7 ms·

How about confirming that Chloroquine works?[1] Yeah, it's a boring old out of patent drug. New uses for out of patent synthetic drugs is like the most unsexy

How about confirming that Chloroquine works?[1] Yeah, it's a boring old out of patent drug. New uses for out of patent synthetic drugs is like the most unsexy thing in all of medicine. Even herbal cures get more respect, because they are from mother earth. [1]https://www.sciencedirect.com/science/article/pii/S0166354220301145 https://www.sciencedirect.com/science/article/pii/S016635422...

jmnicolas 7y ago
This makes no sense to me : malaria is due to a bacteria and COVID19 is a virus, why choloroquine would work on both ?
- jansan 7y ago
  Read the paper. They tried it on many viruses, but it had no effect, except for Hepatitis C, where it had a mild effect. Now a first small study indicates that it may be highly effective for the treatment of COVID-19. Just a try-and-error process I guess, of all available tools use the one that works best.
- pasquinelli 7y ago
  If it helps, malaria is caused by a single celled parasite that isn't a bacterium. Though i don't know why that would help. Choloroquine is also used for autoimmune disease, which also doesn't make sense. Of course none of any of this makes sense to me because i don't know anything about it.
  - easymodex 7y ago
    From what i understand, one of the ways COVID-19 kills is by triggering an extreme autoimmune reaction which attacks the lungs (see: Cytokine storm).
- easytiger 7y ago
  The side effects of choloroquine will make you forget about the very mild flu like illness you just contracted.
  - throwaway2048 7y ago
    nCOV/COVID-19 is not a flu let alone "a very mild flu" stop spreading this bullshit.
    - mschuster91 7y ago
      For healthy young people, covid19 is a mild-ish flu. The ones in danger are their parents and grandparents, which is why Italy has been hit so hard - many young people still live with their families in cramped conditions because they cannot afford renting or much less owning their own places. Probably it will become a huge problem in the US too, with the added difficulty that even seniors often have to work to survive and there not being a properly funded healthcare and sick leave system.
      - easytiger 7y ago
        Yes. Italy experienced 24k deaths in the 16/17 influenza season alone. But we didn't try to annihilate the global status quo to contain it.
        empath75 7y ago
        https://twitter.com/jasonvanschoor/status/1237144089855963136?s=21 https://twitter.com/jasonvanschoor/status/123714408985596313... Read this thread about what is happening in Italy. That’s a preview of what the rest of the world will be dealing with in the next three weeks.
        hef19898 7y ago
        Ah, that thread again. Why not linking the official statement? Which by the way confirms a lot of the thread but in a way less dramatic manner.
      - DalasNoin 7y ago
        Here is a report of a 21 year old, seems like more than a mild flu https://www.theguardian.com/world/2020/feb/29/to-hell-and-back-my-three-weeks-suffering-from-coronavirus https://www.theguardian.com/world/2020/feb/29/to-hell-and-ba...
- Cantbekhan 7y ago
  Several EU countries in addition to China are already actively using chloroquine and hydroxichloroquine to treat COVID19 patients. And I mean outside trials. For instance: Here are the Netherlands treatment guidelines (in Dutch): https://lci.rivm.nl/covid-19/bijlage/medicamenteuze-behandelopties https://lci.rivm.nl/covid-19/bijlage/medicamenteuze-behandel... Here are the Italy treatment guidelines (in Italian): http://www.simit.org/medias/1555-covid19-linee-guida-trattamento-01mar.pdf http://www.simit.org/medias/1555-covid19-linee-guida-trattam... I think the anecdote on how they found out about the effectiveness of chloroquine in China is fascinating and has nothing to do with the in vitro efficiency study nor with the malaria usage but solely with the immunomodulator effect. They just noticed that there were no lupus patients infected with Covid19. And after investigating with the dermatology dept, they confirmed that indeed there were no reported lupus patients of that hospital infected with covid19. Their common treatment was chloroquine... Source: https://www.jqknews.com/news/388543-The_novel_coronavirus_pneumonia_has_short_term_curative_effect_on_the_treatment_of_new_crown_pneumonia.html https://www.jqknews.com/news/388543-The_novel_coronavirus_pn... It should be noted that as far as the Chinese are concerned, it doesn't seem like there is any debate about chloroquine usefulness for COVID19. Sources: https://pubmed.ncbi.nlm.nih.gov/32075365-expert-consensus-on-chloroquine-phosphate-for-the-treatment-of-novel-coronavirus-pneumonia/ https://pubmed.ncbi.nlm.nih.gov/32075365-expert-consensus-on... and https://pubmed.ncbi.nlm.nih.gov/32074550-breakthrough-chloroquine-phosphate-has-shown-apparent-efficacy-in-treatment-of-covid-19-associated-pneumonia-in-clinical-studies/ https://pubmed.ncbi.nlm.nih.gov/32074550-breakthrough-chloro...
