The CardBoard
Chloroquine trials - Printable Version

+- The CardBoard (https://thecardboard.org/board)
+-- Forum: Emergency (https://thecardboard.org/board/forum-11.html)
+--- Forum: Covid-19 (https://thecardboard.org/board/forum-12.html)
+--- Thread: Chloroquine trials (/thread-19212.html)

Pages: 1 2 3 4 5 6 7 8 9

RE: Chloroquine trials - dabigv13 - 06-05-2020

Trump was very much an Anti-Vaxxer for a decade before becoming president. Perhaps that's one thing he can great credit for, he has actually somewhat changed his tune since becoming president. But he cultivated that part of his base for many years.

RE: Chloroquine trials - 76lsjumb - 06-05-2020

(06-05-2020, 08:45 PM)BostonCard Wrote:  Unfortunately, also not the first time the Lancet has retracted a controversial paper.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60175-4/fulltext

Pretty sure that for all his faults, Trump is not an anti-vaxxer (this was one of the papers purporting to find a link between vaccines and autism, and it remained in the Lancet for 12 years before being retracted).

BC

No, I think you're right.  That would be Robert F. Kennedy, Jr.
(06-05-2020, 08:49 PM)dabigv13 Wrote:  Trump was very much an Anti-Vaxxer for a decade before becoming president. Perhaps that's one thing he can great credit for, he has actually somewhat changed his tune since becoming president. But he cultivated that part of his base for many years.

So he must have read The Lancet... Who knew?

RE: Chloroquine trials - BostonCard - 06-05-2020

It goes both ways.  Trump supporters can’t seem to fathom that his opponents might be interested in the truth no matter whether it helps or hurts Trump.  Keep in mind that 2006alum was the first to report today’s job numbers even though they are unambiguously good for Trump.  I pointed out weaknesses in the hydroxychloroquine paper before the provenance of its data came under question, and I was the one who posted questions about the paper, the statement of concern, and then the retraction.  I actually would love for Trump to be proved right about hydroxychloroquine, because that would mean that doctors would have a cheap and relatively safe (QT issues aside) treatment for COVID-19.  I have defended the motives and methods of Ioannidis and Bhattarcharya, (and critiqued the conclusions when merited). I firmly believe you have to follow the science wherever it leads. And I have no doubt that the editors of the Lancet feel the same way, just as I don’t think the editors of JAMA are biased because they published the serology paper.  I think it is pretty ridiculous to think that the editors would sacrifice scientific integrity because... Trump.  The world does not revolve around him, and for those of us working to defeat COVID-19, the imperative is the thousands of people dying from it, full stop.  If hydroxychloroquine really were increasing the risk of death in patients with COVID-19, that’s an important finding.  It’s unfortunate that some studies were put on hold due to the results of the paper, doubly so because it might have relied on fraudulent data, but the opposite scenario (delay in publication leading to delay in finding a harmful effect of hydroxychloroquine would have been just as bad). Bottom line, especially in these fast moving and uncertain times, we cant let let politics bias our understanding of the facts. We just have to understand that in the rush to publish and disseminate knowledge about COVID-19 as quickly as possible, inevitably we will jump the gun on some things.  That we do so is not a problem, so long as we are able to self-correct when flaws are uncovered.

BC

RE: Chloroquine trials - 76lsjumb - 06-05-2020

(06-05-2020, 09:07 PM)BostonCard Wrote:  It goes both ways.  Trump supporters can’t seem to fathom that his opponents might be interested in the truth no matter whether it helps or hurts Trump.  Keep in mind that 2006alum was the first to report today’s job numbers even though they are unambiguously good for Trump.  I pointed out weaknesses in the hydroxychloroquine paper before the provenance of its data came under question, and I was the one who posted questions about the paper, the statement of concern, and then the retraction.  I actually would love for Trump to be proved right about hydroxychloroquine, because that would mean that doctors would have a cheap and relatively safe (QT issues aside) treatment for COVID-19.  I have defended the motives and methods of Ioannidis and Bhattarcharya, (and critiqued the conclusions when merited). I firmly believe you have to follow the science wherever it leads. And I have no doubt that the editors of the Lancet feel the same way, just as I don’t think the editors of JAMA are biased because they published the serology paper.  I think it is pretty ridiculous to think that the editors would sacrifice scientific integrity because... Trump.  The world does not revolve around him, and for those of us working to defeat COVID-19, the imperative is the thousands of people dying from it, full stop.  If hydroxychloroquine really were increasing the risk of death in patients with COVID-19, that’s an important finding.  It’s unfortunate that some studies were put on hold due to the results of the paper, doubly so because it might have relied on fraudulent data, but the opposite scenario (delay in publication leading to delay in finding a harmful effect of hydroxychloroquine would have been just as bad). Bottom line, especially in these fast moving and uncertain times, we cant let let politics bias our understanding of the facts. We just have to understand that in the rush to publish and disseminate knowledge about COVID-19 as quickly as possible, inevitably we will jump the gun on some things.  That we do so is not a problem, so long as we are able to self-correct when flaws are uncovered.

