5 ms·

Clinical trials launch to test coronavirus treatments

45 points by sohkamyung 7y ago

hurrdurr2 7y ago
They literally have a trial on Forsythia. If I recall this was the snakeoil peddled as a miracle cure in the plotline to the movie Contagion.
- Alex3917 7y ago
  I mean it makes sense. We already know Forsythia is safe-ish to eat, has antiviral properties, and it's probably growing within a couple blocks of wherever you live. If it works for COVID-19 then that's kind of the ideal scenario. ~80% of people recover on their own, so a treatment doesn't even need to work that well if it's something that's safe enough for people to just start taking as soon as they get symptoms but before they're sick enough to warrant seeing a doctor, if at that point it can actually make a difference in clinical outcomes. Something that slows down viral growth by 10% isn't going to do anything if you start taking it a week after you get sick, but if you start taking it at t=0 it could make an enormous difference.
  - koheripbal 7y ago
    > ~80% of people recover on their own, so a treatment doesn't even need to work that well... 20% of people needing hospitalization and 5-10% needing mechanical ventilation in an ICU does NOT mean treatments don't need to be very effective. ...unless you assume your in the 80% and you don't care about anyone else.
wyxuan 7y ago
This is crazy fast. Usually hit to target takes almost a year, and they are doing this all in less than a month.
- xiphias2 7y ago
  The fact that coronavirus kills people so fast means that the test results come in in 20 days. Of course the biggest problem is that the administration overhead needs to be significantly smaller, which means taking shortcuts.
- DarthGhandi 7y ago
  Quite sure they had a Zika virus vaccine completed within a few months after the outbreak. Obviously getting regulatory approval takes much, much longer but people would probably be surprised how quickly such things can be developed.
  - koheripbal 7y ago
    Zika vaccine is still in clinical trials.
    - DarthGhandi 7y ago
      > Obviously getting regulatory approval takes much, much longer
  - tim333 7y ago
    In China they could probably do the regulatory bit quickly but it still takes a while to test if vaccines are safe and work. I don't any of the stuff being tested in the article are vaccines.
- refurb 7y ago
  A lot (most?) of these are skipping “hit to target” entirely. They are just testing if previously identified drugs also work for the virus.
AtomicOrbital 7y ago
Interesting ethics of using people as the null hypothesis population knowing they are then condemned to death
- loeg 7y ago
  You give the control arm the current best standard of care until and unless it becomes statistically obvious that your test arm is better and then ethically you're supposed to switch everyone to the drug at that point. It's not like the control group is denied the best care we know how to provide, just to accommodate experimentation.
- knzhou 7y ago
  This is an objection that could be raised against literally any clinical trial. If we knew that a treatment was effective and safe, it would indeed be immoral to withhold it from people. But we don't know that. Finding that out is the whole point of having trials!
- samatman 7y ago
  The alternative is to treat everyone as the null hypothesis population, or administer the treatment to everyone and then be unable to determine if it's effective. Both of these are strictly worse, since neither of them can result in the discovery of an effective treatment.
- belltaco 7y ago
  What if the treatment causes adverse effects? That way the control population are better off.
- empath75 7y ago
  They might be more likely to die if you give them the wrong medicine.
corona-chan 7y ago
The official infection and death numbers in China appear to be completely fabricated as they followed an almost perfect quadratic progression: https://old.reddit.com/r/dataisbeautiful/comments/ez13dv/oc_quadratic_coronavirus_epidemic_growth_model/ https://old.reddit.com/r/dataisbeautiful/comments/ez13dv/oc_... None of the various measures taken to contain the outbreak have affected those numbers. This apparently has happened before with organ donation data: https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0406-6#citeas https://bmcmedethics.biomedcentral.com/articles/10.1186/s129...
- ggm 7y ago
  A zero karma two day old account says something. Please. You're trolling.
  - deleted 7y ago
    [deleted]
- eganist 7y ago
  For all you know, this is the best-case outcome with countermeasures.
  - corona-chan 7y ago
    I would have expected the rolling out of various countermeasures as the epidemic spreads to have a visible effects on the figures. It's weird that it fits a predictable progression so smoothly.
- knzhou 7y ago
  This is a breathtakingly stupid abuse of data analysis. Which of course means it's at the top of Reddit's r/bestof, with thousands of upvotes. Let's take a look at that paper you linked. The supposedly damning point is that you can fit the data extremely well with a quadratic, in the sense that R^2 is high. However, the data points are rapidly increasing, and because of the way R^2 works, that means only the last ~4 data points have any impact on R^2 at all. The statement of the paper boils down to the claim that you can fit 4 data points on a smooth curve accurately using a 3-parameter fit whose form you got to choose. This is obviously true, for any 4 data points. It's too bad that reason goes out the window whenever China is involved.
3fe9a03ccd14ca5 7y ago
> Another study — a 300-person controlled trial — will test serum from COVID-19 survivors. The bare-bones strategy, based on the idea that the antibodies one person steadily builds up to fight a virus can rapidly help someone freshly infected to fight it off, has had modest success when used to treat other viruses in decades past I’m surprised we don’t see this type of treatment more often. It might be worth it to set up infrastructure to do this type of treatment at scale everywhere, since it presumably works in most recoverable viral infections.
- londons_explore 7y ago
  It has many of the same risks as cannibalism - there are lots of unknown viruses and proteins that normally don't get transferred from person to person, but could cause harm, and if you start distributing them widely, you're gonna have problems.
  - blueprint 7y ago
    can the relevant antibodies be isolated?
    - londons_explore 7y ago
      Viruses and prions are so small it's pretty much impossible to be sure you have removed them all from some sample. Sure you can remove most, but you'll never get all of them.
- tim333 7y ago
  This has been reported to work: >China National Biotec Group has been using this plasma, which contains highly potent antibodies, to treat more than 10 seriously ill patients since Feb 8, > It claimed that those receiving the treatment improved within 24 hours, with reduced inflammation and viral loads along with better oxygen levels in the blood. https://www.straitstimes.com/asia/east-asia/china-seeks-plasma-from-recovered-patients-as-coronavirus-treatment https://www.straitstimes.com/asia/east-asia/china-seeks-plas...

