[BostonCard]

Lex referred to this professor in this thread: https://thecardboard.org/board/showthrea...hloroquine

Here is his article in AJE.

The editorial was written in May.  As I noted, since May when the epidemiological articles came out, multiple randomized, placebo controlled trials of HCQ ± Azithromycin in a variety of settings of COVID-19 have come out, all of them showing no effect.  There is always a possibility that the negative results are due to the fact that the wrong population was sampled (too severe or too mild disease to benefit), or that it wasn't given at the right time (too soon, or too late).  However, my experience is that when multiple studies across a spectrum of disease and in a variety of settings are negative, it would not be compatible with a whopping effect in a particular subgroup or a particular setting.  At best the drug is of very limited benefit in a certain population in a particular setting, but most likely, hydroxychloroquine probably doesn't work for COVID-19.

Here is a recent systematic review of hydroxychloroquine ± azithromycin for COVID-19:

https://pubmed.ncbi.nlm.nih.gov/32683212/

Low and moderate risk of bias studies suggest that treatment of hospitalized COVID-19 with CQ/HCQ may not reduce risk of death, compared to standard care. High dose regimens or combination with macrolides may be associated with harm. Postexposure prophylaxis may not reduce the rate of infection but the quality of the evidence is low.

The drug isn't going unusued because of political considerations; it is going unused because it doesn't seem to work.  That's nothing personal against HCQ.  Most drugs don't work.  The likelihood of success of a drug entering clinical trials is 15% at best.  There are lots of very promising drugs that work in vitro, or in mice, or in theory, or in small observational studies, that don't work in randomized, placebo controlled studies.  I long ago learned not to get too attached to a particular program.

BC

[BostonCard]

Lex referred to this professor in this thread: https://thecardboard.org/board/showthrea...hloroquine

Here is his article in AJE.

The editorial was written in May.  As I noted, since May when the epidemiological articles came out, multiple randomized, placebo controlled trials of HCQ ± Azithromycin in a variety of settings of COVID-19 have come out, all of them showing no effect.  There is always a possibility that the negative results are due to the fact that the wrong population was sampled (too severe or too mild disease to benefit), or that it wasn't given at the right time (too soon, or too late).  However, my experience is that when multiple studies across a spectrum of disease and in a variety of settings are negative, it would not be compatible with a whopping effect in a particular subgroup or a particular setting.  At best the drug is of very limited benefit in a certain population in a particular setting, but most likely, hydroxychloroquine probably doesn't work for COVID-19.

Here is a recent systematic review of hydroxychloroquine ± azithromycin for COVID-19:

https://pubmed.ncbi.nlm.nih.gov/32683212/

Low and moderate risk of bias studies suggest that treatment of hospitalized COVID-19 with CQ/HCQ may not reduce risk of death, compared to standard care. High dose regimens or combination with macrolides may be associated with harm. Postexposure prophylaxis may not reduce the rate of infection but the quality of the evidence is low.

The drug isn't going unusued because of political considerations; it is going unused because it doesn't seem to work.  That's nothing personal against HCQ.  Most drugs don't work.  The likelihood of success of a drug entering clinical trials is 15% at best.  There are lots of very promising drugs that work in vitro, or in mice, or in theory, or in small observational studies, that don't work in randomized, placebo controlled studies.  I long ago learned not to get too attached to a particular program.

BC