New study on Hydroxychloroquine for Covid: No benefit in non-critical hospitalized New study on Hydroxychloroquine for Covid: No benefit in non-critical hospitalized - Page 3 - Talk of The Villages Florida

New study on Hydroxychloroquine for Covid: No benefit in non-critical hospitalized

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  #31  
Old 04-15-2020, 11:36 AM
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Tom Hanks and his wife took it. Hmmm......
I watched her interview. Her symptoms were worse than Tom’s. She didn’t say anything about if he took it, only about her bad reactions to the drug.
I’m only saying this because, it is an option. It is not totally proven. It is a prescription medicine. Don’t demand. Ask. Ask if this is an option for you.
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Old 04-15-2020, 11:47 AM
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I watched her interview. Her symptoms were worse than Tom’s. She didn’t say anything about if he took it, only about her bad reactions to the drug.
I’m only saying this because, it is an option. It is not totally proven. It is a prescription medicine. Don’t demand. Ask. Ask if this is an option for you.
Yep
Link to clinical trials,

Search of: Covid-19 - List Results - ClinicalTrials.gov
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  #33  
Old 04-15-2020, 11:47 AM
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Did you see Tom Hanks wife, Rita, telling what she experienced? Nauseous and couldn’t walk. Did it help??? Point being let the studies play out, it’s been such a short time and the best of the best, and all the rest, worldwide are working on it.
Weakness with difficulty walking and nausea are symptoms of the Wuhan virus, not necessarily from hydroxychloroquine.
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  #34  
Old 04-15-2020, 12:08 PM
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I will continue to post updates to TOTV on both positive and negative outcomes.

Sure you will. Your two threads on hydroxychloroquine

New study on Hydroxychloroquine for Covid: No benefit in non-critical hospitalized

New study on Hydroxychloroquine with Azithromycin, failure

I see a trend here.
You are absolutely correct about that. The trend is that the recent are showing no benefit. That trend may reverse or may not. You posted that I have omitted positive results and posted a study details. I then showed you that I did post about that study in detail. And I have posted about the initial French study. I am not saying there may not be more studies I may have missed. That is going to happen if it has not already.

When a new study appears that shows benefit I now promise you I will start a new thread rather than include that study in an existing thread. Does that make you happier?

I would like HCQ to work. It is cheap, it is mostly available, it is generic, its side effect profile is well known, the specific monitoring needs are established. You don't seem to believe that is my hope, but it is. IMO it is being promoted as a near certain cure by one segment of our country without science based evidence to support that near certainty. When someone says I hear this works, it's great, you should take this, then perhaps throws in a maybe, maybe not, that is not a balanced presentation. That's an endorsement with a caveat.
The science is not endorsing this drug with or without other medications. And talking heads on TV or online should not be suggesting that the science is clearly pointing in one direction, or the other. I will continue to look for studies. I don't know the best evidence conclusion yet. I welcome your continued input. I look forward to you perhaps even finding and posting a negative result once.

Remember when you used to hear the phrase "fair and balanced" I think my approach re HCQ has been both. YMMV
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Old 04-15-2020, 02:44 PM
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It is indeed a sad commentary on our times that, based on the comments and replies here, one's approach to medical information is based on one's tribal loyalties s to either Trump or not Trump.
  #36  
Old 04-15-2020, 03:18 PM
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You are absolutely correct about that. The trend is that the recent are showing no benefit. That trend may reverse or may not. You posted that I have omitted positive results and posted a study details. I then showed you that I did post about that study in detail. And I have posted about the initial French study. I am not saying there may not be more studies I may have missed. That is going to happen if it has not already.


When a new study appears that shows benefit I now promise you I will start a new thread rather than include that study in an existing thread. Does that make you happier?

I would like HCQ to work. It is cheap, it is mostly available, it is generic, its side effect profile is well known, the specific monitoring needs are established. You don't seem to believe that is my hope, but it is. IMO it is being promoted as a near certain cure by one segment of our country without science based evidence to support that near certainty. When someone says I hear this works, it's great, you should take this, then perhaps throws in a maybe, maybe not, that is not a balanced presentation. That's an endorsement with a caveat.

The science is not endorsing this drug with or without other medications. And talking heads on TV or online should not be suggesting that the science is clearly pointing in one direction, or the other. I will continue to look for studies. I don't know the best evidence conclusion yet. I welcome your continued input. I look forward to you perhaps even finding and posting a negative result once.

Remember when you used to hear the phrase "fair and balanced" I think my approach re HCQ has been both. YMMV
Yes, that will make me happy. In your comment about the Chinese study with control group, you Implied it didn't mean anything because other drugs were involved. Pretty much every study involves a cocktail of drugs. The difference from the two groups was HCQ, and the HCQ group did better, no deaths, faster improvement.

