Good News! Trump is taking hydroxychloroquine!

[_Icarus]

even shorter takeaway:
EAllusion uses google to find at least one study that confirms position while ignoring any contrary studies.

Such as?

[_Icarus]

This was by far the largest ever study of hydroxychloroquine and it was published just today. The study included 14,888 patients across almost 700 hospitals and 6 continents being administered HCQ or CQ (with or without a macrolide). All treatments demonstrated a significant increase in death and a significant increase in serious heart arrhythmias.

But yeah, tell us about those fringe doctors who said their anecdotal experiences with fewer than 100 patients suggests its a miracle drug.

[_Chap]

https://marlin-prod.literatumonline.com ... 311806.pdf

Study recently published in the Lancet. It's a large observational study rather than a blinded trial.

Short takeaway:

Hydroxychlorquine, alone or in combination with a macrolide antibiotic, did not demonstrate any efficacy in improved COVID outcomes, but did lead to decreased survival of patients due to heart complications.

Here's the beginning of the article.

It's a study with a knowledge base of 96 032 patients, from 671 hospitals in six continents, of whom 14 888 patients received various treatments involving chloroquine or hydroxychloroquine.

That's a very large study, and its conclusions that, on the whole, all those treatments were associated with an increased risk of in-hospital mortality deserves careful attention.

Of course, because this is science, not religion or politics, we are doing here, one looks with interest for another study, based on a patient sample of the same order of magnitude, that comes to a different conclusion.

Can anybody find one?

Summary
Background
Hydroxychloroquine or chloroquine, often in combination with a second-generation macrolide, are being widely used for treatment of COVID-19, despite no conclusive evidence of their benefit. Although generally safe when used for approved indications such as autoimmune disease or malaria, the safety and benefit of these treatment regimens are poorly evaluated in COVID-19.

Methods
We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents. We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2. Patients who received one of the treatments of interest within 48 h of diagnosis were included in one of four treatment groups (chloroquine alone, chloroquine with a macrolide, hydroxychloroquine alone, or hydroxychloroquine with a macrolide), and patients who received none of these treatments formed the control group. Patients for whom one of the treatments of interest was initiated more than 48 h after diagnosis or while they were on mechanical ventilation, as well as patients who received remdesivir, were excluded. The main outcomes of interest were in-hospital mortality and the occurrence of de-novo ventricular arrhythmias (non-sustained or sustained ventricular tachycardia or ventricular fibrillation).

Findings
96 032 patients (mean age 53·8 years, 46·3% women) with COVID-19 were hospitalised during the study period and met the inclusion criteria. Of these, 14 888 patients were in the treatment groups (1868 received chloroquine, 3783 received chloroquine with a macrolide, 3016 received hydroxychloroquine, and 6221 received hydroxychloroquine with a macrolide) and 81 144 patients were in the control group. 10 698 (11·1%) patients died in hospital. After controlling for multiple confounding factors (age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity), when compared with mortality in the control group (9·3%), hydroxychloroquine (18·0%; hazard ratio 1·335, 95% CI 1·223–1·457), hydroxychloroquine with a macrolide (23·8%; 1·447, 1·368–1·531), chloroquine (16·4%; 1·365, 1·218–1·531), and chloroquine with a macrolide (22·2%; 1·368, 1·273–1·469) were each independently associated with an increased risk of in-hospital mortality. Compared with the control group (0·3%), hydroxychloroquine (6·1%; 2·369, 1·935–2·900), hydroxychloroquine with a macrolide (8·1%; 5·106, 4·106–5·983), chloroquine (4·3%; 3·561, 2·760–4·596), and chloroquine with a macrolide (6·5%; 4·011, 3·344–4·812) were independently associated with an increased risk of de-novo ventricular arrhythmia during hospitalisation.

[_canpakes]

the self-claimed most-watched cable news station, Fox ...

By emphasizing "self-claimed" are you suggesting that the 2019 Rankings are not indicative while Fox has asserted being "most-watched"?

The text is self-evident. But thanks for also pointing out that Fox is essentially mainstream media.

[_EAllusion]

[quote=subgenius post_id=1225335 time=1590156892 user_id=14415]
EAllusion uses google to find at least one study that confirms position while ignoring any contrary studies.

and an even shorter takeaway:
ego defense mechanism asserts a single published study.
[/quote]

It's a study published today in the one of the premier medical journals in the world that is by far the largest of its type. While a retrospective observational study, it's the best study available at the moment. I didn't google to find it. It's part of today's news. It found me.

What contrary studies are you referring to subs? I have read a few, and while they are all preliminary due to methodological limitations, they all point in the same direction. I'm also aware of two abandoned attempts at clinical trials due ethical concerns because initial findings were showing increased mortality associated with the drug. There are other ongoing clinical trials that results are pending on. In the meantime, seems like a real bad idea to recommend taking the drug right now outside of an experimental setting given lack of evidence for efficacy and some potential serious risk associated with use.

