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Medicine Biotech

'No Clear Evidence' Hydroxychloroquine Works Against COVID-19 (washingtonpost.com) 548

This week the Washington Post asked their "business of health care" reporter to explain the true status in the scientific community of hydroxychloroquine, an already-approved malaria drug also used to control inflammation in lupus and rheumatoid arthritis patients.

"There is no clear evidence that the drugs work against the coronavirus," he writes, "despite their use by hospitals and doctors in the United States and other countries since the outbreak began." Their antiviral properties have been proved in test tubes, but rigorous clinical trials to test their effectiveness in humans have not been completed. Limited studies on coronavirus patients have been published by researchers in France and China, but their extremely small size and other problems prevented them from being statistically significant. The French study included a combination of hydroxychloroquine with the antibiotic azithromycin that showed benefit in six patients... Another study in 11 patients in France showed no evidence the regimen works. A Chinese study also showed no benefit over the standard course of treatment.

Mainstream scientists caution against using the drugs without more evidence they are effective... The dangerous side effects of the drugs are much better known. Most seriously, the drugs can trigger arrhythmia, which can lead to a fatal heart attack in patients with cardiovascular disease or who are taking certain drugs, including anti-depression medications. Doctors recommend screening with an electrocardiogram to prevent the drug from being given to the 1 percent of patients at the greatest risk of a cardiac event. The drugs also can cause vision loss called retinopathy with long-term use, and chloroquine has been associated with psychosis...

As the coronavirus has spread from China across the world and to the United States, the dire reality is that there is no vaccine and no approved drug available to treat the serious respiratory symptoms that are claiming thousand of lives.

Long-time Slashdot reader UnknowingFool shares doubts raised about that small French study, as even its publisher now acknowledges it "does not meet" their own expected standards.

The Post does note that multiple trials are "ongoing" (though six different research centers testing the drug told CNN it would be "months" before results were known). But the Post adds that already "public and political interest has caused runs, hoarding and severe shortages in recent weeks."
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'No Clear Evidence' Hydroxychloroquine Works Against COVID-19

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  • Copy pasted from:

    https://www.tillett.info/2020/... [tillett.info]

    A possible new solution. ...This data suggests a simple and testable hypothesis â" there are natural strains of SARS-CoV-2 in the world that have mutated to be non-pathogenic (asymptomatic or mild), but which are still infective and will provide immunity to the more pathogenic (deadly) strains.

    If we can find one of these non-pathogenic viral strains out in the wild we could give it to everyone in the world and solve our diabolic problem. This non-pathog

  • unfortunately, doctors are pressurised to dosomethingforgodsakedosomething [subtext: if you don't, i'll sue you and bring criminal charges against you]. unfortunately, time has shown, from the example of the common cold (where this virus as we know is in the same family), *not* giving people "drugs" is usually the right course of action. sadly, saying to people, "relax, trust, stop worrying, let nature take its course" can sound so patronising it would almost guarantee, in the U.S., a lawsuit. we call vi

    • by gtall ( 79522 )

      It is a bit worse than that. The alleged president bulldozed the CDC into investigating a hunch from his dyspeptic gut. This is the same diseased organ that theorized there was massive voter fraud in the last presidential election. His own gofer, Kris Kobach from Kansas couldn't even find any and retreated back to Kansas to afflict its suffering people:

      https://apnews.com/f5f6a73b2af... [apnews.com]

  • Washington Post (Score:2, Interesting)

    by inhuman_4 ( 1294516 )

    The Washington Post is just trying to play word games to cover their ass. They've been going after Trump hard for saying that hydroxychloroquine shows promise and might work out to be a treatment. That hydroxychloroquine was just Trump promoting nonsense with no evidence. Blaming Trump for the guy that died drinking fish tank cleaner. But now others like France [france24.com] have officially sanctioned it's use in certain cases:

    The French government has officially sanctioned prescriptions of chloroquine to treat certain coronavirus patients. Speaking about chloroquine, Jérôme Salomon, France's director general of health, said: "This ensures continued treatment of patients who have been treated for several years for a chronic condition with this drug, but also allows a temporary authorization to allow certain patients with coronavirus to benefit from this therapeutic route."

    I wonder, if someone in France kills themselves drinking fish tank-cleaner will WaPo blame Fran

    • Re:Washington Post (Score:4, Interesting)

      by Joce640k ( 829181 ) on Sunday April 12, 2020 @08:46AM (#59936082) Homepage

      But now others like France [france24.com] have officially sanctioned it's use in certain cases:

      The French government has officially sanctioned prescriptions of chloroquine

      Proving nothing except that the French are also desperate to find something.

      • Re: (Score:3, Interesting)

        by cirby ( 2599 )

        France, and South Korea, and India, and the UK, and all of the other countries who have been using HCQ for a couple of months now (without talking about it too much), and have been getting good-to-great results. They've been holding back, though, since there wasn't enough of a stockpile of the stuff for wide use, and the production lines had to be retooled to make more of it.

