4 ms·

I live in an island where during a viral outbreak some were advocating for chloroquine against the Chikungunya virus. The initial in-vitro tests were promising

by tangue 7y ago

I live in an island where during a viral outbreak some were advocating for chloroquine against the Chikungunya virus. The initial in-vitro tests were promising but it turns out during human trials it has a reverse effect and delayed adaptive immune responses (1). It's sad to see scientific method destroyed by politics and social networks. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977261/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977261/

Alex3917 7y ago
> It's sad to see scientific method destroyed by politics and social networks. If there were such a thing as phase 5 trials with at least a million participants, it would be completely insane to use anything that had only undergone phase 3 clinical trials. People should make rational decisions based on the best evidence that's available at the time. Whether or not it's rational to take HCQ, there's nothing magical about phase 3 studies. Antiviral drugs only really work in the first couple days of the illness, and with this disease you usually don't get symptoms until at least day 5. And in the current environment, no one is getting put on prescription antivirals until at least day 10, and usually even later. To me this raises the question of whether clinical trials are really even possible right now in the first place, or whether making decisions based off in vitro data is the best we can do for right now.
- James_Henry 7y ago
  >To me this raises the question of whether clinical trials are really even possible right now in the first place, or whether making decisions based off in vitro data is the best we can do for right now. I don't think I understand this. We have a clinical trial with in vivo data right here though, right?
  - Alex3917 7y ago
    > We have a clinical trial with in vivo data right here though, right? AFAIK there's no clinical trial data, but there is in vivo data. My point though is that these are drugs that block viral replication, and we're mostly only administering them after the virus has already finished replicating. So in that scenario of course it's going to look ineffective regardless of whether it actually works or not. I don't believe the data showing it works, but I also don't believe the data showing it doesn't work.
    - James_Henry 7y ago
      When you say clinical trial, what are you meaning? I think the usual definition would include this paper as a clinical trial. Do you mean the FDA hasn't overseen any clinical trials? Also, why don't you believe the data? or is it the conclusions that the researchers draw from the data that you don't believe? The statistics and trial design in this paper seem to be sound.
fb1994 7y ago
It modulates immune response.So needs to be give in the condition of a cytokine storm by the immune system which is the cause of complications and death
corybrown 7y ago
You live on Reunion? What is that like?
- tangue 7y ago
  Yep I live on Reunion. I might be biased, as I was born there, but if you have a job, a decent house, and loves nature living here is quite pleasant. It's like France with less grumpy people, tropical weather but with some third-world issues. Problem is jobs are scarce and aren't well paid (unless you're a french expat) and rents are astronomical.

by tangue 7y ago

Alex3917 7y ago

> It's sad to see scientific method destroyed by politics and social networks. If there were such a thing as phase 5 trials with at least a million participants, it would be completely insane to use anything that had only undergone phase 3 clinical trials. People should make rational decisions based on the best evidence that's available at the time. Whether or not it's rational to take HCQ, there's nothing magical about phase 3 studies. Antiviral drugs only really work in the first couple days of the illness, and with this disease you usually don't get symptoms until at least day 5. And in the current environment, no one is getting put on prescription antivirals until at least day 10, and usually even later. To me this raises the question of whether clinical trials are really even possible right now in the first place, or whether making decisions based off in vitro data is the best we can do for right now.

James_Henry 7y ago
>To me this raises the question of whether clinical trials are really even possible right now in the first place, or whether making decisions based off in vitro data is the best we can do for right now. I don't think I understand this. We have a clinical trial with in vivo data right here though, right?
- Alex3917 7y ago
  > We have a clinical trial with in vivo data right here though, right? AFAIK there's no clinical trial data, but there is in vivo data. My point though is that these are drugs that block viral replication, and we're mostly only administering them after the virus has already finished replicating. So in that scenario of course it's going to look ineffective regardless of whether it actually works or not. I don't believe the data showing it works, but I also don't believe the data showing it doesn't work.
  - James_Henry 7y ago
    When you say clinical trial, what are you meaning? I think the usual definition would include this paper as a clinical trial. Do you mean the FDA hasn't overseen any clinical trials? Also, why don't you believe the data? or is it the conclusions that the researchers draw from the data that you don't believe? The statistics and trial design in this paper seem to be sound.

fb1994 7y ago

It modulates immune response.So needs to be give in the condition of a cytokine storm by the immune system which is the cause of complications and death

corybrown 7y ago

You live on Reunion? What is that like?

tangue 7y ago
Yep I live on Reunion. I might be biased, as I was born there, but if you have a job, a decent house, and loves nature living here is quite pleasant. It's like France with less grumpy people, tropical weather but with some third-world issues. Problem is jobs are scarce and aren't well paid (unless you're a french expat) and rents are astronomical.