23 studies-HCQ-AZ combination appears to be safe and efficient treatment for COVID-19

4,981 Views | 25 Replies | Last: 5 yr ago by 94chem
Houston Lee
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Quote:

Sequential CQ / HCQ Research Papers and Reports

January to April 20, 2020

Executive Summary Interpretation of the Data In This Report

The HCQ-AZ combination, when started immediately after diagnosis, appears to be a safe and efficient treatment for COVID-19, with a mortality rate of 0.5%, in elderly patients. It avoids worsening and clears virus persistence and contagious infectivity in most cases.





https://docs.google.com/document/d/1545C_dJWMIAgqeLEsfo2U8Kq5WprDuARXrJl6N1aDjY/preview?pru=AAABceuproU*Na6uS_JQHlzvKHLE_IRBJA
Cancelled
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incoming.
Houston Lee
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aggiegolfer03
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"when started immediately after diagnosis"

What is the common patient being offered immediately at diagnosis right now?
Houston Lee
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https://aapsonline.org/aaps-letter-asking-gov-ducey-to-rescind-executive-order-concerning-hydroxychloroquine-in-covid-19/

AAPS Letter Asking Gov. Ducey to Rescind Executive Order concerning hydroxychloroquine in COVID-19

Quote:

April 27, 2020
The Honorable Doug Ducey
1700 West Washington St.
Phoenix, AZ 85007

Dear Governor Ducey:

This concerns your Executive Order forbidding prophylactic use of chloroquine (CQ) or hydroxychloroquine (HCQ) unless peer-reviewed evidence becomes available.

Attached and posted here (https://bit.ly/cqhcqresearch) is a summary of peer-reviewed evidence, indexed in PubMed, concerning the use of CQ and HCQ against coronavirus. We believe that there is clear and convincing evidence of benefit both pre-exposure and post-exposure.

In addition, Michael J. A. Robb, M.D., of Phoenix is compiling all reports as they come in. As of this date, the total number of reported patients treated with HCQ, with or without azithromycin and zinc, is 2,333. Of these, 2,137 or 91.6 percent improved clinically. There were 63 deaths, all but 11 in a single retrospective report from the Veterans Administration where the patients were severely ill.

Most of the data concerns use of HCQ for treatment, but one study included used the medication as prophylaxis with excellent results. Many nations, including Turkey and India, are protecting medical workers and contacts of infected persons prophylactically. According to worldometers.info, deaths per million persons from COVID-19 as of Apr 27 are 167 in the U.S., 33 in Turkey, and 0.6 in India.

Based on this evidence, we request that you rescind your Executive Orders impeding the use of CQ and HCQ and further order that administrative agencies not impose any requirements on the prescription of CQ, HCQ, azithromycin, or other drugs intended to treat or prevent coronavirus illness that do not apply equally to all approved medications that may be used off-label for any purpose.

Respectfully,
Michael J. A. Robb, M.D.
President, Arizona State Chapter of the Association of American Physicians and Surgeons

Jane M. Orient, M.D.
Executive Director, Association of American Physicians and Surgeons

CC Speaker Rusty Bowers, Rep. Warren Petersen, Rep. Nancy Barto, Sen. Karen Fann, Sen. Rick Gray, and Sen. Kate Brophy-McGee

Attachments:
Sequential CQ / HCQ Research Papers and Reports, January to April 20, 2020 https://bit.ly/cqhcqresearch
The probabilities of clinical success using hydroxychloroquine, azithromycin and zinc against the novel betacoronavirus, COVID-19, revised Apr 26, 2020 https://bit.ly/hcqtable
Houston Lee
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Marcus Aurelius
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Is this a meta-analysis? If so where are the published statistics/methods? My gut tells me this is accurate however. But the ivory tower folks won't agree until the DBRPCT with a large N is published.
DadHammer
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You don't say....
dreyOO
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dang, that's an interesting angle I hadn't even considered.