45 points by sohkamyung 7y ago

They literally have a trial on Forsythia. If I recall this was the snakeoil peddled as a miracle cure in the plotline to the movie Contagion.

Alex3917 7y ago
I mean it makes sense. We already know Forsythia is safe-ish to eat, has antiviral properties, and it's probably growing within a couple blocks of wherever you live. If it works for COVID-19 then that's kind of the ideal scenario. ~80% of people recover on their own, so a treatment doesn't even need to work that well if it's something that's safe enough for people to just start taking as soon as they get symptoms but before they're sick enough to warrant seeing a doctor, if at that point it can actually make a difference in clinical outcomes. Something that slows down viral growth by 10% isn't going to do anything if you start taking it a week after you get sick, but if you start taking it at t=0 it could make an enormous difference.
- koheripbal 7y ago
  > ~80% of people recover on their own, so a treatment doesn't even need to work that well... 20% of people needing hospitalization and 5-10% needing mechanical ventilation in an ICU does NOT mean treatments don't need to be very effective. ...unless you assume your in the 80% and you don't care about anyone else.

wyxuan 7y ago

This is crazy fast. Usually hit to target takes almost a year, and they are doing this all in less than a month.

xiphias2 7y ago
The fact that coronavirus kills people so fast means that the test results come in in 20 days. Of course the biggest problem is that the administration overhead needs to be significantly smaller, which means taking shortcuts.
DarthGhandi 7y ago
Quite sure they had a Zika virus vaccine completed within a few months after the outbreak. Obviously getting regulatory approval takes much, much longer but people would probably be surprised how quickly such things can be developed.
- koheripbal 7y ago
  Zika vaccine is still in clinical trials.
  - DarthGhandi 7y ago
    > Obviously getting regulatory approval takes much, much longer
- tim333 7y ago
  In China they could probably do the regulatory bit quickly but it still takes a while to test if vaccines are safe and work. I don't any of the stuff being tested in the article are vaccines.
refurb 7y ago
A lot (most?) of these are skipping “hit to target” entirely. They are just testing if previously identified drugs also work for the virus.

