Chloroquine?

[WPOZZZ]

My mother, sister and I are considered high risk, so my PCP prescribed meds for us to have on hand. It is a combination of hydroxychloroquine, z-pack and Tamiflu. I hope it works.

[tdw28210]

Originally Posted by jyl

China is the world’s largest supplier of pharma API and Chinese companies make hydroxychloroquine. It is a small molecule and probably pretty straightforward to make and to ramp up capacity. They don’t need to buy it from other countries. They might simply need to not export it.

An actual randomized and blinded trial in China, albeit small (n=30), found no effectiveness of hydroxychloroquine vs control. A Wall Street analyst dug this up with some good research, the Chinese weren’t actively publicizing it. Larger trials are under way and will help answer the question. Both the small Chinese trials and the even smaller French not-actually-a-trial appear to have been in mild cases, as the control groups recovered fairly quickly too.

Can you share a link to the analyst research you mention? I would be helpful to see.

[tcar]

Originally Posted by WPOZZZ

.... It is a combination of hydroxychloroquine, z-pack and Tamiflu. I hope it works.

Tamiflu helps with 'regular' influenza... It has no effect with a corona type virus.
Totally different virus families.

However, the regular flu is still out there killing thousands of people a day.

[pmax]

Originally Posted by jyl

China is the world’s largest supplier of pharma API and Chinese companies make hydroxychloroquine. It is a small molecule and probably pretty straightforward to make and to ramp up capacity. They don’t need to buy it from other countries. They might simply need to not export it.

There's a shortage of these drugs here. For all we know, there's one in China too given how many would be buying (and possibly hoarding) them.

An actual randomized and blinded trial in China, albeit small (n=30), found no effectiveness of hydroxychloroquine vs control. A Wall Street analyst dug this up with some good research, the Chinese weren’t actively publicizing it. Larger trials are under way and will help answer the question. Both the small Chinese trials and the even smaller French not-actually-a-trial appear to have been in mild cases, as the control groups recovered fairly quickly too.

Given the study was published in some local Chinese medical journal, personally I don't put much weight on it.

Let's see what the larger trials say.

[berettafan]

Big picture China is ****ed after this passes. Going to lose a fair amount of US critical mfg facilities. Would make sense for them to grab every advantage/dollar possible right now at all costs.

[tdw28210]

https://thetexan.news/one-million-potential-coronavirus-treatment-pills-donated-to-texas-state-pharmacy/?utm_content=bufferb65d0&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

"As the government enacts policies trying to control the coronavirus pandemic, the private sector is finding ways to provide essential help. In fact, a donation of 1,000,000 tablets of hydroxychloroquine sulfate to the Texas State Pharmacy was just announced.

State Senator Bryan Hughes (R-Tyler) worked with Amneal Pharmaceuticals to secure the donation. The tablets will be distributed to hospitals as a potential treatment option for COVID-19."

[jyl]

Originally Posted by pmax

There's a shortage of these drugs here. For all we know, there's one in China too given how many would be buying (and possibly hoarding) them.



Given the study was published in some local Chinese medical journal, personally I don't put much weight on it.

Let's see what the larger trials say.

Sure, but the positive French study is far less meaningful.

[pmax]

Originally Posted by jyl

Sure, but the positive French study is far less meaningful.

I believe the author's legit so the results are valid. What it means is subject to interpretation of course.

[Chocaholic]

From a CNN hit piece in today’s news. Probably unreliable but the premise is that no HQ trials are funded because the drug is cheap and readily available. There's billions to be made on more sophisticated developments like monoclonals and anti virals.

From CNN: At a White House briefing last week, Trump said hydroxychloroquine, which is used to treat malaria, lupus, and rheumatoid arthritis, shows "tremendous promise" of working against coronavirus as well.
"I think it's going to be great," he said. "We're quickly studying this drug."
But the National Institute of Allergy and Infectious Diseases isn't sponsoring any studies on hydroxychloroquine, according to a statement from the agency, which added that the agency is "considering" trials that examine the drug or its analogue chloroquine as a potential treatment for Covid-19. studies.

[pmax]

FDA approved.

Did no one report it ?

[legion]

Apparently not.

[Geary]

Hydroxychloroquine Sulfate is also made by Watson Laboratories in CORONA California

[Seahawk]

https://spectator.org/the-20-solution-to-coronavirus-anecdotal-evidence-is-a-life-saver/

Read the whole thing.

