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Medicine Biotech

UK Halts Hydroxychloroquine Trial, Calling It 'Useless' for Covid-19 Patients (reuters.com) 245

An anonymous reader quotes Reuters: British scientists halted a major drug trial on Friday after it found that the anti-malarial hydroxychloroquine, touted by U.S. President Donald Trump as a potential "game changer" in the pandemic, was "useless" at treating COVID-19 patients. "This is not a treatment for COVID-19. It doesn't work," Martin Landray, an Oxford University professor who is co-leading the RECOVERY trial, told reporters.

"This result should change medical practice worldwide. We can now stop using a drug that is useless..."

Landray, a professor of medicine and epidemiology at Oxford University, noted the "huge speculation" about the drug as a treatment for COVID-19 but said there had been until now "an absence of reliable information from large randomised trials". He said the preliminary results from RECOVERY, which was a randomised trial, were now quite clear: hydroxychloroquine does not reduce the risk of death among hospitalised patients with COVID-19.

"If you're admitted to hospital, don't take hydroxychloroquine," he said.

The trial involved over 11,000 patients in a randomized trial begun in March.

The article ends by quoting Parastou Donyai, director of Pharmacy Practice at the University of Reading in England, who describes the announcement as "welcome relief to thousands of scientists, doctors and academics who have been crying out for proper proof of whether hydroxychloroquine works in COVID-19 or not" -- and calling the conclusion that it does not work "definitive."
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UK Halts Hydroxychloroquine Trial, Calling It 'Useless' for Covid-19 Patients

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  • The end of it? (Score:3, Insightful)

    by tchdab1 ( 164848 ) on Saturday June 06, 2020 @10:37AM (#60152636) Homepage

    Let's hope the energy/time/resources put into testing and retesting this can now be better spent elsewhere.

    • Re:The end of it? (Score:5, Interesting)

      by Zocalo ( 252965 ) on Saturday June 06, 2020 @10:50AM (#60152686) Homepage
      I doubt it. HCQ proponents have been claiming it works better if combined with other things (e.g. Zinc), or is useful to prevent / reduce the risk of infection in the first place, at which point I kind of switched off since it's all speculative until reliable double-blind trials are completed, but there are probably several others by now. Whether one of those combinations has any efficacy or not, it's got the same kind of legs as a conspiracy theory, or any of the other miracle cures that (at best) have a placebo effect - disprove one, and the true believers will just come up with another "OK, but what about...". At this point, even if it truly is completely useless against Covid-19, I suspect there is always going to be a hardcore that refuse to accept defeat and convincing them otherwise will be like changing the minds of those who believe in a flat Earth or that the Moon landings were faked.
      • Re:The end of it? (Score:4, Insightful)

        by UnknowingFool ( 672806 ) on Saturday June 06, 2020 @11:50AM (#60152876)
        Yes it’s called moving the goalposts. It’s the same with the antivaxx/autism crowd. No matter what evidence emerges, they’ll shift the claim. And the whataboutism is part of Trump’s modus operandi.
        • Moving the goalposts would occur after the findings emerged. The suggestion to combine hydroxycholoroquine with zinc goes back to at least March [google.com]. Not that the British study was wrong to use hydroxycholorquine alone; it's useful data to know that it's not effective alone against COVID.

          We're still in the discovery phase of COVID. It's not like the situation with antivaxxers, where decades of evidence exist to rebut outlandish claims.

          • Of course it's moving the goalposts. First the claim was HCQ helps in the treatment of CoVID. When that wasn't found to be true, then the claim is it has to be used with Zinc. When that wasn't found to be true, now the claim is that you have to take it before the claim was those people were close to death and it has to be given as preventative treatment. Each time, HCQ shows little benefit and each time there's a claim that it wasn't administered "correctly".
          • The suggestion to combine hydroxycholoroquine with zinc goes back to at least March [google.com].

            Here's where the whole scenario started [uchealth.org]. It's from a journalist who said zinc lozenges have been shown to shorten (not cure) the time someone has a cold. He cites a Dr. Ian Tullberg who said, "“there’s good evidence that oral zinc works well," in regards to helping people get over colds.

            The journalist then goes on to say, citing a Dr. James A. Robb, a molecular virologist, who said, in regard to

          • by XXongo ( 3986865 )

            Moving the goalposts would occur after the findings emerged. The suggestion to combine hydroxycholoroquine with zinc goes back to at least March [google.com].

            The letter you link here is dated "April 28, 2020".

            The citations given by the letter you link are "I combined the data available from China and South Korea with the recent study published from France."

            All of these are studies of hydroxycholoroquine alone; none of these are studies of hydroxycholoroquine with zinc.

            Not that the British study was wrong to use hydroxycholorquine alone; it's useful data to know that it's not effective alone against COVID.