I've also read the French study, if it can be called that, that seemed to play a significant role in the hype for the drug. Is that what you are referring to? By all means, start linking some examples of "contrary studies" that I'm sure you wont' be hastily googling in an epic case of projection.

[_Res Ipsa]

Chap, it appears to be a solid retrospective study. It is limited to hospitalized patients, and so doesn’t tell us much about whether, like Tamiflu, it would prove benefit if administered right after infection or prophlactically. (Not that I’m suggesting use under those conditions.) If I were tested positive, I might enroll in a randomized trial to assess effectiveness of early treatment. (Volunteers for such a study are being recruited in my area.) Otherwise, based on data to date, I would not consent to be treated with this stuff.

[_Chap]

Chap, it appears to be a solid retrospective study. It is limited to hospitalized patients,

Yup, that's how the authors characterised it.

..

.and so doesn’t tell us much about whether, like Tamiflu, it would prove benefit if administered right after infection or prophylactically. ...

See here:

Global clinical trial of 40,000+ healthcare workers begins to test in UK if chloroquine and hydroxychloroquine can prevent COVID-19

The Centre for Tropical Medicine and Global Health is a world leading Centre within the Nuffield Department of Clinical Medicine, University of Oxford, comprised of research groups who are permanently based in Africa and Asia as well as across two sites in Oxford.

A global study to test if either chloroquine or hydroxychloroquine can prevent COVID-19 in vital frontline healthcare workers will open to UK participants at hospital sites in Brighton and Oxford today.

Laboratory evidence shows that these well-established drugs might be effective in preventing or treating COVID-19 but there is no conclusive proof. Despite the lack of strong evidence these drugs are being widely recommended, and they are being widely used in some countries– so finding out if they can protect against COVID-19 - yes or no - is of tremendous importance.

Led by the University of Oxford and Wellcome supported Mahidol Oxford Tropical Medicine Research Unit (MORU) in Bangkok, Thailand, the COPCOV study is a double-blind, randomised, placebo-controlled trial that will enrol 40,000+ frontline healthcare workers and staff from Europe, Africa, Asia and South America who have close contact with patients with COVID-19 to determine definitively if chloroquine and hydroxychloroquine are effective in preventing COVID-19.

“COVID-19 is a major risk for frontline healthcare workers around the world,” said COPCOV Co-Principal Investigator Professor Sir Nicholas White, of the University of Oxford who is based at MORU.

“We really do not know if chloroquine or hydroxychloroquine are beneficial or harmful against COVID-19. The best way to find out if they are effective in preventing COVID-19 is in a randomised clinical trial. That’s what COPCOV is – and why we’re doing this study,” said Prof White.

Note this bit:

Despite the lack of strong evidence these drugs are being widely recommended, and they are being widely used in some countries– so finding out if they can protect against COVID-19 - yes or no - is of tremendous importance.

It seems quite possible that the fact that a very effective propaganda effort has led to the widespread clinical use of a drug with no clear application to COVID-19 infection means that the question finally has got to be settled one way or another, to avoid further waste of time and resources if (as seems likely enough) this drug is without significant clinical value against this virus.

And let us not forget that the Lancet study suggested that it may be well be significantly harmful to patients suffering from a fully developed infection.

[_Themis]

Assuming you didn't get your degree from a cracker-jack box, when you went to school, did they explain to you the difference between a clinical trial of a drug and prescribing drugs for off-label uses as an unproven treatment?

It's a shame I can't put you on ignore as well. You're becoming all bite and no substance.

Why would you need to put him on ignore when you just ignore his relevant points like he does here. All kinds of drugs that prove useful for some treatments or are failures for a treatment that they were created tend to be looked at whether they can be useful for some other treatments. This is why this drug is being researched against Covid 19.So far it is unproven and some research is suggesting it is not effective and harmful. This is why it is very irresponsible for any president prime minister or politician to promote unproven drugs. I would criticize Biden or any leader who promoted an unproven drug, and this is a problem that comes up once in a while. Trump unfortunately does these kind of things regularly. The difference between us is I can criticize people on both sides.

[_ajax18]

The difference between us is I can criticize people on both sides.

So you hate everyone equally?

[_Res Ipsa]

Yeah, Chap, that also looks like a good study aimed at prophylaxis.

And good point about the negative effects. My friend originally thought we knew it was safe because it had been used safely for decades for other conditions. I kept trying to convince her that that doesn’t mean it is safe for treating COVID patients. And, while some of the increased risk is caused by use of the antibiotic, most of it is attributable to the chloroquine itself.