COVID-19 drugs that work

[cabmandone]

Originally Posted by group911@aol.co

So, the takeaway is to trust the scientists that agree with a persons preconceived notions and call the others a fraud.

Originally Posted by group911@aol.co

It's almost like someone stands to gain something from pushing this drug. It like some sort of cartel or something.

Ummm... yeah...

[RWebb]

Disagreements among scientists are resolved by experiments.

[cabmandone]

Hopefully there will be more findings from studies released soon. I saw that NY's study is complete but I haven't found any published results yet. I don't have a have a horse in this race. I just want effective treatments to be found, whatever those treatments might be.

[jyl]

https://www.wired.com/story/scientists-may-be-using-the-wrong-cells-to-study-covid-19/

Can we stop with HCQ?

TL-DR version: the initial in vitro (i.e. in lab cell culture) experiments that got people thinking that HCQ could stop SARS2 replication were done in the wrong kind of cells (a type of monkey kidney cell). Those cells are different from human cells in a way that happens to matter here. When those experiments are repeated in human lung cells, HCQ does not stop SARS2 replication, even in vitro. Just as it doesn’t do a thing in vivo (in living humans).

[jyl]

For drugs that may work (in addition to remdesivir and dexamethasone), watch the ongoing trials of targeted antibodies (Regenron REGN-COV2, Lilly [I forget the name of its drug]). Also a bunch of trials for drugs that inhibit immune response in various ways, though a bunch of those have failed too (Actemra, Kevzara). Interferons are also in trials. There’s hundreds of other drug trials in progress, though that includes a bunch of spitballing and sadly some outright stock manipulation.

[Aurel]

I wish they would sell HCQ and zinc sulfate pills or inhalers at CVS...prevention and self medication could help many folks, and the positive studies are around. Here is one I just read:

https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v1.full.pdf

[RWebb]

Baricitinib? Lilly licensed it from Incyte - it inhibits JAK1/2 a key enzyme that 'causes' inflammation

I guess I'd call it supportive therapy tho it can reduce spread

[pmax]

Originally Posted by jyl

For drugs that may work (in addition to remdesivir and dexamethasone), watch the ongoing trials of targeted antibodies (Regenron REGN-COV2, Lilly [I forget the name of its drug]). Also a bunch of trials for drugs that inhibit immune response in various ways, though a bunch of those have failed too (Actemra, Kevzara). Interferons are also in trials. There’s hundreds of other drug trials in progress, though that includes a bunch of spitballing and sadly some outright stock manipulation.

Updates



https://www.biocentury.com/article/630983

[jyl]

Originally Posted by Aurel

I wish they would sell HCQ and zinc sulfate pills or inhalers at CVS...prevention and self medication could help many folks, and the positive studies are around. Here is one I just read:

https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v1.full.pdf

Yeah, that is a retrospective open label study, not a randomized placebo controlled trial, and they had to data-mine and "adjust" to find the hint of an effect.

Compare to large RECOVERY trial in UK, which was a large randomized blinded placebo controlled trial. 1561 pts on HCQ vs 3155 on placebo, both arms also on standard of care. 27% on HCQ died in 28 days vs 25% on placebo, 59.6% discharged in 28 days vs 62.9% on placebo, 30.7% on HCQ ended up on ventilators in 28 days vs 26.9% on placebo. HCQ failed on every measure and it actually hints like it might be harmful.

[pmax]

Originally Posted by jyl

Yeah, that is a retrospective open label study, not a randomized placebo controlled trial, and they had to data-mine and "adjust" to find the hint of an effect.

Compare to large RECOVERY trial in UK, which was a large randomized blinded placebo controlled trial. 1561 pts on HCQ vs 3155 on placebo, both arms also on standard of care. 27% on HCQ died in 28 days vs 25% on placebo, 59.6% discharged in 28 days vs 62.9% on placebo, 30.7% on HCQ ended up on ventilators in 28 days vs 26.9% on placebo. HCQ failed on every measure and it actually hints like it might be harmful.

Yes, the RECOVERY trial with 3-4x HCQ doses that most true experts recommend, that one.

[jyl]

Ouch. https://www.medrxiv.org/content/10.1101/2020.10.15.20209817v1

Large RCT finds no survival benefit for remdesivir, lopinavir, hydroxychloroquine, or interferon beta.

