5 ms·

> dangerous to take unsupervised That's not what anyone is suggesting, and it seems disingenuous for you to suggest that it is. The drug is well-known, and it'

by ColanR 6y ago

> dangerous to take unsupervised That's not what anyone is suggesting, and it seems disingenuous for you to suggest that it is. The drug is well-known, and it's reasonable to attempt its use when there's the potential for a large success rate. The people "hoarding" it are doctors who can get prescriptions for it - and who I imagine know more about the drug than you or I do. Based on the Ford study [1], the 10-50% success rate might be a confusion with the hazard ratio reduction, which was 66%. The actual in-hospital mortality rates in that study were 20% with hydroxychloroquine + azithromycin vs. 26% with neither. I'd say a 6 percentage point difference in lives saved is enough to warrant further investigation. [1] https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext https://www.ijidonline.com/article/S1201-9712(20)30534-8/ful...

fabian2k 6y ago
The Ford study is one of the weaker ones, it's a retrospective study and not a randomized controlled trial. There are better studies available, so it doesn't make sense to focus on this specific one that is inherently weaker and subject to more confounding factors than a randomized trial.
- ColanR 6y ago
  I'd love to hear about the better ones.
  - fabian2k 6y ago
    UK RECOVERY trial: https://www.bmj.com/content/369/bmj.m2263?ijkey=355d5085a0aeed4493a778233d1ae2127edd2cc4&keytype2=tf_ipsecsha https://www.bmj.com/content/369/bmj.m2263?ijkey=355d5085a0ae... WHO SOLIDARITY trial (aborted due to lack of efficiency for hospital patients, still running for prophylaxis) https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments https://www.who.int/emergencies/diseases/novel-coronavirus-2... HCQ as prophylaxis trial: https://www.bmj.com/content/369/bmj.m2242?ijkey=2811796ab15e2b1f6ecc0a1fd760c6540ff0b04d&keytype2=tf_ipsecsha https://www.bmj.com/content/369/bmj.m2242?ijkey=2811796ab15e...
    - ColanR 6y ago
      Here's another: https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa093/5847586 https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa093... > Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. None of your sources deal with outpatients or the combination of hydroxychloroquine and azithromycin.
      - irishjohnnie 6y ago
        There is also a glaring conflict of interest regarding the author of that paper and some manufacturers of the drugs in question, https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa156/5873642 https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa156...
      - treeman79 6y ago
        I Spent a year trying to get a prescription for azithromycin before giving up. I was explaining to a new doctor how my weird symptoms would go away on azithromycin or doxycycline for several weeks. He looked at me and said, oh you have an autoimmune disorder then. He even guessed the correct one. One I had never heard of. He hadn’t read any studies on it. Was just something he noticed in decades of treating people.
      - irishjohnnie 6y ago
        It also looks like that study is still in the peer review process. It has the "Accepted Manuscript" flag (https://academic.oup.com/aje/pages/Instructions_To_Authors https://academic.oup.com/aje/pages/Instructions_To_Authors) and has at least one major error, https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa155/5873637 https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa155...
notacoward 6y ago
> That's not what anyone is suggesting ...and yet that's what people are doing. https://www.usatoday.com/story/news/nation/2020/07/07/teen-who-died-covid-19-got-hydroxychloroquine-treatment-home/5389870002/ https://www.usatoday.com/story/news/nation/2020/07/07/teen-w... > The drug is well-known So are its risks. > there's the potential for a large success rate Every treatment has some potential. Funny how there's been a chorus of "eVerY drUg hAS rIsks" to make HCQ seem unexceptional in that regard (even though most drugs don't carry disk of heart problems and blindness) while clinging to the idea that its potential is exceptional. In the case of HCQ for COVID-19 we don't need to guess about potential, because there have been many studies by now and we have empirical evidence of weak effect. It shouldn't be ignored, but it should be far from the top of anyone's list either. It's only getting attention at all because of who keeps touting it. You talk about being disingenuous, but I think the disingenuous behavior in this thread is the extreme cherry-picking of favorable results while ignoring less favorable results and risks.
- ColanR 6y ago
  > > That's not what anyone is suggesting > ...and yet that's what people are doing. > Her mother, a nurse, and a man identified in the report as her father, a physician assistant, gave the girl azithromycin...The report does not state if the girl had a prescription for either drug. You need a better source. There was supervision in that case. Sadly, the girl was apparently part of the ~75-80% that don't survive COVID-19, even with azithromycin & hydroxychloroquine. > So are its risks. And that means its risks can be addressed and quantified. > extreme cherry-picking Two points. 1. A great example of cherry picking is the single instance of mortality associated with using azithromycin that you gave in your source. 2. The issue of degree of efficacy is secondary to the fact that it's potential for efficacy is being hidden and labeled disinformation, when the drug should be investigated for its potential to save lives.
  - notacoward 6y ago
    > You need a better source. There was supervision in that case You're being disingenuous again. Read the article. She was given the drugs by her parents, who were not authorized to prescribe them or supervise their use on their own. The outcome is not the point. The point is the lack of proper supervision. The outcome could have been different, and it would still be wrong for people to be using HCQ other than in a controlled trial ... but that's exactly what hype like yours leads to.

by ColanR 6y ago

fabian2k 6y ago

The Ford study is one of the weaker ones, it's a retrospective study and not a randomized controlled trial. There are better studies available, so it doesn't make sense to focus on this specific one that is inherently weaker and subject to more confounding factors than a randomized trial.