  - gnulinux 7y ago
    Why do these things take slowly in US but are much faster in the EU? Even though Italy and Netherlands are already using it, no patient in US is treated with chloroquine since it's not FDA approved. Why does FDA approval matter for a brand new disease, in an emergency situation like this?
    - mrfusion 7y ago
      You’re definitely asking the right questions. The answer is because that’s how things are done.
- agumonkey 7y ago
  covid harm is due to many layers in the immune response, chloroquine might help at one layer. it's said that many covid death are related to cytokine storm, hence why anti rhumatism drugs help, they tame the storm even if they dont touch the originating virus. maybe, and plausibly, cquine has a similar purpose.
- refurb 7y ago
  Drugs very rarely (especially small molecules) have an impact on only one target. Take SSRIs (selective serotonin uptake inhibitors) used for depression. If you dig up the data, they also hit (at a lower level) acetylcholine, dopamine, histamine, and other receptors. Those off target effects are often responsible for side effects. So chloroquine could very easily be doing something different for Coronavirus than what it does for malaria.
- Leary 7y ago
  https://www.youtube.com/watch?v=U7F1cnWup9M https://www.youtube.com/watch?v=U7F1cnWup9M Essentially it opens some ion gates that allows Zinc to inhibit the virus.
- DarthGhandi 7y ago
  It's from the work on SARS of which this virus is very similar too.
paulbaumgart 7y ago
Looks like the work is underway: “At least ten clinical trials are testing chloroquine, approved as an antimalarial and autoimmune disease drug. In vitro, the endosomal acidification fusion inhibitor blocked infection of a clinical isolate of SARS-CoV-2.” https://www.nature.com/articles/d41587-020-00003-1 https://www.nature.com/articles/d41587-020-00003-1
- jansan 7y ago
  Wow, it really must be promising, given that the second highest number of trials for any other drug is three.
  - yspeak 7y ago
    Does Not look very promising: >>• In past research, chloroquine has shown in vitro activity against many different viruses, but no benefit in animal models. • Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success.
  - hanniabu 7y ago
    Might just be because it was an existing solution that didn't need r&d so maybe it had a jump start on testing
dna_polymerase 7y ago
"One of the screens of known drugs in China that also flagged remdesivir noted that the old antimalarial drug chloroquine seemed to be effective in vitro. It had been reported some years back as a possible antiviral, working through more than one mechanism, probably both at viral entry and intracellularly thereafter. That part shouldn’t be surprising – chloroquine’s actual mode(s) of action against malaria parasites are still not completely worked out, either, and some of what people thought they knew about it has turned out to be wrong. There are several trials underway with it at Chinese facilities, some in combination with other agents like remdesivir. Chloroquine has of course been taken for many decades as an antimalarial, but it has a number of liabilities, including seizures, hearing damage, retinopathy and sudden effects on blood glucose. So it’s going to be important to establish just how effective it is and what doses will be needed. Just as with vaccine candidates, it’s possible to do more harm with a rushed treatment than the disease is doing itself." - Derek Lowe https://blogs.sciencemag.org/pipeline/archives/2020/03/06/covid-19-small-molecule-therapies-reviewed https://blogs.sciencemag.org/pipeline/archives/2020/03/06/co...
- yspeak 7y ago
  If you read the articles it has had almost no effect clinically in past trials and may have worsened some cases.
zadler 7y ago
Im hopeful about chloroquine but concerned that blocking the virus may lead to recovery but not give the body time to develop immunity. So far I havn’t seen much discussion about this.
- konschubert 7y ago
  You would block it in people with severe complications and let the people with fewer symptoms take care of developing the herd immunity.

