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First hydroxychloroquine randomized controlled trial: results disappointing

199 pointsby aaavl2821about 5 years ago

16 comments

throwaway5466about 5 years ago
For people that didn&#x27;t read: it&#x27;s &quot;disappointing&quot; because both the control and study groups largely tested negative (93% and 87% respectively). That 87% figure sounds worse than the control but it actually is better than in the French study.<p>What happened in essence is that almost all cases were mild so the patients almost all got better after a while, with or without medication. This doesn&#x27;t mean HCQ is ineffective, only that its efficacy couldn&#x27;t be measured in this instance. And I wouldn&#x27;t call a study where almost everyone gets better at the end &quot;disappointing&quot;.
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hampelmabout 5 years ago
Why are we amplifying someone posting a compressed jpeg to 3,000 followers who lists no name, has a photo of George Costanza, and claims to be a virologist?
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djvu9about 5 years ago
It is a 30 patients test and almost everybody’s fever was gone right after enrollment. Even the swab test results turned negative in 2-4 days. Why is medicine ever needed for such group of patients?
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nikolayabout 5 years ago
I am sorry, but isn&#x27;t the mechanism of action that hydroxychloroquine is simply a zinc ionophore, i.e. you need enough free zinc in the blood for this to work? I read doctors suggesting using hydroxychloroquine along with 50mg of ionic zinc.
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hannobabout 5 years ago
Has anyone found the study they&#x27;re talking about? This tweet is only a screenshot of the abstract.<p>And the trials registry entry says &quot;No results published&quot;: <a href="https:&#x2F;&#x2F;clinicaltrials.gov&#x2F;ct2&#x2F;show&#x2F;NCT04261517" rel="nofollow">https:&#x2F;&#x2F;clinicaltrials.gov&#x2F;ct2&#x2F;show&#x2F;NCT04261517</a><p>Update: I asked the person on twitter and here it is: <a href="http:&#x2F;&#x2F;subject.med.wanfangdata.com.cn&#x2F;UpLoad&#x2F;Files&#x2F;202003&#x2F;43f8625d4dc74e42bbcf24795de1c77c.pdf" rel="nofollow">http:&#x2F;&#x2F;subject.med.wanfangdata.com.cn&#x2F;UpLoad&#x2F;Files&#x2F;202003&#x2F;43...</a> Apparently it&#x27;s in chinese.
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aaavl2821about 5 years ago
didnt find a link to the abstract, seems the results are just being published<p>link to the trial on clinicaltrials.gov is here: <a href="https:&#x2F;&#x2F;clinicaltrials.gov&#x2F;ct2&#x2F;show&#x2F;NCT04261517" rel="nofollow">https:&#x2F;&#x2F;clinicaltrials.gov&#x2F;ct2&#x2F;show&#x2F;NCT04261517</a><p>patients in both tx and control arm fared better than in the french study from earlier this week, suggesting patients were healthier &#x2F; lower risk at baseline<p>patients got slightly lower dose in this study (400 mg &#x2F; day) vs the french study (600 mg &#x2F; day)
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sanxiynabout 5 years ago
Here is actual publication: <a href="http:&#x2F;&#x2F;www.zjujournals.com&#x2F;med&#x2F;EN&#x2F;10.3785&#x2F;j.issn.1008-9292.2020.03.03" rel="nofollow">http:&#x2F;&#x2F;www.zjujournals.com&#x2F;med&#x2F;EN&#x2F;10.3785&#x2F;j.issn.1008-9292.2...</a>
JohnJamesRamboabout 5 years ago
&gt; That was a first run trial without the Zpak. The following trial with both showed 100% efficacy after 5-6 days.<p>Is that twitter reply accurate?
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knownabout 5 years ago
