Chloroquine?

[legion]

I'm seeing multiple stories that Chloroquine is effective in treating COVID-19. Chloroquine is cheap and widely available. If this is effective, why is it not being widely used?

[GH85Carrera]

I simply has not been clinically tested for that.

[Mahler9th]

In all or nearly all healthcare systems, clinical, scientific and regulatory treatment evaluations focus on safety and efficacy.

In most, if not all cases, the process of establishing safety and efficacy involves "studies." When/as applicable these often start in vitro, then small animals, then small groups of people, then large trials.

I have not yet read published studies describing the potential efficacy of Chloroquine in the treatment of Covid-19 disease, but I have heard the NIH lead indicate that the work done thus far is on smallish numbers of cases, and in non-controlled studies.

Non-control could mean that we don't know if any of the folks who got benefcial results would have not gotten the same results if they had not been given the drug.

Folks are working really hard and as fast as they can to figure out if this drug can help. And I think they will try to be smart about relaxing some, if any of the norms in place to be sure that any final decisions don't place public health at more harm than good.

[vash]

i would piss on a sparkplug if i thought it would help

[red-beard]

Originally Posted by GH85Carrera

I simply has not been clinically tested for that.

It has not been tested for SARS-Co-v2. It has been tested on a variety of other Corona viruses, including the 2003 SARS, and found to be effective.

The other issue, the dosage has not been worked out. When we were taking it for Malaria, we took 2 tablets, once per week. The dosage I've read on-line for SARS-Co-v2 is 2 tablets, twice per day.

The mouse trials I read showed 100% effective at around 25mg per kg. I believe it was still effective down around 15mg per kg. Treatment in the mice was about 1 week. Below 10mg per kg was ineffective.

And again I don't know the dosage, but the trials in mice showed that mice exposed to the virus who were taking the drugs prophylactically, would not pickup the virus.

So, number 1 is start dosing the healthcare workers. Start dosing people with active virus. When enough available, start treating people immediately who were exposed.

The US doesn't stockpile this drug. US Military might. It is commonly available for travelers to certain countries. But that doesn't require much.

[ckelly78z]

Originally Posted by vash

i would piss on a sparkplug if i thought it would help

That's a "shocking" revelation ! Just not on my car !

[john70t]

Check the foreign manufacturer origin of certain biological (i.e. genetic) drugs...

One size will never fit all..
Despite government spending.

[techweenie]

Well, on the one hand you have Dr Fauci saying it's not determined yet, and on the other, well, you fill in the qualifications of the 'heard on the internet or at the press conference' source.

[red-beard]

Nov 12th, 2008 Mouse study using Chloroquine for SARS-CoV

https://aac.asm.org/content/53/8/3416

[tevake]

That chloroquine is not for everyone. U S Troups were required to take in while in V N.
And that stuff allmost took me out for the few month that I did take it. Couldn't keep food in me and had terrible gut cramps. Allmost debilitating after a while.

So I stopped taking it, then ended up getting Malaria, which was bad for a week or so then started clearing up. The impact of takeing the Chloroquine was much worse for me than the malaria.

Cheers Richard

[Seahawk]

Interesting info:

https://www.powerlineblog.com/archives/2020/03/brian-sullivan-what-is-to-be-done.php

Our friend Brian Sullivan is the founder and chief executive officer of a sophisticated biomedical company. In commenting on the Wuhan virus and related issues, John and I have been guided by his review of the literature and his analysis of the data. I asked Brian for his thoughts following yesterday’s confusing White House task force briefing with FDA Commissioner Stephen Hahn. Brian has responded as follows:

In the White House briefing yesterday, FDA Commissioner Stephen Hahn described the FDA’s approach to investigating the efficacy of treatments for Wuhan virus. He didn’t sound like a man on a mission.

As President Trump and others have articulated, we are at war. Our current strategy requires Americans to fight in the trenches and suffer severe economic hardship. This approach is not sustainable over the next 12 months while we wait for a vaccine. To survive in the meantime, the federal government needs to scale its efforts to find treatments that reduce the risk of death from this virus as soon as possible.

Dr. Hahn is serving as the equivalent of a military general in the war effort. He is the point person responsible for leveraging the resources of the federal government to investigate the various treatment options. He cannot fall captive to the same bureaucratic tangle that hampered development and deployment of Wuhan virus tests.

The President clearly is pushing the FDA to move quickly, but he also appeared hesitant to direct the FDA more forcefully. Given the stakes, it is entirely appropriate for the President to direct the FDA to achieve a specific goal – provide the American people with efficacy data by the end of the April on the most promising treatments.

To accomplish this, Dr. Hahn and the FDA need to make some quick decisions and then enable steps that often take months to get completed in days.