        One hint was the way so many countries blocked the export of HCQ back in early March, to keep the supplies in-country for their own pe

        • Re:Washington Post (Score:5, Insightful)

          by Joce640k ( 829181 ) on Sunday April 12, 2020 @09:04AM (#59936182) Homepage

          and have been getting good-to-great results.

          Citation needed.

        • One hint was the way so many countries blocked the export of HCQ back in early March, to keep the supplies in-country for their own people.

          That could also just be because it's a drug used for other things. Even worse than a run on toilet paper and hand sanitizer. Would be a run on a medicine used and produced in small quantities, suddenly becoming flavor of the month during a pandemic.

  • by bdh ( 96224 ) on Sunday April 12, 2020 @08:14AM (#59935980)
    From what I've read about this, and I've read a lot, there are numerous documented cases where it (paired with zinc or other treatments) has absolutely been a successful treatment.

    And there are just as many if not more cases where it has done absolutely nothing.

    So it is neither the miracle drug that Trump has proclaimed it is nor is it just quackery. It's a YMMV drug.

    It may be that it only works when the Covid-19 disease is at a certain stage. Or it may be that people that have (or do not have) certain genetic markers that make them respond to it. It might be affected by certain pre-existing comorbidities.

    There have simply been too many documented cases where it has had a mitigating effect to say that there's no benefit to it. We don't know how, or under what conditions it helps, but sometimes it has.

    We simply don't understand it yet. It's like the Corona virus itself in that way. Why are some people (the majority) who get it minimally affected, while others become gravely ill, and die from it?

    We shouldn't dismiss it or embrace it wholeheartedly, either. We should study it, as we are, but I can understand why people in the middle of a pandemic want to rush to embrace something that's worked at least some of the time.
    • by bluegutang ( 2814641 ) on Sunday April 12, 2020 @08:22AM (#59936004)

      From what I've read about this, and I've read a lot, there are numerous documented cases where it (paired with zinc or other treatments) has absolutely been a successful treatment.

      You mean, there are numerous documented cases where someone has taken it and then gotten better.

      It could, however, be that they would have gotten better without the treatment. Most people get better from coronavirus, after all. It could be that this treatment does not change the survival rate, or even makes survival rates worse. That is why scientists run actual controlled scientific experiments, to figure out what actually helps, rather than relying on a few meaningless anecdotes.

      • by thejam ( 655457 )

        That is why scientists run actual controlled scientific experiments, to figure out what actually helps, rather than relying on a few meaningless anecdotes.

        But science is slow, and in some cases the patient may only have days to live. The patient ought to have the right to decide to accept the risk that it may do more harm than good (of course, without being denied access to all known information).

        • Re: (Score:3, Insightful)

          That may be. But that isn't science, and certainly isn't the kind of decision making any health agency should dedicate scarce resources to.

          I'm trying to figure out why you guys are pumping this bullshit. Are you Russians just trying to fuck over the US? Are you Trump supporters desperate to make him look good? Are you just idiots?

      • True for ALL meds. So?

        Anecdote: my relative was put on hydroxychloroquine for her lupus. She decided she'd rather put up with the lupus symptoms. She's still surviving. And she won't go back onto it again. Even though she lives in NYC.

      • by rattaroaz ( 1491445 ) on Sunday April 12, 2020 @12:26PM (#59937016)
        Exactly. This is the same with all antibiotics. People see the doctor for a cold. The doctor prescribes antibiotics, and the cold goes away. That doesn't mean colds should be treated with antibiotics. COVID-19 is not the same, but just as you suggested, the plural of anecdote is still not data.
  • by transporter_ii ( 986545 ) on Sunday April 12, 2020 @08:29AM (#59936016) Homepage

    I'm not saying it does work. However, it doesn't have to be an antiviral to actually work. Part of what kills people from COVID-19 is not the virus at all, but your own immune response to the virus. This is a fact. DuckDuckGo it. Lupus is an autoimmune disease. Not a stretch at all that a drug used to treat an autoimmune disease could very well save the lives of COVID-19 patients. There are other similar drugs that may help with COVID-19 as well.

    If hydroxychloroquine doesn't work, it won't hurt my feelings. That's how science works. To just throw something out the window that might work because it doesn't make sense to some researchers, that shouldn't be how science works. Also, let's throw it out the windows because it is old and cheap. Nothing like an expensive drug to treat 330 million people with.

    • Also, not everyone seems to have this really bad immune response to COVID-19. Thus, a reason why hydroxychloroquine could work really well on some people and not that much on other people.

      And yet again, if it doesn't work, my feelings are hurt none. Science shouldn't be about feelings.