In late January 2020 during the 2019–20 coronavirus outbreak, Chinese medical researchers stated that exploratory research into chloroquine and two other medications, remdesivir and lopinavir&#x2F;ritonavir, seemed to have &quot;fairly good inhibitory effects&quot; on the SARS-CoV-2 virus, which is the virus that causes COVID-19. Requests to start clinical testing were submitted.[43] Chloroquine had been also proposed as a treatment for SARS, with in vitro tests inhibiting the SARS-CoV virus.[44][45] However, at least one case of self-medication with chloroquine for COVID-19 has caused a fatality, and the Nigeria Centre for Disease Control has stated that such self-medication &quot;will cause harm and can lead to death.&quot;<p>Chloroquine has been recommended by Chinese, South Korean and Italian health authorities for the treatment of COVID-19.[47][48] These agencies noted contraindications for people with heart disease or diabetes.[49] Both chloroquine and hydroxychloroquine were shown to inhibit SARS-CoV-2 in vitro, but a further study concluded that hydroxychloroquine was more potent than chloroquine, with a more tolerable safety profile.[50] Preliminary results from a trial suggested that chloroquine is effective and safe in COVID-19 pneumonia, &quot;improving lung imaging findings, promoting a virus-negative conversion, and shortening the disease course.&quot;[51] Self-medication with chloroquine has caused one known fatality.<p><a href="https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Chloroquine#COVID-19" rel="nofollow">https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Chloroquine#COVID-19</a>
cycrutchfieldabout 5 years ago
Thank goodness that we are actually getting some RCT results. There has been a huge confirmation bias towards any positive results for chloroquine, no matter how specious or flawed the underlying science was. Everybody wants this to work because the drug is well-tested on humans, cheap, and broadly available. It would be a panacea, a miracle drug. My concern is that the desire for this drug to be effective has clouded people&#x27;s judgment (even seasoned researchers) and led to bad science.
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fourcolordeckabout 5 years ago
It&#x27;s two samples of 15. 13&#x2F;15 and 14&#x2F;15 successes. Much too small to draw any conclusions. It&#x27;s even noted a larger sample size is needed
mirimirabout 5 years ago
Wait. I thought that hydroxychloroquine was hypothesized to protect against wet lung, as an anti-inflammatory, and not as an antiviral.<p>Did I just make that up?
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HarryHirschabout 5 years ago
Not unexpected. A week or two ago a Chinese treatment protocol made the rounds where hydroxychloroquine was suggested as an alternative to HIV protease inhibitors. Since we now know that ritonavir&#x2F;lopinavir doesn&#x27;t work well, one wouldn&#x27;t expect hydroxychloroquine to do any better. If it had remarkable clinical effects <i>it</i> would be the first-line treatment.
roenxiabout 5 years ago
This is evidence; it isn&#x27;t great but it also isn&#x27;t conclusive. We&#x27;ll need to wait longer for something a little more decisive. A twitter link is also unhelpful because we only get a blurry abstract to go off.<p>The happy dream is maybe hydroxychloroquine has prophylactic tendencies since it is something people can take long term to be at a substantially lower risk vs catching COVID. The abstract doesn&#x27;t really show much either way on that front.<p>Spitballing as an amateur, I suspect once someone has actual symptoms or is verging on a serious case it is too late to help - what is a drug supposed to do, regrow a busted lung? It comes to a point where the virus isn&#x27;t what is killing you, it is the damage the virus did while breeding and&#x2F;or the immune system overreacting fighting back and going haywire. Antivirals should help but aren&#x27;t expected to be magic for either of those things.
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microcolonelabout 5 years ago
It seems like the study was conducted on the complete wrong set of patients.
akarveabout 5 years ago
The reported dosage is less than half what the Chinese Government recommends (500mg x 2 (BID)). So it&#x27;s possible that they didn&#x27;t hit the effective dose. <a href="https:&#x2F;&#x2F;medium.com&#x2F;@balajis&#x2F;the-official-chinese-government-guide-to-diagnosing-and-treating-the-novel-coronavirus-9d06868f8df4" rel="nofollow">https:&#x2F;&#x2F;medium.com&#x2F;@balajis&#x2F;the-official-chinese-government-...</a>
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