1. Select and build teams for the most promising treatment candidates to study and eliminate roadblocks to approving the trials.

The candidates would likely be: 1) Chloroquine or Hydroxychloroquine; 2) Gilead’s anti-viral, Remdesivir; and 3) human convalescent sera. The good news is that three trials are already underway for Remdesivir. A team led by Johns Hopkins researcher, Arturo Casadevall, has already submitted an application to the FDA to study human convalescent serum, which contains the antibodies in blood from recovered patients. This could boost immunity of newly infected people. It is the approach used to combat measles and mumps 100 years ago. According to the team, though, as of yesterday, they have not heard back from the FDA on their application. That application should get turned around immediately. A chloroquine trial is the simplest to move forward in some ways but it needs a clinical team to lead it and take ownership. Publicly call for leading infectious disease doctors to volunteer over the next 24 hours to lead this trial or assign the head of the NIH to lead the effort.

2. Approve the use of a central group of patients who could serve as controls.

Each of the different drugs needs must have results compared to a control group of patients who don’t receive the treatment in order to determine whether they are effective or not. If these drugs are studied in an uncoordinated, independent fashion, each drug trial would need its own control groups of patients. Since each drug must study three different types of patients – patients with severe disease, moderate disease, and ones in close contact with diseased patients – this would mean nine patient control groups would be required. Enrolling the thousands of patients required for these control groups will slow down enrollment significantly, delaying availability of results.

To eliminate this inefficiency, the FDA could mandate that the clinical teams leading these trials establish common eligibility criteria for each patient group so that data from each control group could reliably be compared to the data from the patient groups who receive the different study drugs. This would address one of the biggest obstacles to getting data quickly.

3. Streamline the pathway for approving and activating trials.

Under normal circumstances, it can take months for a trial to get the approvals needed to start enrolling patients. The FDA needs to define a pathway that enable clinical sites to initiate patient enrollment within a week. Again, we are at war.

4. Leverage the clinical trial infrastructure Gilead has already established for the other drug trials.

The longest lead time item for many trials is creation of the protocols and database needed to manage patients and their data. Under normal circumstances, this can take months. Since Gilead is already recruiting patients, they have protocols and a database in place. The FDA should encourage (force) Gilead to offer these tools to the other trial teams.

5. Coordinate trial sites.

The FDA needs to ensure these trials aren’t competing for hospitals and patients in counterproductive ways. Gilead is already in the field and can provide feedback to the FDA and the other clinical teams about obstacles that need to be addressed. All the clinical teams need to be aware of what the others are doing and adjust accordingly.

The FDA is naturally a cautious agency, but we are at war and the agency needs to adapt. Dr. Hahn’s remarks yesterday suggested he has not adapted his mindset to this reality. President Kennedy laid out a goal of landing a man on the moon by the end of the sixties. The stakes today are much higher than a space race. President Trump must tell the FDA that their goal is to get data by the end of April. We can absolutely achieve this.

[Seahawk]

Originally Posted by tevake

That chloroquine is not for everyone.

See above. Fast track as possible.

[coldstart]

The anti-viral drug Remdesivir is in stage III testing in a number of Asian countries.

If it is effective, it will likely be the best drug as it has limited side effects. That is a big IF....

The company, Gilead, went from $60 to $80 in the past two weeks. It either could go back down to the $60s or up to $100. It will be interesting to watch. Some people are going to get rich off the treatment of Covid-19.

Correction: Gilead is now at $74, not $80.

[Geneman]

Chloroquine is a bum fock simple drug..... it works by simply slightly changing the pH ( acidity). of small vesicles inside the cell. these are the macro-pinocytic vesicles that bud off the membrane and carry virus ( or the malarial parasite) inside the cell.... when the pH is changed, the vesicle cannot unload its contents into the cell for infection to occur. so eventuially, the contents of the vesicle are degrade, or just routed back outside the cell.

So Cq does not kill the virus, and in fact does not limit binding to the cell or internalization of the virus. It simply inhibits delivery of the virus to the cytoplasm. its is not therapeutic at all, just preventative

problem is that, for it to be effective, you must maintain a reasonably constant level of cq in the bloodstream, meaning constant , consistent dosing.

BTW. it was developed from quinine pills during ww2. also, you can got a reasonable dose of quinine by drinking gin!

[Brown747]

https://m.youtube.com/watch?v=rRgnQs6D1u8&feature=emb_title

[93nav]

Small sample, so who knows yet. and not a 'blind' study. All knew who was getting what.

https://www.telegraph.co.uk/global-health/science-and-disease/chloroquine-70-year-old-treatment-malaria-key-beating-coronavirus/

Doctors in Marseille in the south of France have claimed that patients have successfully been treated with the malaria drug chloroquine. In a study of 36 patients 20 were given the drug. After six days, 70 per cent of the chloroquine patients were considered cured, that is the virus was no longer detected in blood samples, compared to just 12.5 per cent of the control group of patients.

