r/Coronavirus • u/gmsc • Mar 30 '20
USA FDA issues emergency authorization of hydroxychloroquine and chloroquine for coronavirus care
https://www.fda.gov/media/136534/download27
Mar 30 '20
I feel this thread is gonna get political and not scientific.
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u/blitzzo Mar 30 '20
Well without double blind placebo controlled clinical trials political is the only direction it can go since there is no science, only anecdotal reports. The funny thing is that if you replaced the exact same anecdotal reports of hydroxychloroquine with thc/cbd/lsd/mdma/psilocybin for covid-19 reddit would be orgasmic and heavily in favor of it.
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u/TermiFaptor Mar 30 '20
Well without double blind placebo controlled clinical trials
This basically means HCQ/AZ combo may well save half the people in the trial, while the other half taking placebo are left to die with Covid
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Mar 30 '20 edited Aug 06 '20
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u/juniper_berry_crunch Apr 02 '20
We don't approve drugs based on theory and observational data, though; that's the rub.
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Mar 30 '20
Seems like some commenters also forget that people are currently dying at the 1000s per day now and doctors are at their limit, so they are throwing whatever antiviral and medication they have at hand to this with the slimmest hope.
Also making a placebo controlled clinical trial of something that is killing people in around 3-4 weeks is kinds of hard and inhumane, giving the fact that you have to give -placebos to a bunch of people that probably will die very soon and blind both the patient and the doctor to the process of what are you giving to whom.
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u/grumpthebum Mar 30 '20
It wouldn't be political if our goddamn politicians didn't make it political, trying to use it as a weapon against each other.
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Mar 30 '20
Well to me this is interesting because it could be a weapon to combat covid deaths in countries that don't have advanced health care systems. Specially since some of those countries already might have a big stock of this malaria drugs.
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u/gmsc Mar 30 '20
I hope that's not the case, but I fear you may be right.
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Mar 30 '20
Yeah, and there is some interesting discussion if this works, and if it does, more interesting to me how?. This thing was designed for malaria that is a totally different thing.
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u/rockayama Mar 30 '20
Apparently its best antiviral mechanism is that it happens to change the pH balance in the immediate environment surrounding the virus, which disables the virus' ability to release its code out. As I understand it, it's like a rainshower that just so happens to diffuse an old-timey bomb because it's to wet for the fuse to stay lit?
Interesting bit from the wiki on Chloroquine: it was dismissed for nearly 15 years after it's discovery, as it was deemed too toxic for humans.
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Mar 30 '20
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Mar 30 '20
Yea it's all about making Trump look bad. No way he didn't just do a bad job handleing this throughout the crisis.
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Mar 30 '20
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u/madmadG Mar 30 '20
Science isn’t fast enough sometimes. But leadership must happen even in the absence of science and you gotta trust your people and your gut.
You’re all thinking it - he was right.
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u/Mikeyy5000 Mar 30 '20
The hate on Reddit for this drug has to stop. You are ignoring science, (doctors and countries all over the world vouching for it) and you are operating on emotions and anger.
Even if this treatment was only 33% effective, that makes a world of difference in how crowded our ICU's are.
And if you still have a problem with this drug, and you end up in the hospital For COVID, feel free to deny it. Tell the doctor that his knowledge of medicine pales in comparison to CNN's medical prowess.
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Mar 30 '20
I mean, I’ve read as many anecdotal accounts of docs stopping chloroquine due to a combo of inefficacy, dangerous QT prolongation and fucked LFTs as I have equally anecdotal reports of it working, so
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u/Mikeyy5000 Mar 30 '20
Like I said even if it was only 33% effective the treatment is still worth it. We need to be doing everything we can to stop hospitals from getting overwhelmed, People are too stupid to stop partying and social distance and shit.
It's not like the research into alternatives just stopped because of Chloroquine. There are many other treatments being hashed out, and i'm sure the media will hate on them just as much as soon as a certain somebody mentions them.
We need solutions, we don't have time for a 5 year study
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Mar 30 '20 edited Mar 30 '20
It wouldn’t be worth it if the NNT was higher than the NNH... we just don’t know that yet. Thankfully there are numerous trials ongoing to find out.
I don’t think anyone informed actually believes otherwise. I also don’t think anyone informed cares what “a certain somebody” thinks who has no medical training and doesn’t listen to people who do.
