Hydroxychloroquine...........

336,722 Views | 1854 Replies | Last: 11 mo ago by Jabin
2PacShakur
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Look at the age distributions between the study arms.
amercer
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2PacShakur said:

Look at the age distributions between the study arms.


Looks like I didn't need the whole 48 hours.
Keegan99
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Good summary of studies.

https://c19study.com/
Infection_Ag11
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Keegan99 said:




The groups that received HCQ were considerably younger than those who did not receive it. A 6 year average gap in a study population that large is unlikely due to chance and indicates selection bias.

Additionally they excluded the drug from the sickest 10% of patients which, again, can make ANYTHING look good in a low mortality illness on the basis of chance alone.
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Keegan99
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But if you're wishing to test an early intervention hypothesis wouldn't you want to avoid including the sickest?
Red Fishing Ag93
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Keegan99 said:

Good summary of studies.

https://c19study.com/
74Ag1
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Red Fishing Ag93
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--- So....roughly 225+ patients AS OUTPATIENTS, zero deaths and zero hospitalizations, <$50 treatment.
DadHammer
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Keegan99 said:

Good summary of studies.

https://c19study.com/

Very interesting. Thanks for sharing.
Ranger222
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"Retrospective analysis" is a red flag.

There have been clinical control trials with large sample sizes and they show no benefit.

Not sure why we want to continue to beat this dead horse. There is no benefit, unless you are trying to manufacture one.

kb2001
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Ranger222 said:

"Retrospective analysis" is a red flag.

There have been clinical control trials with large sample sizes and they show no benefit.

Not sure why we want to continue to beat this dead horse. There is no benefit, unless you are trying to manufacture one.


Could you provide a link to one of these clinical trials with large sample sizes that show no benefit? I have seen none of these.

The only two completed clinical studies I'm aware of are both from March, small sample sizes and both showed promise (one from Wuhan, one from France). Beyond that, I'm aware of two ongoing double blind clinical trials, one from NIH, one in Spain, these are scheduled to complete in September. They were both delayed once the retrospective analysis showing HCQ to have no effect was found to be based on invalid and falsified data. NEJM and the Lancet both pulled back their analysis and "expressed concern".

If you are aware of a completed clinical trial showing no benefit, provide a link to the study here, please.
Dr. Not Yet Dr. Ag
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kb2001 said:

Ranger222 said:

"Retrospective analysis" is a red flag.

There have been clinical control trials with large sample sizes and they show no benefit.

Not sure why we want to continue to beat this dead horse. There is no benefit, unless you are trying to manufacture one.


Could you provide a link to one of these clinical trials with large sample sizes that show no benefit? I have seen none of these.

The only two completed clinical studies I'm aware of are both from March, small sample sizes and both showed promise (one from Wuhan, one from France). Beyond that, I'm aware of two ongoing double blind clinical trials, one from NIH, one in Spain, these are scheduled to complete in September. They were both delayed once the retrospective analysis showing HCQ to have no effect was found to be based on invalid and falsified data. NEJM and the Lancet both pulled back their analysis and "expressed concern".

If you are aware of a completed clinical trial showing no benefit, provide a link to the study here, please.
https://www.recoverytrial.net/news/statement-from-the-chief-investigators-of-the-randomised-evaluation-of-covid-19-therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19

Pre-print is not out yet, but they have already reported the results and have clearly listed study protocols on their website.The WHO and NIH also stopped their trials and reviewed their data from their ongoing RCTs which both found no benefit.

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638 Prophylaxis study

https://www.bmj.com/content/369/bmj.m1849 Open label RCT
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Skillet Shot
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Don't you know? The science is settled.

Every clinical trial I have seen with negative or minimal results have been from treating patients that are already hospitalized or not in combination with Zinc and Z pack. The premise behind the efficacy of the drug is to slow down viral replication. So testing at a late stage in the disease is ineffective by design.

I don't know if HCQ is effective or not. I just haven't seen a clinical trial that tests the drug in the way that doctors who are seeing positive anecdotal results have recommended.
Red Fishing Ag93
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kb2001 said:

Ranger222 said:

"Retrospective analysis" is a red flag.

There have been clinical control trials with large sample sizes and they show no benefit.

Not sure why we want to continue to beat this dead horse. There is no benefit, unless you are trying to manufacture one.


Could you provide a link to one of these clinical trials with large sample sizes that show no benefit? I have seen none of these.

The only two completed clinical studies I'm aware of are both from March, small sample sizes and both showed promise (one from Wuhan, one from France). Beyond that, I'm aware of two ongoing double blind clinical trials, one from NIH, one in Spain, these are scheduled to complete in September. They were both delayed once the retrospective analysis showing HCQ to have no effect was found to be based on invalid and falsified data. NEJM and the Lancet both pulled back their analysis and "expressed concern".

If you are aware of a completed clinical trial showing no benefit, provide a link to the study here, please.
They are included on the complete list that Keegan99 provided above.
Red Fishing Ag93
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Skillet Shot said:

Don't you know? The science is settled.