Do you actually think because you know who said things like "It may or may not work" "I'm not a doctor" and "I may take it, I'll have to ask my doctors" that 1000s of Doctors are now prescribing HCQ in combination with other drugs all over the world? That's basically saying all these doctors actually treating covid 19 are complete dummies.
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Old 04-15-2020, 04:20 PM
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In your comment about the Chinese study with control group, you Implied it didn't mean anything because other drugs were involved. Pretty much every study involves a cocktail of drugs. The difference from the two groups was HCQ, and the HCQ group did better, no deaths, faster improvement.
In every study both positive and negative I look for confounding factors The referenced study from China never informs the reader how the other treatments were distributed between the control and drug arms. Most other studies include that information, not all. Your note about no deaths is striking as it would lead the reader to be misled as it implies there were no deaths in the HCQ arm as a difference. I'd gently point out there were no deaths in the control arm either. None of the patients in the study had died in either group. The only significant differences between the treated and the control groups were as listed by the authors:

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Compared with the [17 patients] control group [3.2 (1.3) days], the body temperature recovery time was significantly shortened in the HCQ [22 patients] treatment group [2.2 (0.4) days].
This means the treated group had one fewer day of fever. The authors did not show the statistical measures used to see if this was significant. Most papers give a p value or similar measure and a confidence interval. There are none in the paper given although the authors state an analysis was done.

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For cough, 15 patients in the control group and 22 patients in the HCQ treatment group had a cough in day 0, The cough remission time was significantly reduced in the HCQ treatment group.
The authors do not provide the data they measured for this outcome. Perhaps the treated group had more patients on steroids or inhalers.
Because the allocation of the other medications is not given and the authors did not anywhere indicate that other medications were equally distributed between the arms, it is not certain from the results presented whether the HCQ was the only variable between the arms. I believe, you don't, that my presentation of the findings was fair.

A new study just reported, you can start a thread if you like as I'll not be doing it today

https://www.medrxiv.org/content/10.1...558v1.full.pdf
  #38  
Old 04-15-2020, 06:52 PM
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And what does that prove to you? Science is not advanced by anecdotes. Over 80 patients took it in the above study without benefit. The evidence is still murky. It may help - it may hurt it - may do nothing. The important part of a negative report it that it disproves the claim that HCQ is a miracle that will benefit a large percentage of the ill people who receive it. That part is clearly wrong in the patient population studied. If it helps some, that evidence is not yet established or disproven.
Wrong. Science often advances first from anecdotal evidence. Often medical and scientific advances are found after information comes in about something unexpected that is working for a problem. It can be a complete surprise but it works! Afterward it can be put into testing and proof. History abounds with this type of advancement.
  #39  
Old 04-15-2020, 07:28 PM
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I am not saying that HCQ with or without other therapeutics is of benefit or not. I am just reporting every study I can find.

This is from France. They looked back at the records from 4 hospitals of all patients who were ill enough to be admitted and required oxygen help, but not ICU ill at the time of admission. Then they analyzed the hospital course comparing those who did vs did not get HCQ. The patients were not randomized but the authors used the records to check whether the treated vs the untreated patients differed on admission in several ways.

Interestingly "All comorbidities were less frequent in the HCQ group." This would mean that the likelihood of progressing to severe illness would theoretically be higher in the NOT treated group as they had more comorbidities. The differences were trends, not significantly different.

84 patients received HCQ, 97 did not receive HCQ.


None of these are significant differences. See the article for full statistical analysis.

This study showed no benefit on any of the measures examined. This is limited to patients admitted with an oxygen requirement but not ICU ill on admission.

You can read the details HERE. Note this is pre-publication and not yet peer reviewed.
Doctor,

Have you heard about a "positional" therapy for people with pneumonia that has them placed on their stomach? I heard the tale end of this discussed and I don't know whether it is ever used or not and wonder how it would help. I can't find much when I google and there are so many wild ideas floating around about treatments for Covid-19. I thought I would ask an expert.
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Old 04-15-2020, 11:01 PM
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Doctor,

Have you heard about a "positional" therapy for people with pneumonia that has them placed on their stomach? I heard the tale end of this discussed and I don't know whether it is ever used or not and wonder how it would help. I can't find much when I google and there are so many wild ideas floating around about treatments for Covid-19. I thought I would ask an expert.
The positional information relates mostly to studies that have been done to examine whether patients do better on their back [supine] or on their belly [prone]. The evidence in patients with ARDS [acute respiratory distress syndrome which is the lung failure from Covid pneumonia and other causes] is that they do better on the belly.

If you go to the middle of this document from Mass General you can see the recommendation
And HERE is the statement from the Intensive Care Society which has many references and the explanation of the mechanical and physiologic advantages of being place on the belly in ARDS.
  #41  
Old 04-16-2020, 02:26 AM
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Wow, just keep shaking my head at this one! I get blueash...he's a research, fact-based, by the book professional and we're fortunate to have his insight. But, I'm watching video after video of doctors ON THE FRONT LINE saying there's NO approved therapy or cure so they're left to try to figure out the best therapy while their patients die. Hmmm, I truly believe if Trump touted tap water as beneficial, many would line up to call him crazy, urging an unproven, even dangerous (if too much consumed) therapy with unproven side-effects!