jmnicolas 7y ago

This makes no sense to me : malaria is due to a bacteria and COVID19 is a virus, why choloroquine would work on both ?

jansan 7y ago
Read the paper. They tried it on many viruses, but it had no effect, except for Hepatitis C, where it had a mild effect. Now a first small study indicates that it may be highly effective for the treatment of COVID-19. Just a try-and-error process I guess, of all available tools use the one that works best.
pasquinelli 7y ago
If it helps, malaria is caused by a single celled parasite that isn't a bacterium. Though i don't know why that would help. Choloroquine is also used for autoimmune disease, which also doesn't make sense. Of course none of any of this makes sense to me because i don't know anything about it.
- easymodex 7y ago
  From what i understand, one of the ways COVID-19 kills is by triggering an extreme autoimmune reaction which attacks the lungs (see: Cytokine storm).
easytiger 7y ago
The side effects of choloroquine will make you forget about the very mild flu like illness you just contracted.
- throwaway2048 7y ago
  nCOV/COVID-19 is not a flu let alone "a very mild flu" stop spreading this bullshit.
  - mschuster91 7y ago
    For healthy young people, covid19 is a mild-ish flu. The ones in danger are their parents and grandparents, which is why Italy has been hit so hard - many young people still live with their families in cramped conditions because they cannot afford renting or much less owning their own places. Probably it will become a huge problem in the US too, with the added difficulty that even seniors often have to work to survive and there not being a properly funded healthcare and sick leave system.
    - easytiger 7y ago
      Yes. Italy experienced 24k deaths in the 16/17 influenza season alone. But we didn't try to annihilate the global status quo to contain it.
      - empath75 7y ago
        https://twitter.com/jasonvanschoor/status/1237144089855963136?s=21 https://twitter.com/jasonvanschoor/status/123714408985596313... Read this thread about what is happening in Italy. That’s a preview of what the rest of the world will be dealing with in the next three weeks.
        hef19898 7y ago
        Ah, that thread again. Why not linking the official statement? Which by the way confirms a lot of the thread but in a way less dramatic manner.
    - DalasNoin 7y ago
      Here is a report of a 21 year old, seems like more than a mild flu https://www.theguardian.com/world/2020/feb/29/to-hell-and-back-my-three-weeks-suffering-from-coronavirus https://www.theguardian.com/world/2020/feb/29/to-hell-and-ba...
Cantbekhan 7y ago
Several EU countries in addition to China are already actively using chloroquine and hydroxichloroquine to treat COVID19 patients. And I mean outside trials. For instance: Here are the Netherlands treatment guidelines (in Dutch): https://lci.rivm.nl/covid-19/bijlage/medicamenteuze-behandelopties https://lci.rivm.nl/covid-19/bijlage/medicamenteuze-behandel... Here are the Italy treatment guidelines (in Italian): http://www.simit.org/medias/1555-covid19-linee-guida-trattamento-01mar.pdf http://www.simit.org/medias/1555-covid19-linee-guida-trattam... I think the anecdote on how they found out about the effectiveness of chloroquine in China is fascinating and has nothing to do with the in vitro efficiency study nor with the malaria usage but solely with the immunomodulator effect. They just noticed that there were no lupus patients infected with Covid19. And after investigating with the dermatology dept, they confirmed that indeed there were no reported lupus patients of that hospital infected with covid19. Their common treatment was chloroquine... Source: https://www.jqknews.com/news/388543-The_novel_coronavirus_pneumonia_has_short_term_curative_effect_on_the_treatment_of_new_crown_pneumonia.html https://www.jqknews.com/news/388543-The_novel_coronavirus_pn... It should be noted that as far as the Chinese are concerned, it doesn't seem like there is any debate about chloroquine usefulness for COVID19. Sources: https://pubmed.ncbi.nlm.nih.gov/32075365-expert-consensus-on-chloroquine-phosphate-for-the-treatment-of-novel-coronavirus-pneumonia/ https://pubmed.ncbi.nlm.nih.gov/32075365-expert-consensus-on... and https://pubmed.ncbi.nlm.nih.gov/32074550-breakthrough-chloroquine-phosphate-has-shown-apparent-efficacy-in-treatment-of-covid-19-associated-pneumonia-in-clinical-studies/ https://pubmed.ncbi.nlm.nih.gov/32074550-breakthrough-chloro...
- gnulinux 7y ago
  Why do these things take slowly in US but are much faster in the EU? Even though Italy and Netherlands are already using it, no patient in US is treated with chloroquine since it's not FDA approved. Why does FDA approval matter for a brand new disease, in an emergency situation like this?
  - mrfusion 7y ago
    You’re definitely asking the right questions. The answer is because that’s how things are done.
agumonkey 7y ago
covid harm is due to many layers in the immune response, chloroquine might help at one layer. it's said that many covid death are related to cytokine storm, hence why anti rhumatism drugs help, they tame the storm even if they dont touch the originating virus. maybe, and plausibly, cquine has a similar purpose.
refurb 7y ago
Drugs very rarely (especially small molecules) have an impact on only one target. Take SSRIs (selective serotonin uptake inhibitors) used for depression. If you dig up the data, they also hit (at a lower level) acetylcholine, dopamine, histamine, and other receptors. Those off target effects are often responsible for side effects. So chloroquine could very easily be doing something different for Coronavirus than what it does for malaria.
Leary 7y ago
https://www.youtube.com/watch?v=U7F1cnWup9M https://www.youtube.com/watch?v=U7F1cnWup9M Essentially it opens some ion gates that allows Zinc to inhibit the virus.
DarthGhandi 7y ago
It's from the work on SARS of which this virus is very similar too.