Every clinical trial I have seen with negative or minimal results have been from treating patients that are already hospitalized or not in combination with Zinc and Z pack. The premise behind the efficacy of the drug is to slow down viral replication. So testing at a late stage in the disease is ineffective by design.

I don't know if HCQ is effective or not. I just haven't seen a clinical trial that tests the drug in the way that doctors who are seeing positive anecdotal results have recommended.

So what is really interesting to me is all this other "noise" about studies that have nothing to do with the very clear, easy to understand hypothesis.
Skillet Shot
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Ranger222 said:

"Retrospective analysis" is a red flag.

There have been clinical control trials with large sample sizes and they show no benefit.

Not sure why we want to continue to beat this dead horse. There is no benefit, unless you are trying to manufacture one.


Retrospective analysis is a red flag.
Anecdotal positive reports are a red flag.

I wouldn't call either a red flag. I would say it shows promise and warrants further investigation. I agree a well designed double blind peer reviewed clinical trial is the golden standard. But the only clinical trials that have been conducted have had major design flaws: too high dosage, testing hospitalized patients, falsifying data (Lancet), etc.

The only thing we can rely on is a double blind peer reviewed clinical trial (unless its Remdesivir)
Reveille
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Dr. Not Yet Dr. Ag said:

kb2001 said:

Ranger222 said:

"Retrospective analysis" is a red flag.

There have been clinical control trials with large sample sizes and they show no benefit.

Not sure why we want to continue to beat this dead horse. There is no benefit, unless you are trying to manufacture one.


Could you provide a link to one of these clinical trials with large sample sizes that show no benefit? I have seen none of these.

The only two completed clinical studies I'm aware of are both from March, small sample sizes and both showed promise (one from Wuhan, one from France). Beyond that, I'm aware of two ongoing double blind clinical trials, one from NIH, one in Spain, these are scheduled to complete in September. They were both delayed once the retrospective analysis showing HCQ to have no effect was found to be based on invalid and falsified data. NEJM and the Lancet both pulled back their analysis and "expressed concern".

If you are aware of a completed clinical trial showing no benefit, provide a link to the study here, please.
https://www.recoverytrial.net/news/statement-from-the-chief-investigators-of-the-randomised-evaluation-of-covid-19-therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19

Pre-print is not out yet, but they have already reported the results and have clearly listed study protocols on their website.The WHO and NIH also stopped their trials and reviewed their data from their ongoing RCTs which both found no benefit.

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638 Prophylaxis study

https://www.bmj.com/content/369/bmj.m1849 Open label RCT
While I agree that I don't think HCQ should be used for or will show any benefit in hospitalized patients. The Recovery Trial results are extremely suspect. They concluded it showed no benefit and possible harm since 25.7% died in the HCQ group and only 23.5% in the usual care group. However, in this study they gave 2400 mg of HCQ on day 1 while doses greater than 1600 mg are considered toxic. In France a dose of over 1875 mg requires immediate admission and hospital care. In addition to the loading dose they continued to give 800 mg per day for 9 days. That is a total of 9600 mg of HCQ.

Compare to what we are typically doing in the outpatient setting. Which is 800 mg on day one and than 400 mg for days 2-5. A total of of 2400 mg for the whole treatment. So considering these extreme dosages I am surprised there was not more deaths from arrhythmia's. The Author's have responded saying "There's no recommended dosage for Covid-19 because it's a new disease." While true using a dose 4 times the maximum dose and considered a toxic amount seems very unreasonable.

No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
HowdyTexasAggies
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edit - removed comment because the context is lost with previous posts removed....don't want it to seem directed toward Dr. above as it wasn't.
2PacShakur
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Reveille said:

Dr. Not Yet Dr. Ag said:

kb2001 said:

Ranger222 said:

"Retrospective analysis" is a red flag.

There have been clinical control trials with large sample sizes and they show no benefit.

Not sure why we want to continue to beat this dead horse. There is no benefit, unless you are trying to manufacture one.


Could you provide a link to one of these clinical trials with large sample sizes that show no benefit? I have seen none of these.

The only two completed clinical studies I'm aware of are both from March, small sample sizes and both showed promise (one from Wuhan, one from France). Beyond that, I'm aware of two ongoing double blind clinical trials, one from NIH, one in Spain, these are scheduled to complete in September. They were both delayed once the retrospective analysis showing HCQ to have no effect was found to be based on invalid and falsified data. NEJM and the Lancet both pulled back their analysis and "expressed concern".

If you are aware of a completed clinical trial showing no benefit, provide a link to the study here, please.
https://www.recoverytrial.net/news/statement-from-the-chief-investigators-of-the-randomised-evaluation-of-covid-19-therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19

Pre-print is not out yet, but they have already reported the results and have clearly listed study protocols on their website.The WHO and NIH also stopped their trials and reviewed their data from their ongoing RCTs which both found no benefit.