            We're still in the discovery phase of COVID. It's not like the situation with antivaxxers, where decades of evidence exist to rebut outlandish claims.

            • All of these are studies of hydroxycholoroquine alone; none of these are studies of hydroxycholoroquine with zinc.

              There are studies [startribune.com]

              While not a primary goal, the study also found no increased protection for participants who also took zinc or vitamin C. A separate study suggested that zinc could boost the effectiveness of chloroquine, but even if that’s true, the U authors noted that most Americans consume enough zinc already so supplements shouldn’t be needed.

              So now it's zinc. Here's the pattern: HCQ. No HCQ with Az. No it's for prevention. No it's with zinc. At what point will you admit there is little benefit?

      • Re:The end of it? (Score:5, Insightful)

        by Solandri ( 704621 ) on Saturday June 06, 2020 @11:54AM (#60152892)
        Unfortunately it's gotten politicizied, leading to erroneous claims and demands by both sides.

        The way it's playing out:
        • If you're a Trump supporter: A study showed HCQ didn't work. It was flawed in this way, or it didn't test this combo. It still must be effective. We must keep testing.
        • If you're a Trump opponent: A study showed HCQ didn't work. Can we please halt ALL testing of HCQ now?

        The way it's supposed to work: HCQ might be effective. Do randomized blind tests to find out. Someone suggests HCQ might be effective in combination with other things. Do randomized blind tests of those combinations to find out. etc.

        Because you can't prove a negative, the burden of proof is upon those who think HCQ is effective to conduct studies which show its efficacy. But likewise, such a study failing to find efficacy does not automatically close off all further avenues of study along those lines (e.g. HCQ in combination with other substances). Those avenues, if different enough from the original, should be treated as new hypotheses unrelated to the original. Need I point out that our most effective treatment of HIV currently involves a cocktail of multiple drugs which by themselves are ineffective or are limited in their effectiveness.

        e.g. Water puts out fires. Test some fires, put water on them, fires go out. Hypothesis confirmed. Someone then proposes the idea that water won't put out certain fires. You don't call them crazy and cut off their funding just because it contradicts your earlier general test. You allow them to test their hypothesis. And they end up proving that water does not put out grease fires. Then someone else claims that water can put out grease fires. Again, you don't block them just because they're contradicting what's previously been proven true. You allow them to test their hypothesis. And they demonstrate that water mixed with a foaming agent can put out grease fires.

        It's like how a computer learns the game of 20 questions [wikipedia.org]. The first question is not the be-all end-all solution once it's been answered. Each subsequent question refines the answer further, allowing it to map out that branch of the solution space to further refine where each answer works, and where it doesn't. Eventually it builds up a very comprehensive map of branches which allow it to narrow down (e.g.) a specific animal in less than 20 questions. The only consideration when building up this map is whether the resources you spend answering a question pretty far down a branch is worth it. When those resources could instead be spent on a question near the base trunk, and thus answering it gives you coverage of a much larger segment of the solution space.

        • by XXongo ( 3986865 )

          Unfortunately it's gotten politicizied, leading to erroneous claims and demands by both sides. The way it's playing out:

          • If you're a Trump supporter: A study showed HCQ didn't work. It was flawed in this way, or it didn't test this combo. It still must be effective. We must keep testing.
          • If you're a Trump opponent: A study showed HCQ didn't work. Can we please halt ALL testing of HCQ now?

          *I* would like to see tests continue.

          At the moment, the best studies that have been released don't show that it helps, but that doesn't mean we shouldn't keep looking for a protocol in which it does help (as well as continuing to gather data to verify the other studies).

          But, at the moment, I'd also say that this is a low probability shot.

        • Re: (Score:2, Insightful)

          by dfghjk ( 711126 )

          "Unfortunately it's gotten politicizied, leading to erroneous claims and demands by both sides."

          This a lie right out of the "fine people on both sides" mold. There is the objectively correct side and the Trump side. Arguing that there is no evidence is not "political" when there is no evidence.

        • What to trial (Score:3, Interesting)

          by michaelni ( 5226911 )

          The way it's supposed to work: HCQ might be effective. Do randomized blind tests to find out. Someone suggests HCQ might be effective in combination with other things. Do randomized blind tests of those combinations to find out. etc.

          No, The way its supposed to work, is you first have some reasonable evidence that suggests it might work. For HCQ alone there was solid evidence from cell cultures where they tested many drugs. For HCQ+Azitromycin AFAIK the evidence was a french study though there was no mechanism known why it would make a difference. for the HCQ+Zink thing, what i ve seen so far was only from people who lack the biochemistry knowledge. It reminds me of the ivermectin study where 10000 times the normal dosage had an effect

      • by gtall ( 79522 )

        The proponents are using the G-d of the Gaps argument. "The reason it didn't work is because you didn't use it with THIS extra-special elixir, oh yes!!" Next we'll be told they weren't holding the pills correctly.