paulbaumgart 7y ago

Looks like the work is underway: “At least ten clinical trials are testing chloroquine, approved as an antimalarial and autoimmune disease drug. In vitro, the endosomal acidification fusion inhibitor blocked infection of a clinical isolate of SARS-CoV-2.” https://www.nature.com/articles/d41587-020-00003-1 https://www.nature.com/articles/d41587-020-00003-1

jansan 7y ago
Wow, it really must be promising, given that the second highest number of trials for any other drug is three.
- yspeak 7y ago
  Does Not look very promising: >>• In past research, chloroquine has shown in vitro activity against many different viruses, but no benefit in animal models. • Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success.
- hanniabu 7y ago
  Might just be because it was an existing solution that didn't need r&d so maybe it had a jump start on testing

dna_polymerase 7y ago

"One of the screens of known drugs in China that also flagged remdesivir noted that the old antimalarial drug chloroquine seemed to be effective in vitro. It had been reported some years back as a possible antiviral, working through more than one mechanism, probably both at viral entry and intracellularly thereafter. That part shouldn’t be surprising – chloroquine’s actual mode(s) of action against malaria parasites are still not completely worked out, either, and some of what people thought they knew about it has turned out to be wrong. There are several trials underway with it at Chinese facilities, some in combination with other agents like remdesivir. Chloroquine has of course been taken for many decades as an antimalarial, but it has a number of liabilities, including seizures, hearing damage, retinopathy and sudden effects on blood glucose. So it’s going to be important to establish just how effective it is and what doses will be needed. Just as with vaccine candidates, it’s possible to do more harm with a rushed treatment than the disease is doing itself." - Derek Lowe https://blogs.sciencemag.org/pipeline/archives/2020/03/06/covid-19-small-molecule-therapies-reviewed https://blogs.sciencemag.org/pipeline/archives/2020/03/06/co...

yspeak 7y ago
If you read the articles it has had almost no effect clinically in past trials and may have worsened some cases.

zadler 7y ago

Im hopeful about chloroquine but concerned that blocking the virus may lead to recovery but not give the body time to develop immunity. So far I havn’t seen much discussion about this.

konschubert 7y ago
You would block it in people with severe complications and let the people with fewer symptoms take care of developing the herd immunity.