[red-beard]

Originally Posted by Geneman

Chloroquine is a bum fock simple drug..... it works by simply slightly changing the pH ( acidity). of small vesicles inside the cell. these are the macro-pinocytic vesicles that bud off the membrane and carry virus ( or the malarial parasite) inside the cell.... when the pH is changed, the vesicle cannot unload its contents into the cell for infection to occur. so eventuially, the contents of the vesicle are degrade, or just routed back outside the cell.

So Cq does not kill the virus, and in fact does not limit binding to the cell or internalization of the virus. It simply inhibits delivery of the virus to the cytoplasm. its is not therapeutic at all, just preventative

problem is that, for it to be effective, you must maintain a reasonably constant level of cq in the bloodstream, meaning constant , consistent dosing.

BTW. it was developed from quinine pills during ww2. also, you can got a reasonable dose of quinine by drinking gin!

It was developed in 1934. Gin was used in India by the British to make daily doses of quinine more palatable. Gin is flavored with Juniper berries.

Tonic Water is limited to around 100 mg/l, which is not enough for protection.

The action you describe does not match the mice studies I posted, which show release of Zinc and inhibiting of replication.

The recent "micro"-trials carried out by the French show both prophylactic and therapeutic properties.

https://www.ncbi.nlm.nih.gov/pubmed/32147496

https://www.sciencedirect.com/science/article/pii/S0166354220301145?via%3Dihub

Recently, Wang and colleagues (Wang et al., 2020) evaluated in vitro five FDA-approved drugs and two broad spectrum antivirals against a clinical isolate of SARS-CoV-2. One of their conclusions was that "chloroquine (is) highly effective in the control of 2019-nCoV infection in vitro" and that its "safety track record suggests that it should be assessed in human patients suffering from the novel coronavirus disease". At least 16 different trials for SARS-CoV-2 already registered in the Chinese Clinical Trial Registry (ChiCTR2000029939, ChiCTR2000029935, ChiCTR2000029899, ChiCTR2000029898, ChiCTR2000029868, ChiCTR2000029837, ChiCTR2000029826, ChiCTR2000029803, ChiCTR2000029762, ChiCTR2000029761, ChiCTR2000029760, ChiCTR2000029741, ChiCTR2000029740, ChiCTR2000029609, ChiCTR2000029559, ChiCTR2000029542) propose to use chloroquine or hydroxychloroquine in the treatment of COVID-19 ("Chinese Clinical Trial Register" (ChiCTR)). In a recent publication (Gao et al., 2020), Gao and colleagues indicate that, "according to the news briefing", "results from more than 100 patients have demonstrated that chloroquine phosphate is superior to the control treatment in inhibiting the exacerbation of pneumonia, improving lung imaging findings, promoting a virus negative conversion, and shortening the disease course".

[RWebb]

nothing definitive yet - this drug is well-known as to its side effects & contra-indications; others are not

there are at least 6 antiviral drugs in development

[pmax]

Originally Posted by Geneman

It simply inhibits delivery of the virus to the cytoplasm. its is not therapeutic at all, just preventative

Thanks for the info.

I understand no one in the medical profession gonna come out and say it definitely works but I think I'm reading hints, winks and nudges from more than one source that this is a good idea.

Does that sound about right ?

[gacook]

Originally Posted by red-beard

It has not been tested for SARS-Co-v2. It has been tested on a variety of other Corona viruses, including the 2003 SARS, and found to be effective.

The other issue, the dosage has not been worked out. When we were taking it for Malaria, we took 2 tablets, once per week. The dosage I've read on-line for SARS-Co-v2 is 2 tablets, twice per day.

The mouse trials I read showed 100% effective at around 25mg per kg. I believe it was still effective down around 15mg per kg. Treatment in the mice was about 1 week. Below 10mg per kg was ineffective.

And again I don't know the dosage, but the trials in mice showed that mice exposed to the virus who were taking the drugs prophylactically, would not pickup the virus.

So, number 1 is start dosing the healthcare workers. Start dosing people with active virus. When enough available, start treating people immediately who were exposed.

The US doesn't stockpile this drug. US Military might. It is commonly available for travelers to certain countries. But that doesn't require much.

When were you taking it for Malaria? When I took Malaria pills (1999-2000 timeframe), it was 1 a day--starting a week prior to the deployment and continuing a week after the deployment. To be perfectly frank, I haven't had any real sickness--even a mild flu--since then...