No, you saw Boulware’s data, thanks to Watanabe. We have only seen Mitja’s (Barcelona) data for the first three days together, not each day separately.
None of the proponents of HCQ think it should be used in monotherapy. All favor some combination of HCQ with AZ or Doxycycline, and some insist that Zinc must be included, also. But HCQ might be enough as a pre-exposure prophylaxis. If Watanbe’s argument is good, then had it been given on day 0 (I think he means right after exposure) it would have been 72% effective. But even if it is only about 50% effective, that means 50% less cases of Covid-19 to deal with. My doctor gave me a pneumonia vaccine, while telling me it was only 50% effective. That was good enough for him. It looks like it will be a while before we get the results of the trials for pre-exposure.
Get back to us when there is strong evidence that it is.
The problem is that you are extrapolating from very small numbers.
I would wager money that the study involving the vaccine did not have numbers like 6 out of 70 were infected in the placebo group and 3 out of 60 were infected in the vaccinated group.
I am beyond exasperated about this to be honest! The TRUTH is that there are negative clinical trials for outpatients, prophylaxis, and especially treatment of inpatients. (where the Brits have come to the rescue yet again and in a multiple thousand patient study categorically demonstrated this drug simply doesn’t work in a hospital setting. As each negative study reports it surely becomes LESS and LESS likely that any other PROPER RANDOMISED CONTROLLED TRIAL actually shows that this malaria drug has any efficacy whatsoever against COVID19. If this was a Pharma industry drug we would have given up on it by now. And yet there are LOADS of clinical trials still studying it… and there are loads of mostly it has to be said American doctors advocating it like snake oil salesman.
At this point, I am FIRMLY of the belief that this should NOT be given AT ALL except inside a randomised clinical controlled trial and only then when the patients have seen all the data that suggests it doesn’t work. Where is the excitement about dexamethasone that the UK huge trial has shown to work?
And whilst not that subject I do I am afraid have to echo the critisicsm I begin this article I am about to link to with from the Oxford scientists of the US medical establishment that have failed to set up huge RCTs like we have.
You could have done a large simple RCT of Convalescent plasma for example. We still do not know for sure if that works…why give it to 10,000 people without randomization. You could have randomised people on admission to hospital and made the primary endpoint deterioration to needing ventilatory support of any kind (maybe even just o2?) and if you insisted then allowed those randomised to NOT get the plasma to have it then. But as I understand it you didn’t even have enough plasma to treat everyone anyway so why not share it out by random allocation and quickly learn if it actually works, makes no difference, or hopefully not makes the disease worse (remember over activity of the immune system causes the lung problems…). So yes, there has been a lack of trust in RCTs seen I would argue even in the US medical establishment. Or at least a lack of will and maybe experience in setting up these huge simple studies we in the UK are becoming quite good at. The moral of the story and of MANY failed Pharma drugs is that even very promising medicines that we are SURE will work do not always work when you subject them to the rigour of a RCT.
It sounds like you are referring to the RECOVERY trial, where they gave a loading dose of 2,000mg of HCQ and 800mg per day after that for 9 days. Sounds like they were trying to poison the patients with near toxic levels of HCQ. All it proved is that very high doses of HCQ don’t help very sick patients, thank you very much.
But meanwhile, you have ignored Professor Risch’s point that by the time patients are hospitalized, fighting the virus is secondary. The time for HCQ is early treatment, which none of you Brits has bothered to study, yet.
But don’t take my word for it. Listen to your own countryman:
There is already a negative trial for milder patients https://www.researchgate.net/publication/343002783_Hydroxychloroquine_in_Nonhospitalized_Adults_With_Early_COVID-19_A_Randomized_Trial BUT I have no issue with people trying this medicine still in a clinical trial just in case they come up with a different answer. But if high dose doesnt work in severely ill people then I very much doubt low dose will work in mildly ill people. Why should it? Most of them will get better anyway. So the placebo effect is huge. And this is why many swear by it if they have seen it used anecdotally. RECOVRY has more or less killed off the idea of hydroxycholoroquine or should have done, just as it PROVED dexamethasone reduces deaths. I just think we need to do RCTs not dish things out without checking if they work. My countryman as you put it is simply advocating an RCT. I think that we should do an RCT provided the patients have access to the data so far which has not been promising. But a large study will give a definitive answer especially if it is done properly.
Yes, Boulware’s trial of low risk patients, who would most likely recover anyway. So HCQ won’t show much advantage (though it did show a small advantage, even among low risk patients). What hasn’t been tested is HCQ for high risk outpatients, those who are at most risk of being hospitalized and dying. Again, it is obvious that you have not bothered to read Professor Risch’s article.
But the RECOVERY trial should probably be probed for criminal intent:
Thanks Adrian, I separated your paragraph a bit so it was easier for me to read if that’s okay. I also apologize for changing one British spelling to American.