ETA: regarding the Italian study
culdeus
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TurkeyBaconLeg said:


I'm not sure what he's referring to. If you google this you find some old data that doesn't support his claim.

https://www.reumatologia.it/obj/files/covid19/report25-03-20.pdf

The most recent datapoint

https://www.reumatologia.it/obj/files/covid19/Report_COVID_2020_04_20.pdf

Would list 147 patients. So I'm not sure what he's driving at saying just 20 infected.
Pasquale Liucci
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Anecdotally speaking obviously, do you still see promise in HCQ in early courses?
PikesPeakAg
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Interesting ... somewhat similar to Tamiflu in timing of treatment if proven to be true for the US. Still waiting for the data on the ongoing prevention trials.

Also good to see promising drugs treating the illness once in the hospital. Outside of remdesivir would like to see some data on actemra.


No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Marcus Aurelius
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Being pulm/CC, I have not treated anyone yet from onset of symptoms. I see them when they have viral pneumonia or worse at day 5-7+. Cat's out of the bag by then. Don't think it does anything at that point since viral load is enormous. If you made me guess - with due science: standard evidence based Rx will be HCQ at symptom onset, remdesivir at hospital admit, and IL-6 inhibitors and convalescent plasma at cytokine storm. As has been discussed on here. Reveille may have more experience with HCQ for day one symptoms. Our pharmacy has several units of convalescent plasma on hand now. Wonderful. Can't wait to pull the trigger on transfusing those for the stormers.
Marcus Aurelius
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https://www.apmnews.com/depeche/0/350489/premiere-etude-randomisee-favorable-au-tocilizumab-dans-le-covid-19%2C-en-france


French study. Positive.
BadMoonRisin
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dreyOO said:

dang, that's an interesting angle I hadn't even considered.

ETA: regarding the Italian study
A lot of people have been asking for some definitive data on that since the beginning. This seems to be pretty supportive.
Pasquale Liucci
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Thanks Marcus. I don't have a medical background, but everything posted on here about the mechanisms of action makes a lot of sense. Let's hope continued use bears this out and we get the diagnostic capacity in place to enact each in their appropriate spot in disease course.

God bless you in your work and thanks for taking the time to post here. Hearing from courageous folks like you on the frontlines does more good than you realize.
SoulSlaveAG2005
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Marcus Aurelius said:

Being pulm/CC, I have not treated anyone yet from onset of symptoms. I see them when they have viral pneumonia or worse at day 5-7+. Cat's out of the bag by then. Don't think it does anything at that point since viral load is enormous. If you made me guess - with due science: standard evidence based Rx will be HCQ at symptom onset, remdesivir at hospital admit, and IL-6 inhibitors and convalescent plasma at cytokine storm. As has been discussed on here. Reveille may have more experience with HCQ for day one symptoms. Our pharmacy has several units of convalescent plasma on hand now. Wonderful. Can't wait to pull the trigger on transfusing those for the stormers.


Purely anecdotal, but the docs that we have been working with and shipping convalescent plasma to have all said their patients that they have transfused cvpls show great improvement. Even had 1 they deemed miraculous turn around and was discharged a few days after transfusion. Details are light due to hippa but all indications are it seems to be helpful.

So far our blood center has collected/shipped 225 units of cvpls to area hospitals and even out of state to real emergency cases. Just as we get it labeled and ready for storage we get orders and ship it.
Marcus Aurelius
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Awesome thx.
Pulmcrit_ag
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Everything to this point should teach us to proceed with caution. Quacks assume their competency, physician scholars use empirical evidence to prove it. I have now treated 3 patients with plasma, as it has only recently become available, and have had encouraging results thus far. I had a member of the media relations for my hospital system reach out to see if I could be interviewed to say this therapy was proving beneficial. I told them that would be irresponsible at this point. I am hopeful but we need good, well designed studies to make informed statements. Peripheral physicians like myself are only the smallest cog in the wheel.
Rutedown
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Pulmcrit_ag said:

Everything to this point should teach us to proceed with caution. Quacks assume their competency, physician scholars use empirical evidence to prove it. I have now treated 3 patients with plasma, as it has only recently become available, and have had encouraging results thus far. I had a member of the media relations for my hospital system reach out to see if I could be interviewed to say this therapy was proving beneficial. I told them that would be irresponsible at this point. I am hopeful but we need good, well designed studies to make informed statements. Peripheral physicians like myself are only the smallest cog in the wheel.