      • by hey! ( 33014 )

        If you aren't having some kind of severe immune response syndrome, taking an immunosuppressant for an acute infection seems ... inadvisable.

        Reports are that patients who run higher fevers tend to have better outcomes.

    • by hey! ( 33014 ) on Sunday April 12, 2020 @10:26AM (#59936516) Homepage Journal

      The go-to drug for suppressing acute inflammation is methylprednisolone. In fact it is so commonly used for such a wide variety of inflammatory conditions that there is unlikely to be a supply problem for treating patients with Acute Respiratory Distress Syndrome from COVID-19. It is also used to treat lupus and rheumatoid arthritis.

      The reason people use hydroxychloroquine for RA and lupus is that there are severe health downsides to long-term use of methylprednisolone. Hydroxychloroquine is risky in the doses used for RA and lupus too, but methylprednisolone is riskier if used for months or even years on end. Obviously that's not an issue here.

      So far the evidence for methylprednisolone treating COVID-19 ARDS looks promising, although as always there are conflicting reports. The only reason we're so focused on hydroxychloroquine rather than steroids and other drugs is politics. Larry Ellison (yes THAT Larry Ellison) put the hydroxychloroquine bug in Trump's ear, and it's been touted as a miracle cure ever since.

      Hydroxychloroquine may well turn out to be useful, but if it were a miracle cure we'd know it by now.

  • by BAReFO0t ( 6240524 ) on Sunday April 12, 2020 @09:15AM (#59936222)

    This does not say it doesn't work.
    NOR does it say it works.
    It says what't on the tin: We lack trials.
    For either, that is.
    So it's ternary, not binary.

    Now watch the retards of both camps (camp "blindly believe everything anti-conformist" and camb "blindly believe everything pro-conformist") fight over it anyway. --.--

  • by Texmaize ( 2823935 ) on Sunday April 12, 2020 @09:32AM (#59936264)
    I was surprised when I saw this article, because it is really, really hard to find any information from the New York trials. Having enough grey hairs to remember when journalism was a thing and not the monstrosity of rage click bait we get today, I had hope that a major news outlet had things like, well, facts and sources.

    When you read the source article, it just says "there is no evidence." It does not link to the NY trials study. It doesn't even link to some half assed study. It does not even link to some suspect bottom tier doctor who would say anything, just for some fame or money. If I say, "I am a BILLIONAIRE," it does not make it so. Neither does me proclaiming "IT WORKED!" Or, you saying "UH, UH It doesn't work!"

    Both science and journalism require facts and respect from this. This article, and sadly, increasingly these forums, use neither.

    This is a trash article that is likely written as a political hit piece. People have become so twisted, so sick in the head, that they dump their morals, ignore simple logic, and disown their standards just so long it will make the hobgoblin of Trump lose. If you are at a place in life where you hope that people actually die, just so you can feel smug, you got issues. You are barely human at that point. The world deserves better than you. It needs better than you.
  • by jensend ( 71114 ) on Sunday April 12, 2020 @10:36AM (#59936574)

    I've been prescribed hydroxychloroquine in the past for an inflammatory problem.

    People who take realistic doses of hydroxychloroquine for short periods are unlikely to have serious side effects and complications. The major concerns are all with long-term use. Prominent among these is damage to your retinas [wikipedia.org]; when it was prescribed for me they took detailed scans of my retinas to compare against later in case.

    I find it entirely likely that it could have a benefit for some COVID-19 sufferers. It alleviates some inflammatory symptoms and may have mild antiviral effects. Many are killed not by the virus but by an immune response cytokine storm overwhelming the lungs. It's hard to mitigate that without seriously hampering the immune system, and researchers were speculating seven years ago that hydroxychloroquine might potentially be beneficial in dealing with cytokine storms [nih.gov]. At this stage, when we're desperate for any way to help these people, it should be taken seriously rather than dismissed.

    Because of the way it tinkers with the immune response, if studies aren't showing benefits, it may well still merit further investigation. We should take seriously the possibility that it is a real help in some cases and harms others, depending on what your body's immune response is already doing, and look for indications that help discriminate between the two.

    I also am not at all surprised to see studies tell us that it's not the miracle cure many people have come to expect. Given what I knew about the drug, that never seemed realistic to me.

  • by jtoj ( 537440 ) on Sunday April 12, 2020 @10:43AM (#59936600)
    Ask any MD if he/she would take it or refuse it.
    It is the most common treatment for Malaria. Some take it as a protection against a severe Malaria infection.
    Very common in Africa and South America, and until March/2020 could be had WITHOUT prescription here in Brasil.
    It was added to kitchen salt for a while in the Amazon region - like iodine.

    Its anti-viral properties are known since H1N1/SARs previous surge, it is not a new thing but no Pharma Lab would sponsor a research with no money to be made

    When prescribed by a doctor, according to patient history and status, side-effects are minimized.

    Im not a health or medical professional.

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