    • Re:The end of it? (Score:5, Interesting)

      by hey! ( 33014 ) on Saturday June 06, 2020 @10:51AM (#60152688) Homepage Journal

      I doubt it.

      This isn't about evidence, it's about hope, and for better or worse people have been encouraged to pin their hopes to this drug. They aren't following other research, so asking them to give up on hydroxychloroquine is tantamount to asking them to give up hope.

      So I expect the search will go on for evidence that hydroxychloroquine benefits *some* patients in *some* situations until a vaccine or a definitely superior treatment emerges.

      I do think we can put an upper credible limit on the possible efficacy of this drug. The Marseilles group's extraordinary results are likely a Type 1 error. Hydroxychloroquine has been extensively used as a frontline treatment, both alone and with azithromycin and sometimes zinc sulfate; if the effect were that powerful we wouldn't have to perform statistical yoga to see it.

      • For years I've been advocating the development of what's now being called "tailored medicine". I just wish I knew how to do it well, and how to fund it.

        Take a large pool of subjects. Divide them into treatment and no-treatment groups. Look for a treatment effect. This is how you study drugs.

        But suppose, instead of having just 2 groups, you had many? Suppose there was a blue-eyed group and a brown-eyed group? Males vs females? Caucasian vs non-Caucasian (however you define squishy categories like that)? You

        • by hey! ( 33014 )

          Sure. We know that people seem to have widely different responses to the virus itself, so why not to medicines? For example some people -- even relatively young ons -- have a dangerous clotting complication, others don't seem to. Some seem to have neurological complications, others don't.

          If COVID-19 becomes a permanent feature of society, the way cancer is, then we'll probably explore these things, but for now the highest priority probably should be keeping people from getting hospitalized.

        • by kqs ( 1038910 )

          Umm... this is done now. A lot.

          So, dividing people into 10000 groups like "male, 20-29, blue eyes, ethnic scandanavian, double-jointed" is pointless (no group is large enough). But by taking down all of this information, you can run some well-understood statistical analyses to say "did the blue-eyed behave differently than the brown-eyed in either the control or active groups? How about the double-jointed?" You can check any combination; you effectively create "virtual subgroups" on the fly. And most l

    • isn't whether it works or not, it's there to exist as a miracle cure that can be pointed to as an excuse to reopen before it's safe.
    • by gweihir ( 88907 )

      The resources were well spent. Negative results are very important in medicine, and even more so if some political nil-whits try to tell actual MDs what to do.

  • I see a pattern (Score:4, Insightful)

    by ilguido ( 1704434 ) on Saturday June 06, 2020 @10:39AM (#60152648)
    A new article about the uselessness of hydroxychloroquine pops up: the summary mentions Trump.
    A new article about the usefulness of hydroxychloroquine pops up: the summary does not mention Trump.

    No matter your opinion, this is ridiculous.
    • Re:I see a pattern (Score:4, Insightful)

      by Megol ( 3135005 ) on Saturday June 06, 2020 @10:47AM (#60152666)

      Frequency illusion causing you to see a pattern that isn't there.

      • Unless you've run a statistical analysis you wouldn't know if it is frequency illusion.

        Perhaps you meant to say "it could be frequency illusion"?

        • by Megol ( 3135005 )

          True but given the sampling of articles I've read (popular - as scientific papers tend to ignore such tidbits) either mention Trump or not no matter if reporting positive or negative results. While it's not scientific it effectively falsifies the claim of OP, if that's his experience it'd be a matter of limited sampling and not from a general rule. The frequency illusion is the most likely explanation if he get his news from enough outlets to be able to notice a general pattern.

          IMO. YMMV.

    • I think there’s a growing consensus that points to it being useless as a treatment for someone who has already contracted coronavirus. The earliest talk about it was in reference to it being a prophylactic to potentially help prevent contracting it, but there was at least one study that suggested it wasn’t effective at preventing infection. The only thing that still isn’t clear is whether or not taking it along with zinc (the whole reason behind taking it in the first place is that it incr
      • Yes, it looks like it is ineffective in treating Covid-19. It was worth a shot studying it though.

        Martin Landray, the Oxford University professor, is wrong on one count. It isn't a "useless" drug. It has many medical uses and is very effective for its proven uses.

        • " It isn't a "useless" drug. It has many medical uses and is very effective for its proven uses" - he was correct as he was talking about it being useless for COVID19, not any other application it was designed for.
    • Comment removed based on user account deletion
    • by iCEBaLM ( 34905 )

      Slashdot seems to have a real stake in HCQ failing, they keep posting all these articles against it and keep mentioning Trump.

      All of these trials and articles showing HCQ isn't effective just uses HCQ on it's own. We've known for months that alone it's not very effective. It's the combination of HCQ, Azithromycin, and Zinc that seems to do the trick.