BC

It absolutely does go both ways, which is why, for example, I find quite a few of the commentators on Fox News just as frustrating and difficult to take as those on CNN.  Nevertheless, I don't believe whataboutism is a principled justification for a position.  And, unfortunately, it does seem to me that quite a few Trump opponents -- not including you, from what I've read -- are more interested in what hurts Trump than they are in the truth.

That 2006alum was the first to report today's good economic numbers wasn't lost on me [indeed, I double-checked to see who posted it since it really did catch me by surprise] ... but neither was the stream of posts thereafter questioning the numbers, expressing skepticism that things were really improving, interpreting them as evidence that the lockdown really wasn't so bad after all so all those folks complaining were probably wrong, and otherwise generally leaving a distinct impression that many of the posters were -- though they would likely never admit it -- kind of disappointed in the good news for the very reason you note -- if good things happen, the chances of Trump's defeat are lessened.

All that being said, I don't mean to imply everyone who appears obviously opposed to Trump falls into the "two wrongs make a right" category -- and, indeed, my impression from several of your comments, BC, is that you don't.  Your comment here regarding the possibility of Trump being proved right on hydroxychloroquine, for example, is one that I don't believe, based on what I've read, to be universally shared here.

Also, while I'm willing to accept that the editors of The Lancet "would not intentionally sacrifice scientific integrity because...Trump," that's not really my argument. My point -- "Too good to check" -- arises when someone is inclined to believe something because it aligns with what they want to be true, such that they don't spend the time and effort to subject it to the same amount of scrutiny that they would if they, for example, were trying to disprove it.  Actually, isn't that basically why scientific findings favorable to organizations that funded the research leading to such findings are treated with such skepticism in the scientific community?  

Finally, you mention the need to get things published quickly, and I understand that.  However, in an environment where it is a foregone conclusion that any study having anything to do with Trump is going to be immediately broadcast far and wide by the mainstream media [and twice as fast and loudly if it places him in a bad light], shouldn't there be an even greater effort made by scientific journals to verify accuracy and legitimacy before publishing, precisely to avoid this kind of thing?

You state: "Bottom line, especially in these fast moving and uncertain times, we cant let let politics bias our understanding of the facts."

I agree, although with the caveat that some of those "facts" are, themselves, political questions.  Science can tell you what may happen in certain situations, but it can't tell you, for example, that the risk of that happening is unacceptable in a 200-person church service but acceptable in a 10,000-person civil rights protest.  Is forbidding the first of those events on the basis of "science" while allowing [indeed, encouraging] the other on the basis of "civil rights" appropriate, or is it "letting politics bias our understanding of the facts"?

RE: Chloroquine trials - BostonCard - 06-05-2020

Now back to our regularly scheduled program evaluating the efficacy of hydroxychloroquine for COVID-19.

https://www.recoverytrial.net/news/statement-from-the-chief-investigators-of-the-randomised-evaluation-of-covid-19-therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19

The RECOVERY trial was one of several trials looking at multiple possible treatments for COVID-19 against placebo, in this case, in addition to hydroxychloroquine, they looked a:
[full disclosure, I work for the company that makes tocilizumab and thus cannot talk about it, but I was not involved in this study]

The full results of the analysis haven't been published. This was an interim analysis by the data safety monitoring board (DSMB), which will look at the data and can stop the trial or an arm of the trial early if there is either overwhelming evidence of benefit, or evidence of futility.  In this case, they stopped the hydroxychloroquine arm for evidence of futility.

Quote:‘A total of 1542 patients were randomised to hydroxychloroquine and compared with 3132 patients randomised to usual care alone. There was no significant difference in the primary endpoint of 28-day mortality (25.7% hydroxychloroquine vs. 23.5% usual care; hazard ratio 1.11 [95% confidence interval 0.98-1.26]; p=0.10). There was also no evidence of beneficial effects on hospital stay duration or other outcomes.

As much as I would love for hydroxychloroquine to work, accumulating evidence suggests that it does not.