Over the weekend, the Food and Drug Administration (FDA) issued an emergency authorization for the use of hydroxychloroquine (HCQ) and chloroquine (CQ) to treat hospitalized COVID-19 patients. Simultaneously, the Department of Health and Human Services (HHS) announced that Sandoz has donated 30 million doses of HCQ and Bayer one million doses of CQ to the Strategic National Stockpile. According to HHS, these drugs will be “distributed and prescribed by doctors to hospitalized teen and adult patients with COVID-19, as appropriate, when a clinical trial is not available.”

The effect of the FDA’s emergency authorization is unclear. The FDA regulates the manner in which manufacturers of pharmaceuticals may advertise and sell their products. If, after testing and clinical trials, the FDA approves a drug for a particular use, then the manufacturer may market it for that purpose and no other.

The FDA, however, does not set the standard of care for physicians and does not regulate the practice of medicine. That is why, even before the FDA’s “emergency authorization,” physicians have been free to make “off-label” (non–FDA approved) use of HCQ and CQ to treat COVID-19 patients.

Snip

But to the undoubted dismay of the media and all those who hope the pandemic will destroy Trump’s presidency, that pesky “anecdotal evidence” supporting the use of HCQ and CQ to successfully treat and possibly prevent COVID-19 infections continues to grow at an exponential rate.

For example, in a follow-up of its previously reported study recommending the use of HCQ and azithromycin to treat COVID-19 cases, researchers in France and Vietnam under the leadership of world-renowned infectious disease expert Professor Didier Raoult, the head of the Institut Hospitalo-Universitaire (IHU) Méditerranée Infection in Marseille, have reported another clinical trial in which that drug combination cured 79 out of 80 patients. Noting that “adverse events were rare and minor,” the researchers summarized their findings as follows:

In conclusion, we confirm the efficacy of hydroxychloroquine associated with azithromycin in the treatment of COVID-19 and its potential effectiveness in the early impairment of contagiousness. Given the urgent therapeutic need to manage this disease with effective and safe drugs and given the negligible cost of both hydroxychloroquine and azithromycin, we believe that other teams should urgently evaluate this therapeutic strategy both to avoid the spread of the disease and to treat patients before severe irreversible respiratory complications take hold.

As this report was issued, India’s Ministry of Health and Family Welfare issued a directive declaring that

Whereas, the Central Government is satisfied that the drug ‘Hydroxychloroquine’ is essential to meet the requirements of emergency arising due to pandemic COVID-19 and in the public interest, it is necessary and expedient to regulate and restrict the sale and distribution of the drug “Hydroxychloroquine” … (Emphasis added.)

Based on this finding, India has banned the export of HCQ and is recommending that health-care workers take HCQ prophylactically to avoid becoming infected while treating COVID-19 patients.

Similarly, Belgium and Bahrain are reporting that their hospitals are using HCQ to successfully treat COVID-19 patients. According to the Bahrain News Agency, the head of Bahrain’s National Taskforce for Combatting COVID-19 reports that HCQ has had a “profound impact” when used to treat COVID-19 patients. And Belgium has established a “strategic reserve” of HCQ to treat as many as 22,000 COVID-19 patients on an “off-label” basis.

[tdw28210]

Here's a good analogy:

You're stuck in battle, in a foxhole with a sucking gut wound. The medic arrives and says" Hey, I have this bandage that's been bouncing around in my pack for two weeks, it might not be perfectly clean. Do you still want me to apply it? Or I can travel 2 miles back across the battlefield to the field hospital and get a perfectly clean one , but you have a good chance of dying before I get back.

Trump, French Researchers, Indian Gov' and several US physicians: "Apply the bandage you got".

Most of the media, the FDA, some of Big Pharma and several Governors: "Run back to the field hospital and get the perfectly clean bandage. Try not to get killed in the process and I will try not to die while I wait".

[tadd]

tdw:
Not quite that simple. Your analogy implies that the object used works. It would be apples to apples if we had a bunch of 'out of date' proven medication to give.

What chloroquine is is unproven. It acidifies vesicles, thus possibly slowing COVID transport into the cell. It also causes a variety of other side effects when it does that.

I'm all for last ditch trials. If you are crashing and are on deaths door, give it a shot. Just so long as everyone understands its a hail mary.

The halls of big pharma are littered with drugs that looked promising on the lab scale testing but eventually showed non-stastical effect.