  • And yet... (Score:2, Informative)

    by jamesivie ( 805019 )
    And yet...Lancet, New England Journal retract Covid-19 studies, including one that raised safety concerns about malaria drugs (https://www.statnews.com/2020/06/04/lancet-retracts-major-covid-19-paper-that-raised-safety-concerns-about-malaria-drugs/). I have ZERO trust in any "scientists" or "journalists" when it comes to any topic that either side has decided is political.
    • Re:And yet... (Score:5, Insightful)

      by cmseagle ( 1195671 ) on Saturday June 06, 2020 @12:36PM (#60153052)
      HCQ may not be as harmful as claimed by the now-retracted Lancet paper, but that doesn't mean it's an effective covid-19 treatment. These facts are not mutually exclusive.
    • Re:And yet... (Score:4, Insightful)

      by gweihir ( 88907 ) on Saturday June 06, 2020 @12:38PM (#60153064)

      That is because you have zero understanding of what is going on. The retracted studies were about _side_ _effects_ not primary effects against Covid-19. This is an entirely different topic. And it was a statistical study, not based on a controlled trial. If you do not familiarize yourself with the actual facts or ignore important details, you will never get a good picture of what is going on. You have only yourself to blame for that. Also note that it did not took long for these studies to be recognized as problematic and that means the process works.

    • Why waste time posting about it, go gobble some down then. Fuck dosage recommendations, "scientists" make all those up so you stay sick longer right? Then we'll get you a jar of covid spit, huff that a few minutes, and we'll check if your toes turn red. Badda bing badda boom, Dear Leader's gaze shines upon you, don't let him down or you won't get your COVID check.

      Seriously! Why would some stranger on the internet give you bad advice?

    • I have ZERO trust in any "scientists" or "journalists" when it comes to any topic that either side has decided is political.

      That's amazing. You distrust scientists because you have a your own political agenda and therefore those who disagree with you must be political?

      Well I guess we can throw global warming science out, science about every pandemic, and basically all science based around economics and society. We should tell these scientists that they are all biased, political and therefore need to find other jobs.

  • by rufey ( 683902 ) on Saturday June 06, 2020 @12:01PM (#60152914)

    From my point of view, it seems its becoming clear that HCQ doesn't help much if at all with patients who are already ill and admitted to the hospital. Its good to see studies that are now also starting to follow the patients post-release from the hospital to see what the lingering issues, if any, are. One interesting thing I've seen lately is a possible correlation between losing the sense of taste and smell, at least temporarily, after recovery.

    That being said, I went to the study website for a quick perusal but didn't find much in the way of the results - probably have to dig deeper. What I'm still interested in is if HCQ or any of the other drugs they used for the trial are effective as preventative care. Getting a flu vaccine when you are currently sick with the flu isn't going to help much with getting better. Same with measles and chicken pox and other things we have vaccines for. Same with poor diet or lifestyle choices. Once you are sick, you are now in a reactive mode, not preventative mode.

    Look at the ventilator thing. Its a known fact that the vast majority of patents who have to be put on a ventilator will never come off of the vent. I've read various sources that say that 95% or more of patents on ventilators die before becoming well enough to be taken off them. So the focus should be to prevent patients from getting to the point of needing a vent, not to make millions and millions of vents that in 95% of the cases, doesn't save the life of the patient. With this and other ongoing studies, I think we are starting to see what works or doesn't work when you are already at the point of being in the hospital.

    At the end of the day, finding things that will prevent someone from even having to go to the hospital in the first place needs more attention (besides locking yourself away for days/weeks/months on end).

    • Last week a study came out showing it did not prevent infection. All the conservatives changed tune to it now only helps after infection, but before serious infection. Get up to date.
  • by drwho ( 4190 ) on Saturday June 06, 2020 @01:16PM (#60153244) Homepage Journal

    It's not just Hydroxychloroquin, but zinc, that gets the job done, It's also only effective at the very early stages of infection. This is well known. It is angering that just because Donald Trump recommended it, so many are against it.

  • by littlewink ( 996298 ) on Saturday June 06, 2020 @01:39PM (#60153330)

    All patients were selected after being hospitalized which means they already had been sick too long for the HCQ et al regimen to help them. From the beginning the proposed regimen was

    "Hydroxychloroquine + Zinc Sulfate + Azithromycin EARLY!" to avoid hospitalization.

    So this is yet another study in a series of studies that gave HCQ et al to patients, even patients near death, in flawed attempts to prove that HCQ could not work.

  • Calling him useless for anything.

  • by JackAxe ( 689361 ) on Saturday June 06, 2020 @07:14PM (#60154452)
    From the NYT: https://www.nytimes.com/2020/0... [nytimes.com]

    Here's the Archived version: https://web.archive.org/web/20... [archive.org]

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