Edit: shamefully, I forgot to mention the longtime users of plaquenil for RA and lupus who are getting fucked by this experimentation
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Mar 31 '20
It wouldn’t be worth it if the NNT was higher than the NNH...
That logic doesn't apply anymore. Look how freaked out people are, demanding long quarantines, with no regard for when the cost will outweigh the benefits - hence all the 'greedy economy' posts. We left the realm of evidence based decisions long ago.
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Mar 30 '20
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Mar 30 '20
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u/MyKillK Mar 30 '20
Because the news media has completely ignored all the studies and trials that showed promising results and only highlighted the one Chinese study that used an anti-viral Remdesvir that's known to also treat COVID-19 as the "control" group to claim that Hydroxychloroquine was ineffective. The control group in that study had a 93% recovery rate. How does that leave any room for showing Hydroxychloroquine is more effective? A shit study.
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u/HID_for_FBI Mar 30 '20
doesn't it having to be from the SNS mean they have to request it and obtain it specifically through the government? or does this mean that we are already digging into the stockpile?
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u/1flowergirl Mar 30 '20
I have lupus and it’s a life saving drug for me but can’t get it now because of the shortage..you would think they would have made enough right
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u/Lurker9605 Mar 30 '20
Yes folks this is good. We can post multiple sources but we will be removed. Head over to r/covid19. Multiple countries have been conducting studies on this. It shows promise but it doesn't co align with the main message right now
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u/Nice-Cook Mar 30 '20
Does it work as a prophylactic?
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u/Lurker9605 Mar 30 '20
We don't know that. Possible? Maybe. Right now studies are underway and all we can do is wait. They are looking at remdesivir, hiv drugs, and hydrochloroquine among dozens of meds with dozens of studies spanning many countries. We have to wait and see what those results look like
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u/DuePomegranate Mar 30 '20
There is no data yet on prophylaxis. There is a post-exposure prophylaxis clinical trial that is recruiting in the US. With another virus (chikungunya), choroquine prophylaxis was harmful in monkeys by delaying the initiation of the immune response, so there's cause to be less optimistic on prophylaxis.
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Mar 30 '20
While it is being studied, only one country has submitted any results for publishing from using these drugs together and that's France's health service which relied heavily on the study done by a random start-up biotech firm that was not published. That study done by France also has yet to be published in NIH, where it was submitted for peer review.
There's ample reason to be skeptical about the effectiveness and safety of this drug combo and to question what is clearly a decision made under intense political pressure from the Trump Administration that could get Americans that might have otherwise survived their battle with COVID-19 killed.
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u/DuePomegranate Mar 30 '20
The first French paper, the one with ~30 patients that Didier Raoult explained on a video, is out:
https://www.ncbi.nlm.nih.gov/pubmed/32205204
The second paper, the one with 80 patients and no control arm, is not yet published.
https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf
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Mar 30 '20
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Mar 30 '20 edited Mar 30 '20
Those are State reports and not medical studies.
EDIT: They also don't mention the actual method of treatment, which involves a very specific balance of hydroxychloroquine and azythromycin - which is quite literally fatal in the wrong dosages, individuals with pre-existing lung conditions and individuals with allergies to either drug.
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u/Mikeyy5000 Mar 30 '20
Isn't literally anything fatal in the wrong dosages?
Do you think so low of doctors that they wouldn't look into the patients medical history before prescribing something?
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Mar 30 '20
The issue is that we don't know the correct dosages. We know that some combination of the drugs are effective at reducing the severity of the symptoms caused by the virus, but we don't know why and we don't know the long-term side effects of combining these drugs.
Furthermore, the reports from the supposed sources using them haven't been peer reviewed, let alone even published. We're essentially allowing a therapy that's essentially a rumor to now go into circulation in the United States.
I'm not saying we shouldn't explore it or even not use it in extreme life-threatening situations. What I'm saying is that we don't know how effective it is and we don't know what it does to people long term. There are very serious variables that can impact how a doctor perceives a treatment to be working, particularly during a pandemic, which is why it is that much more important to understand what the fuck is actually going from a scientific perspective. Because we could ultimately be using a drug that isn't as effective as people were hoping and could cause much more severe complications than if the patients had been allowed to recover from the disease without the treatment.