Hell, read the fine print on some of the FDA approved drugs on the TV. The read the botox migraine add last night. Says it can save you one migraine a month assuming you have 15 or more. THAT is approved, so the bar isn't high.

Look at what happened to the COX-2 inhibitor. Less than 1000 people had heart attacks out of hundreds of millions of OTC doses... how did that work out?

[tdw28210]

Originally Posted by tadd

tdw:
Not quite that simple. Your analogy implies that the object used works. It would be apples to apples if we had a bunch of 'out of date' proven medication to give.

What chloroquine is is unproven. It acidifies vesicles, thus possibly slowing COVID transport into the cell. It also causes a variety of other side effects when it does that.

I'm all for last ditch trials. If you are crashing and are on deaths door, give it a shot. Just so long as everyone understands its a hail mary.

The halls of big pharma are littered with drugs that looked promising on the lab scale testing but eventually showed non-stastical effect.

Hell, read the fine print on some of the FDA approved drugs on the TV. The read the botox migraine add last night. Says it can save you one migraine a month assuming you have 15 or more. THAT is approved, so the bar isn't high.

Look at what happened to the COX-2 inhibitor. Less than 1000 people had heart attacks out of hundreds of millions of OTC doses... how did that work out?

Don't agree. "Doesn't work" runs counter to actual clinical research done in places like France and soon to be NYC and India. Is it the double-blind, randomized gold-standard? No, but were in a fox hole here. Have credible researchers provided evidence of efficacy? yep.

[IROC]

Originally Posted by tdw28210

Don't agree. "Doesn't work" runs counter to actual clinical research done in places like France and soon to be NYC and India. Is it the double-blind, randomized gold-standard? No, but were in a fox hole here. Have credible researchers provided evidence of efficacy? yep.

The French study was junk, evidently. Good discussion here:

https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/

[tdw28210]

Originally Posted by IROC

The French study was junk, evidently. Good discussion here:

https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/

I''ve read the study. I understand it's shortcomings (small sample size, single arm, no placebo, etc.).

It's between you and your physician. God forbid, I have to face this decision but if there's no "clean bandage" at my immediate disposal, I'll take the dirty one. YMMV

[tadd]

Tdw:
My point was that to call something a medicine, it has to show efficacy greater than its ability to harm.

I would greatly question how knowledgeable your physician actually is w/respect to drugs. Case in point... the big pain killer given to older folks is tramadol since it is opioid like in strength, but has less side effect issues than true opioids. The other common drug given is Prozac. Well lo and behold, Prozac inhibits tramadol. So the Dr prescribing this isn't actually treating the patients pain. This is really common, and the word just isn't out there. Its not that the Drs don't care, you just cant know everything. So...your Dr may not be the best to actually advise you.

That remains to be seen with a true sample size yet.... let alone unknown issues that only appear in huge sample sizes...which was the point of the VIOXX reference.

Again, if you are dying, give it a shot and that is the approval the FDA has given.

Mylen (a generic manufacturer in WVa) has spooled up to make chloroquine. So at least there will be enough so the proven diseases (lupus) it is used for those patients will get theirs.

The real issue is what will the lawyers do once this is all over. Hopefully there is some anti tort thing in the emergency powers act.

[tdw28210]

From the NY Times :

https://www.nytimes.com/2020/04/01/health/hydroxychloroquine-coronavirus-malaria.html

“It’s going to send a ripple of excitement out through the treating community,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.

The new study, of 62 patients with an average age of about 45, did have a control group. It was conducted at the Renmin Hospital of Wuhan University, in Wuhan, China. The patients were carefully chosen to exclude people with medical problems that could be made worse by hydroxychloroquine, like abnormal heart rhythms, certain eye diseases, and liver or kidney problems.

Half the subjects — the controls — received just the usual care given to coronavirus patients, and half had usual care plus hydroxychloroquine. The usual care included oxygen, antiviral drugs, antibiotics and other treatments.

Their disease was considered mild, even though all had pneumonia that showed up on CT scans. After giving informed consent, they were assigned at random to either the hydroxychloroquine or the control group. They were treated for five days, and their fevers and coughing were monitored. They also had chest CT scans the day before the study treatment began, and the day after it ended.

Coughing and fever eased a day or so earlier in the patients who received hydroxychloroquine, and pneumonia improved in 25 of 31, as opposed to 17 of 31 in the controls.

The illness turned severe in four patients — all in the control group.

Two patients had minor side effects from hydroxychloroquine: One had a rash and another had a headache.