3 ms·

It's one thing to give a drug as part of a cocktail/protocol because it "might just work as well" when the risk/benefit is kind of even. It's a whole other thi

It's one thing to give a drug as part of a cocktail/protocol because it "might just work as well" when the risk/benefit is kind of even. It's a whole other thing to prove HDQ is effective in a randomized controlled trial. As far as I know the group has not published a RTC and in general there is no RTC showing a clear benefit of HDQ in treating Covid. On the contrary there are several RTCs showing no effect, e.g. in preventing Covid [1]. [1] https://www.nejm.org/doi/full/10.1056/nejmoa2016638 https://www.nejm.org/doi/full/10.1056/nejmoa2016638

bsaul 5y ago
problem with rct on covid is that mortality rates are so low that in order to proove anything, you would have to rely on a huge number of patients not a lot of institution have acess to. We had one attempt in europe at trying out various drugs on a sufficient scale but it failed miserably to reach any conclusions due to lack of patient (and used absurd quantities for HCQ, 6 times the maximum dose, which made a few people think the guy organizing the thing weren't that good anyway).
- Pyramus 5y ago
  Yes and no. Yes, mortality is low generally, but grows exponentially with age, so pretty high for older people (1-10+ %). And you don't have to choose death as your trial end point, you can take something else that is clinically meaningful, e.g. duration of stay in the hospital (not an expert). What seems to make things difficult with Covid (according to a German virologist working on treatment options) is that we more and more believe Covid is a conglomerate of several different "sub-diseases" (can't remember the correct medical term), i.e. the virus can trigger qualitatively different physiological reactions in different people, and it's not clear at all why.
  - bsaul 5y ago
    Interesting you mention old people, because one of the most striking results IHU team claimed to have with HCQ was on EPAD (old people house). Unfortunately, their trial was stopped by the health authority (probably at the time HCQ was thought to be toxic based on a now retracted fraudulent study). I know i start to sound like a zealot, but i've been followed this team's work for more than a year now, and i'm absolutely stunned their work isn't more valued, at least in their country. I'm not a health expert, but i've worked for a long enough time to feel when someone's during serious work (not to mention the fact that they've often been very informative on the virus itself, which made me less surprised by the evolution of the pandemic).

bsaul 5y ago

problem with rct on covid is that mortality rates are so low that in order to proove anything, you would have to rely on a huge number of patients not a lot of institution have acess to. We had one attempt in europe at trying out various drugs on a sufficient scale but it failed miserably to reach any conclusions due to lack of patient (and used absurd quantities for HCQ, 6 times the maximum dose, which made a few people think the guy organizing the thing weren't that good anyway).

Pyramus 5y ago
Yes and no. Yes, mortality is low generally, but grows exponentially with age, so pretty high for older people (1-10+ %). And you don't have to choose death as your trial end point, you can take something else that is clinically meaningful, e.g. duration of stay in the hospital (not an expert). What seems to make things difficult with Covid (according to a German virologist working on treatment options) is that we more and more believe Covid is a conglomerate of several different "sub-diseases" (can't remember the correct medical term), i.e. the virus can trigger qualitatively different physiological reactions in different people, and it's not clear at all why.
- bsaul 5y ago
  Interesting you mention old people, because one of the most striking results IHU team claimed to have with HCQ was on EPAD (old people house). Unfortunately, their trial was stopped by the health authority (probably at the time HCQ was thought to be toxic based on a now retracted fraudulent study). I know i start to sound like a zealot, but i've been followed this team's work for more than a year now, and i'm absolutely stunned their work isn't more valued, at least in their country. I'm not a health expert, but i've worked for a long enough time to feel when someone's during serious work (not to mention the fact that they've often been very informative on the virus itself, which made me less surprised by the evolution of the pandemic).