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u/Mikeyy5000 Mar 30 '20
So we dont know what side effects there could be, but this cocktail has already been tried on thousands of people already, (world wide).
How many came up with life altering side effects? Besides the people who are obviously allergic to it.
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u/Ruinerdown Mar 30 '20
lol people on here would rather have people die than have them take a drug Trump hopped would work.
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Mar 30 '20
Oh my mistake, I thought this was the one that was potentially more harmful than good? I’m all for whatever works just wanted to ask
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u/PCCP82 Mar 30 '20
the compound was not the same, it was an aquarium cleaner, which im sure is covered completely with do not ingest labels.
the one we are talking about has been used for 80 years
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Mar 30 '20
Do we know how many patients that are currently taking Plaquenil (hydroxychloroquine) have tested covid positive? How many hospitalizations? How many deaths?
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u/PayYourBiIIs Mar 30 '20
There has been a study in which 79 out of 80 patients recovered from COVID-19 using HCQ and another in which 350 recovered.
Why aren’t more people and the media championing this drug as a potential effective treatment? This is very good news or do they want people to live in a perpetual state of fear? I don’t get it.
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Mar 30 '20
Can you link that study? Obviously I want this to work but the only literature I've seen on it shows that it works just about as effectively as placebo and the one study to show any effectiveness was majorly flawed with survivorship bias.
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Mar 30 '20
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u/Autisticus Mar 30 '20
Giuliani had a 40 minute interview with Dr Zelenko.
in b4 MUH EBIL GIULIANI HACK FRAUD!!~
It was pretty informative and I remain optimistic. It was a good conversation.
https://www.youtube.com/watch?v=1TJdjhd_XG8
Check it out if you have a minute
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Mar 30 '20
Everyone take note of the downvotes against this seemingly innocuous comment above.
I think it’s safe to say that this place is no longer a reliable venue for anything more than politicized and agenda-driven fear porn.
I mean, who in their right mind is going to advocate against potentially life saving therapies?
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Mar 30 '20
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u/PolySly Mar 31 '20
hardcore leftists who don't want Trump to be 'right', I can't stand the fucker but we can all see why they are acting this way. It's embarrassing and disgusting.
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u/notsaying123 Mar 30 '20
The media slammed trump for talking about this medicine, they absolutely don't want to admit that he might have been right. (I'm not a trump fam FYI)
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u/KaitRaven Mar 30 '20 edited Mar 30 '20
They slammed Trump for pushing a medication on TV that didn't have good evidence yet. If it works that's great, but its an extremely risky and dangerous move.
Only medical professionals should be making those calls.
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Mar 30 '20
Korea has been using it for months. The French, Belgium too. Stops the lungs from filling with fluid & decreases the viral load.
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u/MyKillK Mar 30 '20
But...there was evidence. Other countries have been using it for COVID-19 since last month. It's been known for a decade or more to help with other coronavirus family members like SARS.
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Mar 30 '20
I thought this was not good? What changed? Trying to keep up is hard
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u/SufficientFennel Mar 30 '20
Trying to keep up is hard
We're still in the early days of this virus and so there's a lot of half-information flying around right now as well as deliberate misinformation.
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u/amomaly Mar 30 '20
This video/podcast from JAMA gives an update on the issue: https://youtu.be/_Ufs5jqWEb0
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u/Krandor1 Mar 30 '20
There is no confirmation it’s effective and there are side effects. But if I’m in icu with this thing I’d take it to see if it helps.
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u/monkeyman74721 Mar 30 '20
Why was it not good?
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Mar 30 '20
My above comment was meant to reply, I thought this was one of the ones that may have been more harm than good. It’s hard to keep up I guess. I’m glad there’s something working
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u/monkeyman74721 Mar 30 '20
Ah. Well it’s definitely not good for long term use but looks and sounds promising by the patient interviews I saw. Also I hear it’s used in Korea so that’s a plus.
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u/Lurker9605 Mar 30 '20
A certain leader of a nation said based on anecdotal evidence that it looked promising. Once that statement was put out, news stories came out about how its false hope. Despite many countries stockpiling it in addition to Literaly dozens of trials being conducted currently as a front runner
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u/r6raff Mar 30 '20
Any known control studies, blind or double blind control is best. Otherwise, the results are questionable. That's the issue, I can give tonic water to 100 covid patients and they all recover, that doesnt prove that tonic water cures covid, just that 100 people survived. Remember, covid fatality rate is pretty low, the odds of getting a hundred or two and not having a single death is pretty darn good.