AtomicOrbital 7y ago

Interesting ethics of using people as the null hypothesis population knowing they are then condemned to death

loeg 7y ago
You give the control arm the current best standard of care until and unless it becomes statistically obvious that your test arm is better and then ethically you're supposed to switch everyone to the drug at that point. It's not like the control group is denied the best care we know how to provide, just to accommodate experimentation.
knzhou 7y ago
This is an objection that could be raised against literally any clinical trial. If we knew that a treatment was effective and safe, it would indeed be immoral to withhold it from people. But we don't know that. Finding that out is the whole point of having trials!
samatman 7y ago
The alternative is to treat everyone as the null hypothesis population, or administer the treatment to everyone and then be unable to determine if it's effective. Both of these are strictly worse, since neither of them can result in the discovery of an effective treatment.
belltaco 7y ago
What if the treatment causes adverse effects? That way the control population are better off.
empath75 7y ago
They might be more likely to die if you give them the wrong medicine.

corona-chan 7y ago

The official infection and death numbers in China appear to be completely fabricated as they followed an almost perfect quadratic progression: https://old.reddit.com/r/dataisbeautiful/comments/ez13dv/oc_quadratic_coronavirus_epidemic_growth_model/ https://old.reddit.com/r/dataisbeautiful/comments/ez13dv/oc_... None of the various measures taken to contain the outbreak have affected those numbers. This apparently has happened before with organ donation data: https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0406-6#citeas https://bmcmedethics.biomedcentral.com/articles/10.1186/s129...

ggm 7y ago
A zero karma two day old account says something. Please. You're trolling.
- deleted 7y ago
  [deleted]
eganist 7y ago
For all you know, this is the best-case outcome with countermeasures.
- corona-chan 7y ago
  I would have expected the rolling out of various countermeasures as the epidemic spreads to have a visible effects on the figures. It's weird that it fits a predictable progression so smoothly.
knzhou 7y ago
This is a breathtakingly stupid abuse of data analysis. Which of course means it's at the top of Reddit's r/bestof, with thousands of upvotes. Let's take a look at that paper you linked. The supposedly damning point is that you can fit the data extremely well with a quadratic, in the sense that R^2 is high. However, the data points are rapidly increasing, and because of the way R^2 works, that means only the last ~4 data points have any impact on R^2 at all. The statement of the paper boils down to the claim that you can fit 4 data points on a smooth curve accurately using a 3-parameter fit whose form you got to choose. This is obviously true, for any 4 data points. It's too bad that reason goes out the window whenever China is involved.

3fe9a03ccd14ca5 7y ago

> Another study — a 300-person controlled trial — will test serum from COVID-19 survivors. The bare-bones strategy, based on the idea that the antibodies one person steadily builds up to fight a virus can rapidly help someone freshly infected to fight it off, has had modest success when used to treat other viruses in decades past I’m surprised we don’t see this type of treatment more often. It might be worth it to set up infrastructure to do this type of treatment at scale everywhere, since it presumably works in most recoverable viral infections.

londons_explore 7y ago
It has many of the same risks as cannibalism - there are lots of unknown viruses and proteins that normally don't get transferred from person to person, but could cause harm, and if you start distributing them widely, you're gonna have problems.
- blueprint 7y ago
  can the relevant antibodies be isolated?
  - londons_explore 7y ago
    Viruses and prions are so small it's pretty much impossible to be sure you have removed them all from some sample. Sure you can remove most, but you'll never get all of them.
tim333 7y ago
This has been reported to work: >China National Biotec Group has been using this plasma, which contains highly potent antibodies, to treat more than 10 seriously ill patients since Feb 8, > It claimed that those receiving the treatment improved within 24 hours, with reduced inflammation and viral loads along with better oxygen levels in the blood. https://www.straitstimes.com/asia/east-asia/china-seeks-plasma-from-recovered-patients-as-coronavirus-treatment https://www.straitstimes.com/asia/east-asia/china-seeks-plas...