ColanR 6y ago
I'd love to hear about the better ones.
- fabian2k 6y ago
  UK RECOVERY trial: https://www.bmj.com/content/369/bmj.m2263?ijkey=355d5085a0aeed4493a778233d1ae2127edd2cc4&keytype2=tf_ipsecsha https://www.bmj.com/content/369/bmj.m2263?ijkey=355d5085a0ae... WHO SOLIDARITY trial (aborted due to lack of efficiency for hospital patients, still running for prophylaxis) https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments https://www.who.int/emergencies/diseases/novel-coronavirus-2... HCQ as prophylaxis trial: https://www.bmj.com/content/369/bmj.m2242?ijkey=2811796ab15e2b1f6ecc0a1fd760c6540ff0b04d&keytype2=tf_ipsecsha https://www.bmj.com/content/369/bmj.m2242?ijkey=2811796ab15e...
  - ColanR 6y ago
    Here's another: https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa093/5847586 https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa093... > Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. None of your sources deal with outpatients or the combination of hydroxychloroquine and azithromycin.
    - irishjohnnie 6y ago
      There is also a glaring conflict of interest regarding the author of that paper and some manufacturers of the drugs in question, https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa156/5873642 https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa156...
    - treeman79 6y ago
      I Spent a year trying to get a prescription for azithromycin before giving up. I was explaining to a new doctor how my weird symptoms would go away on azithromycin or doxycycline for several weeks. He looked at me and said, oh you have an autoimmune disorder then. He even guessed the correct one. One I had never heard of. He hadn’t read any studies on it. Was just something he noticed in decades of treating people.
    - irishjohnnie 6y ago
      It also looks like that study is still in the peer review process. It has the "Accepted Manuscript" flag (https://academic.oup.com/aje/pages/Instructions_To_Authors https://academic.oup.com/aje/pages/Instructions_To_Authors) and has at least one major error, https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa155/5873637 https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa155...

notacoward 6y ago

> That's not what anyone is suggesting ...and yet that's what people are doing. https://www.usatoday.com/story/news/nation/2020/07/07/teen-who-died-covid-19-got-hydroxychloroquine-treatment-home/5389870002/ https://www.usatoday.com/story/news/nation/2020/07/07/teen-w... > The drug is well-known So are its risks. > there's the potential for a large success rate Every treatment has some potential. Funny how there's been a chorus of "eVerY drUg hAS rIsks" to make HCQ seem unexceptional in that regard (even though most drugs don't carry disk of heart problems and blindness) while clinging to the idea that its potential is exceptional. In the case of HCQ for COVID-19 we don't need to guess about potential, because there have been many studies by now and we have empirical evidence of weak effect. It shouldn't be ignored, but it should be far from the top of anyone's list either. It's only getting attention at all because of who keeps touting it. You talk about being disingenuous, but I think the disingenuous behavior in this thread is the extreme cherry-picking of favorable results while ignoring less favorable results and risks.

ColanR 6y ago
> > That's not what anyone is suggesting > ...and yet that's what people are doing. > Her mother, a nurse, and a man identified in the report as her father, a physician assistant, gave the girl azithromycin...The report does not state if the girl had a prescription for either drug. You need a better source. There was supervision in that case. Sadly, the girl was apparently part of the ~75-80% that don't survive COVID-19, even with azithromycin & hydroxychloroquine. > So are its risks. And that means its risks can be addressed and quantified. > extreme cherry-picking Two points. 1. A great example of cherry picking is the single instance of mortality associated with using azithromycin that you gave in your source. 2. The issue of degree of efficacy is secondary to the fact that it's potential for efficacy is being hidden and labeled disinformation, when the drug should be investigated for its potential to save lives.
- notacoward 6y ago
  > You need a better source. There was supervision in that case You're being disingenuous again. Read the article. She was given the drugs by her parents, who were not authorized to prescribe them or supervise their use on their own. The outcome is not the point. The point is the lack of proper supervision. The outcome could have been different, and it would still be wrong for people to be using HCQ other than in a controlled trial ... but that's exactly what hype like yours leads to.