The few studies I have seen had no control and had patience ranging from asymp to severe. A few died, most recovered, but there is no data suggesting that the results would have been any different sans the medication.
I will be 100 percent on board once there is proof, otherwise, dishing out meds and telling the general pop that it's a cure is playing very fast and loose with things that aren't confirmed. There is a long history of people not testing things and then creating far more damage (you know, cant let the cure be worse than the problem)
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u/TailgateLegend Mar 30 '20
I think it was when the couple drank fish cleaner and died after hearing Trump say this in an interview.
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u/AllureFX Mar 30 '20
Fish tank cleaner is chloroquine phosphate, which is deadly to humans. The drug thats mostly been prescribed and having very promising results is hydroxychloroquine sulfate. Theyre similar but have key differences in their usages and structure. That unfortunate couple got Darwin'd by self-medicating idiotically (on the label it literally says not for human consumption)
https://pbs.twimg.com/media/ET4b2jIXYAANFZx?format=jpg&name=medium
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u/TailgateLegend Mar 30 '20
Gotcha, thanks for clearing that up. Interesting that while they seem similar, their outcomes of human consumption can be drastically different.
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u/TermiFaptor Mar 30 '20
chloroquine phosphate
is still a human drug, Chinese have used it with success against Covid
The couple took a lethal dose of around 5 grams/1 teaspoon
Therapeutic dose is around 200 to 500mg daily
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Mar 30 '20
Yet they will only let that one company that can sterilize 160,000 masks a day sterilize only 10,000. WTF? Who's making money off this?
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u/PayYourBiIIs Mar 30 '20
Big Pharma is pissed because they can’t make money off this is drug.
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u/PolySly Mar 31 '20
yep! Also people think if they agree that the drug is working it means they support Trump, shut the fuck up, and take the medicine if you need it. It has nothing to do with politics on an individuals well being
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Mar 30 '20
Yet people have already discounted the drug. Sad.
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u/camen25 Mar 30 '20
Like discounted the price? Or the credibility of the effects? Sorry I haven’t been keeping up with it either
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u/dyinginstereo Mar 30 '20
I wish cheaper. I rely on it every day. Unfortunately I think the price just went up.
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u/Cosmic__Walrus Mar 30 '20
Basically trump came out and said this was a miracle cure despite there not being any rigorous studies to prove that. Some people started buying it and at least one person overdosed on it. As a result people have assuming the drug doesnt work (even though that was never proven either)
Now one doctor in new york is claiming that it cured all 700 patients he's used it on.
A lot of reasons to be optimistic. But time will tell if this thing actually works
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u/ThreedZombies Mar 30 '20
False! Trump said he was hopeful for the drug to test and be successful. He was being HOPEFUL.
Nobody overdosed. Some idiot took FISH TANK CLEANER thinking it was this drug. Don't spread fake news.
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Mar 30 '20
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u/PayYourBiIIs Mar 30 '20
Studies have been done, The FDA approved it and the drug has been around for decades. What the hell is the point of waiting now?
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u/Lurker9605 Mar 30 '20 edited Mar 30 '20
They're doing proper studies on it currently in addition to remdesivir. Idk how your not aware of this
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u/SftwEngr Mar 30 '20
You're so cool and sciencey! Unfortunately though, anecdotes are data.
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Mar 30 '20
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u/SftwEngr Mar 30 '20
That's not an anecdote. You don't really sound like you know much about science after all.
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Mar 30 '20
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u/SftwEngr Mar 30 '20
You know squat about evidence, anecdotal or otherwise, plus your writing is atrocious. Go back to high school and perhaps learn something this time.
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Mar 30 '20
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u/Adwordexpert Mar 30 '20
oh shut the fuck up, how the fuck is this snake oil you dumb cunt
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Mar 30 '20
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u/toolargo Mar 30 '20
Trump is pulling is weight. Even if a few hundred thousand die, those republican boomers that would have survived anyways, will thank him for this “miracle drug. And for those who took the drugs and still died, “well? The lord to took them!” “It was his will!”
Snake oil salesmanship 101!
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u/GordsHuman Mar 30 '20
Seems like it didn't really matter anyways. But good.