BC
Should add, the DSMC for the WHO Solidarity trial also met, and it concluded that the hydroxchloroquine arm could resume and there was no need to halt the trial.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments

Quote:Originally posted 27 May 2020, updated 4 June 2020
Having met on 23 May 2020, the Executive Group of the Solidarity Trial decided to implement a temporary pause of the hydroxychloroquine arm of the trial, because of concerns raised about the safety of the drug. This decision was taken as a precaution while the safety data were reviewed by the Data Safety and Monitoring Committee of the Solidarity Trial. 
On 3 June 2020, WHO's Director-General announced that on the basis of the available mortality data, the members of the committee have recommended that there are no reasons to modify the trial protocol.

The Executive Group received this recommendation and endorsed the continuation of all arms of the Solidarity Trial, including hydroxychloroquine.

The Data Safety and Monitoring Committee will continue to closely monitor the safety of all therapeutics being tested in the Solidarity Trial.


BC

RE: Chloroquine trials - BostonCard - 06-15-2020

UPDATE: The FDA revoked the emergency use authorization for chloroquine and hydroxychloroquine.

https://www.fda.gov/media/138945/download

Quote:
  • We now believe that the suggested dosing regimens for CQ and HCQ as detailed in the Fact Sheets are unlikely to produce an antiviral effect.
  • Earlier observations of decreased viral shedding with HCQ or CQ treatment have not been consistently replicated and recent data from a randomized controlled trial assessing probability of negative conversion showed no difference between HCQ and standard of care alone.
  • Current U.S. treatment guidelines do not recommend the use of CQ or HCQ in hospitalized patients with COVID-19 outside of a clinical trial, and the NIH guidelines now recommend against such use outside of a clinical trial.
  • Recent data from a large randomized controlled trial showed no evidence of benefit for mortality or other outcomes such as hospital length of stay or need for mechanical ventilation of HCQ treatment in hospitalized patients with COVID- 19.

BC

RE: Chloroquine trials - BostonCard - 06-17-2020

So apparently, now the US is stuck with 66 million doses of stockpiled hydroxychloroquine.

https://www.businessinsider.com/hydroxychloroquine-us-surplus-fda-waiver-revoked-coronavirus-2020-6

I guess we will be well-prepared for the next malaria pandemic.

BC

RE: Chloroquine trials - BostonCard - 06-18-2020

The WHO now stopped their hydroxychloroquine arm of the solidarity trial:

https://www.who.int/docs/default-source/coronaviruse/transcripts/virtual-press-conference---17-june---covid-19.pdf?sfvrsn=548bb249_2

Quote:Today, just five minutes ago we finalised a call with all the investigators in the trial. On the basis of the evidence that is available to the investigators, to the secretariat, to the executive group and to the DSMC a decision was made to stop the randomisation with the hydroxychloroquine trial on the basis of two pieces of information; the first, the data that was published by the UK trial and second, the data that was available to us from the Solidarity trial. I will stop here.

BC

RE: Chloroquine trials - BostonCard - 06-20-2020

And now Novartis is halting its trial of hydroxychloroquine:

https://www.reuters.com/article/us-health-coronavirus-novartis-hydroxych/novartis-halts-malaria-drug-trial-against-covid-19-amid-participant-shortfall-idUSKBN23Q3BC

Quote:ZURICH (Reuters) - Swiss drugmaker Novartis (NOVN.S) is halting its trial of malaria drug hydroxychloroquine (HCQ) against COVID-19 after struggling to find participants, it said on Friday, as data emerged from other studies raising doubts about its efficacy.

BC

RE: Chloroquine trials - Nan3cy - 06-20-2020

(06-17-2020, 11:48 AM)BostonCard Wrote:  So apparently, now the US is stuck with 66 million doses of stockpiled hydroxychloroquine.

https://www.businessinsider.com/hydroxychloroquine-us-surplus-fda-waiver-revoked-coronavirus-2020-6

I guess we will be well-prepared for the next malaria pandemic.

BC

And the people with lupus won’t have to worry about supply. (Or is the other one that people take for lupus? Can’t remember.)

RE: Chloroquine trials - BostonCard - 06-20-2020

Hydroxychloroquine is the one most commonly taken for lupus.

Chloroquine is the one most commonly taken as malaria prophylaxis (in regions of the world where malaria is susceptible).

They are very related compounds.