Most doctors here have helped me understand that there is no silver bullet, but there looks to be some good results at different stages with different treatments. Even the treatments are evolving and we need to, like you said, "proceed with caution". Thank you and the other front-liners for keeping us informed and helping us get a better understanding of all of this and thank you especially for your work.
B-1 83
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One tool in the tool box. Nothing more, nothing less. I can't understand why so many have gone out of their way to show it never works.
Being in TexAgs jail changes a man……..no, not really
SoulSlaveAG2005
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So very true. Our optimism is very guarded, until we have some long term data.

Since CVPLS is a frozen stored product, we are saving a frozen segment off of every unit collected and shipped. Once we have an appropriate antibody test, we are going to test each sample for their antibody titer. We can then study the levels based on time from infection, time from recovery and provide that data to see how/if it effected patient outcomes/responses. We are also working to bring back the same donors at their next 2 eligibility intervals ( every 28 days) so that we can further looks at titer levels as they get further out from recovery. Basically we should be able to have a 30/60/90 day check on antibody levels.

As with any transfused component, it is difficult to pin patient outcome directly to the unit transfused. Typically, at that point there is so much else going on and into the patient, it isn't just 1 action that helps, but a combination of those actions. We are encouraged by the results so far and hopefully it is another arrow docs can keep in their quiver to help improve patient outcomes overall.
FTAG 2000
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culdeus said:

TurkeyBaconLeg said:


I'm not sure what he's referring to. If you google this you find some old data that doesn't support his claim.

https://www.reumatologia.it/obj/files/covid19/report25-03-20.pdf

The most recent datapoint

https://www.reumatologia.it/obj/files/covid19/Report_COVID_2020_04_20.pdf

Would list 147 patients. So I'm not sure what he's driving at saying just 20 infected.
From the article in the tweet: https://www.iltempo.it/salute/2020/04/28/news/coronavirus-farmaci-efficaci-news-danni-cura-annalisa-chiusolo-artrite-terapia-idrossiclorochina-sars-cov2-1321227/

Quote:

To assess the possible correlations between chronic patients and Covid19, SIR interrogated 1,200 rheumatologists throughout Italy to collect statistics on the infections. Out of an audience of 65,000 chronic patients (Lupus and Rheumatoid Arthritis), who systematically take Plaquenil / hydroxychloroquine, only 20 patients tested positive for the virus. Nobody died, nobody is in intensive care, according to the data collected so far.

The math (if I did it right) shows a 0.3% infection rate across all of Italy, with this subset coming out to about a 0.03% infection rate. That's an order of magnitude difference, which seems would be statistically significant.
Keegan99
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Also one would expect arthritis patients to be an older cohort, making them more susceptible than the population at large.
DadHammer
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B-1 83 said:

One tool in the tool box. Nothing more, nothing less. I can't understand why so many have gone out of their way to show it never works.
Good post.
Goose61
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A couple of new studies to add to the mix:

https://www.dailymail.co.uk/health/article-8278001/Hydroxychloroquine-trigger-dangerous-heart-arrhythmia-covid-patients.html

Looks like the focus will be switching even more towards Remdesivir, especially with the FDA emergency approval being announced earlier today.
94chem
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Goose61 said:

A couple of new studies to add to the mix:

https://www.dailymail.co.uk/health/article-8278001/Hydroxychloroquine-trigger-dangerous-heart-arrhythmia-covid-patients.html

Looks like the focus will be switching even more towards Remdesivir, especially with the FDA emergency approval being announced earlier today.


This is 'merica. Ain't nobody got time for preventative care.
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