Common Bilbo. For real though where do you find these things at? And how do you evaluate them for credibility and reliability? What do you think people are hiding about HCQ? Do you honestly think thousands of scientists are this incompetent and criminal?
Also for the FDA, here’s a nice article demonstrating the FDA clamping down on the company that makes Remdesivir delaying or permanently preventing them from making billions of dollars on another drug:
Tell me the FDA is bought out by companies like Gilead one more time.
The fact that the data is rising between the different cuts makes perfect sense. Data is being cleaned and gathered all the time in a huge study like this so the numbers will have gone up! There is nothing nefarious going on. British academics know how to run a clinical trial! We practically invented evidence based medicine. Look if someone, looking the data we have gathered, still thinks it is worth doing another study good luck to them. But ethically you HAVE to show the patients the poor data not just from the recovery trial and this drug simply should not be used outside of a clinical trial. What part of lets run BIG simple clinical trials to see what works rather than handing out things we don’t know work (or alternately have actually shown DO NOT work!)? Where is the ethics in treating people with things and not proving if they work?
On a related note, what do you all think about this article? It makes the point that the whole debate about hydroxychloroquine has become so politicised that it’s hard to tell the wood from the trees. It suggests that because of this, the science probably isn’t as clear-cut as it’s being made out to be. It makes the point that there are conflicts of interest on the anti-HCQ side, that important papers have been retracted, that randomised controlled trials can be, and are, sometimes flawed.
No need to support, as the burden of proof falls on the one with a positive assertion that they do. Speaking of big pharma, looks like they make the drug and donated a bunch back in March when the data was more in doubt, no doubt as some sort of evil public relations ploy. (As an aside, most generic drug makers ARE big pharma. Historically, the big push to generics was by pharmacy chains and wholesalers, as the profit margins are often much higher on generics. Capitalism and lobbying at work.) https://www.hhs.gov/about/news/2020/03/29/hhs-accepts-donations-of-medicine-to-strategic-national-stockpile-as-possible-treatments-for-covid-19-patients.html
tHe author of the article seems to be very biased in favour of hydroxchloroquine I am finding it a bit of a struggle with comments like this " On moral grounds he refuses to set up a control group that withholds a possibly effective treatment from a patient with a lethal illness. " raising my heckles! this is utter tripe to be honest. The whole basis of evidence based medicine is the RCT and the RCT is the only thing we should be paying attention to. I do not understand why only the UK has been able to set up an 11,000+ patient trial of several interventions for COVID19 and so far has provided 3 definitive pieces of data from that study including that. Hdroxychloroquine does not work in hospital patients. That should be the end of it as far as hospital patients go and not nice stories nor political movements but HUGE studies are the way to answer these questions. And it is UNETHICAL not to do the studies including with a control group. Because we waste time and lives giving people things we do not yet know it they work and we will never know without the trials. That is the message that should be loud and clear. That and NOTHING ELSE. The Henry Ford “study” is not randomised so means nothing. they do not even mention the RECOVERY trial in this article. It is a very poor show in my view. There are such nonsense lines like “we already know this drug is for early on” no we do not! We know nothing about it except what is shown in clinical trials.
When you state that Big Pharma has nothing to do with it, that is a positive assertion. It requires evidence. You have provided none.
Your assertion that Big Pharma makes more from generics is false. And I provide a paper that argues that Gilead has very much to lose if HCQ is used extensively.
“Researchers found that for all branded and generic drugs, average gross margins are 71.1% for manufacturers…
Branded drugs net manufacturers about three times the gross profits that generic drugs do…”
‘Gilead’s stock rises and falls based on the successes and failures of both hydroxychloroquine and remdesivir. Immediately before Trump first announced hydroxychloroquine as a promising therapeutic for COVID-19, GILD traded at a local high of $85 per share, a price unattained since early 2018. Hours after Trump’s press conference, GILD dropped 8.7%, and then continued to plummet to $69 per share the following week—erasing $21 billion from its market cap in mere days. Immediately after Dr. Fauci announced the success of remdesivir in the NIH trial, GILD stock surged back to $85 per share. Compared to the largest pharmaceutical companies by revenue, Gilead has consistently outperformed in this pandemic with GILD gaining over 20% YTD while most of its competition struggled with losses or meager gains. This growth is almost certainly attributed to remdesivir’s promise as an effective treatment for COVID-19.”
Good point. iI should have stated, “I have seen no evidence that big pharma influenced the studies that showed hydrocholoquine is ineffective as you assert.”
If you look,at those studies, it is standard to disclose conflicts of interest. I doubt if Gilead (if you consider them big Pharma) is financing hydroxychlorquine studies, but have no desire to waste time researching it for you.