The lopinavir and HCQ results are no surprise. Both have a steady track record of failure in randomized trials. The remedsivir results are disappointing, and this trial is much larger than the ACTT trial on which the drug’s EUA was based. The interferon result is disappointing.

This trial was not designed to limit treatment to pts with early or late stage disease, or other pt subgroups. So it might not detect efficacy if a drug is only beneficial in a subgroup, or if a drug is beneficial in some subgroups but harmful in others.

https://www.medrxiv.org/content/10.1101/2020.10.15.20209817v1

[RWebb]

Looks like they only tried one interferon, a Beta

[Aurel]

I haven’t contributed to this thread for a while, but I just wanted to point out that an old, obese guy can have a good outcome with Dexamethasone, remdesivir and regeneron...so there’s hope for all .

And maybe having used HCQ in advance did not hurt either...

[jyl]

https://www.sciencealert.com/ai-cough-analysis-could-detect-covid-19-even-if-you-re-asymptomatic/amp

[jyl]

Originally Posted by RWebb

Looks like they only tried one interferon, a Beta

And may have given it later in disease course. mAb seem to be harmful late, perhaps INF-beta similar.

https://www.nature.com/articles/d41586-020-03070-1

There’s other INF trials ongoing, including an inhaled (nebulized) INF-beta drug from a little UK company, was developing it for COPD I think.

[jyl]

https://www.statnews.com/2020/11/09/covid-19-vaccine-from-pfizer-and-biontech-is-strongly-effective-early-data-from-large-trial-indicate/

Pfizer vaccine 90% effective on interim analysis of 94 events.

In Oct, PFE decided to not do the first interim at 32 events, possibly due to the FDA advisory committee concerns about unblinding the trial based on only 32 events and the FDA decision that no EUA would be considered until half the study population had two months of safety data which wouldn’t be until mid Nov. The logic was probably that they didn’t want to weaken the data with early disclosure when it would not result in a faster vaccine approval. With FDA’s permission, samples were stored rather than tested immediately, for a couple of weeks, then when 94 events - the third interim analysis point - was reached, those samples were tested and this is the result. Implies vaccine efficacy was higher than their statistical plan had assumed. And that they could possibly gotten a positive result at the second or first interims, had they decided to perform those analyses.

More info will come out but this looks like a best case scenario. Strongly suggests that Moderna’s vaccine will also be successful. And improves odds for Astrazeneca’s as well. HA! to the analysts who were predicting failure for these vaccine. And deep thanks to everyone who volunteered for the trials, like our own redbeard.

Pfizer will have 100 million doses for the US by year-end, Moderna should have 50 million or so, and Astra another 100-200 million I think. Production for each of these will go up 10X in 2021. Even at 2 doses/person, the supply is sufficient to vaccinate all Americans who are at higher risk, by end of spring.

Distribution will be the next question. Pfizer has elected to bypass the US Govt’s distribution systems and handle its own distribution which needs an extreme cold chain. The others will likely use the federal (military, actually) distribution system. Getting needles into arms will be mostly up to the states and cities. I think the plan is for HCW and high risk persons to get the first shots.

There is an obstacle here, which is that all this is happening during an Administration transition. Operation Warp Speed has been pretty autonomous, I think, and is headed by a military officer and a pharma exec, not by political appointees, so I’d like to think it will forge ahead unimpeded. I rather think the FDA head could get fired along with the head of NIAID (Fauci) in the next month, but I hope that won’t slow vaccine approval or distribution.

[URY914]

Last night's 60 Minutes had a good story on the distribution. Interviewed the General in charge. Seems as if they have it figured out. You can find a replay of the story on line.

[pmax]

Besides being cautious about early unreleased unreviewed data ... you might recall the remdesivir pump and dump by statnews, Fauci and co ... , the problem with vaccines is not how effective they are but how many they kill or get sick due to side effects which these have universally.

[pmax]

Originally Posted by RWebb

Disagreements among scientists are resolved by experiments.

You would hope so.

Reality ain’t that pretty.

[jyl]

Not a drug, but pretty darn cool - a breathanalyzer for Covid screening, claims 93-95% accuracy - caveat that many of the rapid screening tests have proven disappointing. I just read that Quidel's SOFIA rapid screening test missed 68% of asymptomatic cases in a study.

https://www.prnewswire.com/news-releases/breathonix-announces-60-secs-on-site-non-intrusive-rapid-breath-test-for-covid-19-301162665.html