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638 Prophylaxis study

https://www.bmj.com/content/369/bmj.m1849 Open label RCT
While I agree that I don't think HCQ should be used for or will show any benefit in hospitalized patients. The Recovery Trial results are extremely suspect. They concluded it showed no benefit and possible harm since 25.7% died in the HCQ group and only 23.5% in the usual care group. However, in this study they gave 2400 mg of HCQ on day 1 while doses greater than 1600 mg are considered toxic. In France a dose of over 1875 mg requires immediate admission and hospital care. In addition to the loading dose they continued to give 800 mg per day for 9 days. That is a total of 9600 mg of HCQ.

Compare to what we are typically doing in the outpatient setting. Which is 800 mg on day one and than 400 mg for days 2-5. A total of of 2400 mg for the whole treatment. So considering these extreme dosages I am surprised there was not more deaths from arrhythmia's. The Author's have responded saying "There's no recommended dosage for Covid-19 because it's a new disease." While true using a dose 4 times the maximum dose and considered a toxic amount seems very unreasonable.
A higher dose shouldn't necessarily result in less efficacy. The percentages you cite are not clinically significant in their study so "possible harm" is a bit of an overstatement (at least statistically, sorry have had arguments with FDA statisticians regarding p-values interpretation but I'm ultimately biased by my ownership %). Though I agree safety could bias the endpoint (time to mortality) if you're "pushing"(/causing/biasing) mortality with a higher dose. Did the study result in significant toxicity or SAEs b/n the treatment arms (studies usually show Grade 3/4 AEs amongst the arms or report significant SAEs amongst the arms)? (Only looked up their info on their website and haven't seen details.) Also, not sure how they wrote their SAP but they could control/account for AE's caused by the treatment by censoring within the KM curves.
DadHammer
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I don't understand the problem here.

1. If you don't want to use it then don't.

2. If you want to use then use it.

It's a Decision between you and your Dr.

HCQ, Zinc, Azithromycin are a cheap safe treatment as the Dr has described it.
2PacShakur
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The problem is you create a limited supply for patients who use it where there's actual efficacy.

E: Also, if it had shown efficacy for Covid, I guarantee the price for the drug would have been inflated extraordinarily for the indication.
DadHammer
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I thought the production of HCQ has been increased massively to fill that gap already? We have stock piled millions of doses are those not available?
2PacShakur
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Is it enough to supply what would be a mass administration of 10's or 100's of thousands of patients? We still seem to have PPE shortages despite ramping supplies of those. Also, who pays for it especially as so far it has been shown as effective as a tic-tac. Look, if a study comes out and shows its niche treatment indication and/or disease stage, then so be it but until then let it play out.
DadHammer
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Well, my Dr. says he is having real success with it early stages so I'm taking it. Thanks for you input though.
Also says there is no shortage of the drugs now, just FYI.
Irwin M. Fletcher
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2PacShakur said:

Is it enough to supply what would be a mass administration of 10's or 100's of thousands of patients? We still seem to have PPE shortages despite ramping supplies of those. Also, who pays for it especially as so far it has been shown as effective as a tic-tac. Look, if a study comes out and shows its niche treatment indication and/or disease stage, then so be it but until then let it play out.
Its as effective as a tic tac in hospitalized patients. It is an ionophore so it will allow zinc into the cell and zinc stops viral replicase this is a fact. Now does it have any any activity in of itself on COVID? Maybe not but it is possible, but a good ionophere and zinc is a good regimen for many viruses. That said there are over the counter ionophores like quercetin that might do just as much as HCQ for prophylaxes or early stage treatment. The funny thing is those saying it doesn't work are only quoting studies in hospitalized patients, well it wouldn't work there much too late at that point.
Picadillo
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Saw a program last night where two doctors who've been using it for years were suggesting an OTC version of lower dosage should go on the market asap. Would be a great idea.
Keegan99
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AG
Need to confirm the source for this, but...
Bonfire1996
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Keegan99 said:

Need to confirm the source for this, but...


That's....compelling
Bonfire1996
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Bonfire1996 said:

That's amazing. Trump has completely broken these people.
Fact check: true

The results will be written in history. As the world used HCQ with great success, America chose to attempt the samurai version of seppuku in order to keep Donald Trump from leading the way out of COVID crisis. The data was always going to win out, as it always does. Simply amazing.
Keegan99
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The Switzerland data seems to be correct.

https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

It's referenced by this Yale faculty member here.

Quote:

A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong.
SwampAg88
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For those who are refused Hydroxychloroquine by their doctor, is Quercetin the next best thing in facilitating zinc transportation?
DadHammer
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SwampAg88 said:

For those who are refused Hydroxychloroquine by their doctor, is Quercetin the next best thing in facilitating zinc transportation?
Go to another Dr.
SwampAg88
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Unfortunately I have a feeling I'll get the same results. I've dealt with 2 now and neither would not prescribe. Both acted put off the moment hydroxychloroquine was brought up. I heard quercetin is good with facilitating zinc as well but not sure how it compares.
DadHammer
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SwampAg88 said:

For those who are refused Hydroxychloroquine by their doctor, is Quercetin the next best thing in facilitating zinc transportation?

I am taking it now as a recommendation from the Aggie doc with his thread pinned above. Call him he is using it. Get a video health visit.

Good luck.
 
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