How about we let the doctors IN THE TRENCHES decide the best therapy until the study results are known. I cannot help but think the P-word has unfortunately reared its head in the utilization of the drug. Until then... my gut will always favor the THOUSANDS of doctors in the hundreds of ER's using this drug until a therapy is proven and established.
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Old 04-16-2020, 08:06 AM
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Originally Posted by B767drvr View Post
Wow, just keep shaking my head at this one! I get blueash...he's a research, fact-based, by the book professional and we're fortunate to have his insight. But, I'm watching video after video of doctors ON THE FRONT LINE saying there's NO approved therapy or cure so they're left to try to figure out the best therapy while their patients die. Hmmm, I truly believe if Trump touted tap water as beneficial, many would line up to call him crazy, urging an unproven, even dangerous (if too much consumed) therapy with unproven side-effects!

How about we let the doctors IN THE TRENCHES decide the best therapy until the study results are known. I cannot help but think the P-word has unfortunately reared its head in the utilization of the drug. Until then... my gut will always favor the THOUSANDS of doctors in the hundreds of ER's using this drug until a therapy is proven and established.
I don’t think he is discouraging use of hydroxychloroquine but is discouraging promotion of it as an established therapy. While there is a suggestion it may be effective, we don’t yet know enough about the disease to determine how much effect it has vs. the normal course for that particular patient. Were they going to recover without the medication anyway? Were they going to succumb even with it? Much more information under much better controls is necessary to determine if this truly an effective therapy.
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Old 04-16-2020, 08:35 AM
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Just another opinion.
We have too many opinions already!!
  #44  
Old 04-16-2020, 09:18 AM
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Originally Posted by B767drvr View Post
Wow, just keep shaking my head at this one! I get blueash...he's a research, fact-based, by the book professional and we're fortunate to have his insight. But, I'm watching video after video of doctors ON THE FRONT LINE saying there's NO approved therapy or cure so they're left to try to figure out the best therapy while their patients die. Hmmm, I truly believe if Trump touted tap water as beneficial, many would line up to call him crazy, urging an unproven, even dangerous (if too much consumed) therapy with unproven side-effects!

How about we let the doctors IN THE TRENCHES decide the best therapy until the study results are known. I cannot help but think the P-word has unfortunately reared its head in the utilization of the drug. Until then... my gut will always favor the THOUSANDS of doctors in the hundreds of ER's using this drug until a therapy is proven and established.
Mikeod seems to understand my posts. This has no relationship to Trump as a politician. It does relate to his promotion of an unproven therapy as if it were proven. He is not a scientist and has admitted he makes decisions on the basis of gut feelings as do you. That is perhaps appropriate in picking your friends, your cabinet, and what to buy for dinner. It is not fine for picking what drugs are best for particular illnesses.

I'll say it again... I do not oppose doctors trying desperate measures when there are no proven measures. If I were still practicing I might very well provide HCQ to my COVID patients.. but I'd be closely following the literature to see whether its use is being supported or refuted by properly conducted studies. It used to be a tongue in cheek comment when dealing with dying patients where you'd run out of options that "No patient should die without the benefit of steroids", and you'd order steroids.

The doctors in the trenches are not supplying the best therapy, they are supplying the therapy promoted by the POTUS outside of his area of any genius. Nobody knows yet if it is the best therapy; perhaps it is actually harmful without benefit. Your jump to using "best therapy" shows how the POTUS has influenced what should be a scientific analysis.

From a study in China:
"HCQ was also recently recommended by the American president Donald Trump. Such a presidential endorsement stimulates an avalanche of demand for HCQ, which buried the dark-side of this drug"

They put that comment in a research study. He should not be influencing medical practice. He is, even in China.

I will, until I burn out on it, continue to post studies on HCQ as I find them. I hope a controlled study establishes HCQ clinically helps patients. So far the evidence for benefit has not been presented.

Thank you for "he's a research, fact-based, by the book professional " I encourage you to find doctors who continue after medical school, to read the research and adjust their therapies based on facts, not gut feelings.

Last edited by blueash; 04-16-2020 at 11:36 AM. Reason: Found the study mentioning Trump and edited to correct
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Old 04-16-2020, 09:35 AM
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The doctors in the trenches are not supplying the best therapy, they are supplying the therapy promoted by the POTUS outside of his area of any genius.

LOL So the 1000s of Doctors all over the world are not using HCQ because they might have studied reports, talked to fellow Doctors treating the virus and seen enough to convince them to use it. Nope, they are all blindly following Trump.

Personally, I am going to listen to Doctors actually treating the disease and follow what they are doing.
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