BC

RE: Chloroquine trials - BostonCard - 06-22-2020

It's the end of the road for chloroquine/hydroxychloroquine for COVID-19.

https://www.fiercepharma.com/pharma/end-road-for-hydroxychloroquine-covid-19-as-novartis-nih-and-who-pull-out-trials

All the major trials are being stopped.  I already mentioned Novartis pulling out; now the NIH and WHO have stopped their trials.  There will be some small trials going forward, and the results of the large trials will still need to be reported in full.  But it is clear that quinine derivatives are not a game changer, and that the President's comments probably diverted attention and resources from other, potentially more worthy, treatments.

Here's the NIH's press release:

https://www.nih.gov/news-events/news-releases/nih-halts-clinical-trial-hydroxychloroquine

Quote:The data from this study indicate that this drug provided no additional benefit compared to placebo control for the treatment of COVID-19 in hospitalized patients.

BC

RE: Chloroquine trials - M T - 06-30-2020

(06-22-2020, 10:44 AM)BostonCard Wrote:  It's the end of the road for chloroquine/hydroxychloroquine for COVID-19.

Here's the NIH's press release:

https://www.nih.gov/news-events/news-releases/nih-halts-clinical-trial-hydroxychloroquine



Quote:The data from this study indicate that this drug provided no additional benefit compared to placebo control for the treatment of COVID-19 in hospitalized patients.
(I made one phrase above bold.)

It appears to me that HCQ+AZ is still being studied as a outpatient treatment.  This paper published late May, urging the need for early outpatient treatments, seems to make a reasonable study-based argument for the potential efficacy and safety (versus not giving the drug) of HCQ+AZ unless contraindicated.   The 4 outpatient studies it lists in its appendix appear to all still be on track, if I correctly understand ClinicalTrials.gov.  3 of those involve HCQ+other drugs (all 3 include AZ).  The 4th study does not involve HCQ.

RE: Chloroquine trials - JustAnotherFan - 07-03-2020

So this is making the rounds on social media.

https://www.henryford.com/news/2020/07/hydro-treatment-study

RE: Chloroquine trials - BostonCard - 07-03-2020

(07-03-2020, 01:03 PM)JustAnotherFan Wrote:  So this is making the rounds on social media.

https://www.henryford.com/news/2020/07/hydro-treatment-study

Thanks for sharing.  Here’s the article:

https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

It is not a randomized study, although I will note that typically the biases (confounding by indication) work against the intervention.  One would still put more stock in a randomized trial, but thanks for sharing.

BC

RE: Chloroquine trials - JustAnotherFan - 07-03-2020

(07-03-2020, 01:56 PM)BostonCard Wrote:  
(07-03-2020, 01:03 PM)JustAnotherFan Wrote:  So this is making the rounds on social media.

https://www.henryford.com/news/2020/07/hydro-treatment-study

Thanks for sharing.  Here’s the article:

https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

It is not a randomized study, although I will note that typically the biases (confounding by indication) work against the intervention.  One would still put more stock in a randomized trial, but thanks for sharing.

BC

I will just add that it's being posted as a political argument to say that this is proof Trump was right all along. It's forever tied to Trump, for better or worse. And everything only has value in relation to whether it makes Trump look good or bad.

RE: Chloroquine trials - BostonCard - 07-07-2020

https://www.bnnbloomberg.ca/trump-touting-hydroxychloroquine-again-despite-fda-warning-1.1461688

I guess we are back to touting unproven therapies.

BC

RE: Chloroquine trials - lex24 - 07-07-2020

(07-07-2020, 01:49 PM)BostonCard Wrote:  https://www.bnnbloomberg.ca/trump-touting-hydroxychloroquine-again-despite-fda-warning-1.1461688

I guess we are back to touting unproven therapies.

BC

Did we ever stop?

RE: Chloroquine trials - magnus - 07-08-2020

The Brazilian president said he was using it.

RE: Chloroquine trials - magnus - 07-09-2020

(07-08-2020, 02:18 AM)magnus Wrote:  The Brazilian president said he was using it.
Not just said,  but advertising his use on social media. 

https://apnews.com/66a86e4cccf4e94ea75a8eedd92afeb3

I guess if he recovers,  it'll give him that much more proof of its effectiveness and of his stance that the coronavirus is just another flu.

Talk about betting on oneself.
In other news, the South Dakota governor was hugging Trump Jr's girlfriend a day before the gf was announced as positive. That next evening, the governor apparently took a flight on Air Force one and chatted with Trump Sr without a mask.  (She had tested negative  before Trump arrived at Mt Rushmore)

https://apnews.com/743c0b135cf849c3c6df312a9d02b9ad

Did WH staff know she had close contact?  Seems risky to let her close to the president even with a negative test.   Or I wonder now if Trump will start taking hydroxychloroquine, just in case.