland

    hinterland Senior Member (Voting Rights)

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    Thanks, I've been wanting to get to the bottom of this hydroxychloroquine story. I can't for the life of me imagine why the Recovery trial went in with such an insanely high dose of HCQ, rather than what was previously reported as a useful dose -- no subtlety and no consideration of any possible synergistic effects between HCQ and the other agents it has been used with, just the worst aspects of reductionist thinking; almost set to fail.

    I'll cut and paste the text of this 'long read' into a text to speech app, and try to listen on my phone later. The author, Norman Doidge, also wrote a book called 'The Brain that Changes Itself', that was an interesting listen, so I'd trust him to be a balanced reporter on this.
     
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  9. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    With regard to HCQ the thing that baffled me was that a drug which has been available since 1955, has been taken millions or billions of times, which was very helpful for various autoimmune diseases and sufferers took it for years, it's on the list of the WHO Essential Medicines, and suddenly we're being told that it is deadly and nobody should prescribe it.

    I could smell the big rotting fish that got chucked into the narrative from miles away.

    At least the article makes it clear that the contradictory results from HCQ were caused by people getting given it when they were already past the point of no return, and that it works best when given early in the disease progression.
     
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  10. Cheshire

    Cheshire Moderator Staff Member

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    Because the dose is different than in autoimmune diseases and it can have heart problem side effects, which, in addition to COVID itself causing heart problem, is a concern.
     
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  11. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    But since Covid-19 is new, nobody would have known what dose was appropriate. Why did someone decide that in a testing phase of using any drug for a new disease it was appropriate to give people four times the dose that was known to be safe?
     
  12. Cheshire

    Cheshire Moderator Staff Member

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    Raoult first used higher doses.
     
  13. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    I still don't understand why using a well understood drug at four times the normal dose is acceptable.
     
  14. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    Title : Doctors Pen Open Letter To Fauci Regarding The Use Of Hydroxychloroquine for Treating COVID-19

    Link : https://www.zerohedge.com/medical/d...ding-use-hydroxychloroquine-treating-covid-19

    Authors : George C. Fareed, MD Brawley, California ; Michael M. Jacobs, MD, MPH Pensacola, Florida ; Donald C. Pompan, MD Salinas, California

    Date : August 12, 2020

    Letter continues...
     
  15. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    Last edited: Aug 18, 2020
  16. lunarainbows

    lunarainbows Senior Member (Voting Rights)

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    From what I know, 200-400mg is a daily dose for lupus, depending on body weight.

    400mg (I think) once a week is or used to be used as a preventative for malaria. But if someone actually had caught malaria, 800mg was often used (for a day? Or for a few days) to treat the parasite. So that’s maybe where the higher dose comes from. Not sure if it’s still used as I had heard that malaria was becoming resistant to hydroxychloroquine.
     
  17. TrixieStix

    TrixieStix Senior Member (Voting Rights)

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    Last edited: Aug 28, 2020
  18. Cheshire

    Cheshire Moderator Staff Member

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    The two treatment arms do not match, so nothing can be deduced from this study.

    The HCQ group includes 36.5% of 45-64 years old, but only 23.5% of +80 years. The group without HCQ: 44.6% over 80 years.
    The high number of people over 80, with a higher risk of death, could in itself explain why the non treatment group had worst outcomes.

    upload_2020-8-28_11-19-19.png
     
    Last edited: Aug 28, 2020
  19. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    As I think I pointed out earlier, because chloroquine has a long half life, if you want it to do anything much in the first day or two you have to give a lot more (maybe 50 times more). The estimated half life is about 7 weeks so for the first month you are just building up levels with standard dosages. The reason for not giving a loading dose is that in the first couple of weeks quite a significant proportion of patients get reactions like light sensitivity so you do not want to give them too much of a load straight away. In an acute situation things are completely different.
     
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  20. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    That looks like a sour grapes letter from some docs losing some nice new income.
     
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