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Hydroxychloroquine lowers Alzheimer's disease and related dementias risk
- fexecve 4y agoBut at what cost? Not drinking water or eating food leads to lower risk of choking to death, but...
- rednerrus 4y agoWhat is the cost of taking hydroxychloroquine? Seems like a well understood drug with minimal side effects.
- emccue 4y agoSee I believe this. There are remarkably fewer demented people as a result of people taking Hydroxychloroquine.
- mattboardman 4y agoRelishing in other people's actions that were driven out of fear during a crisis when our institutions (media and state) failed to keep public trust for millions. Empathy, even for those who make foolish decisions is difficult but necessary, you should try to understand rather than judge.
- ergonaught 4y agoWhy is empathy "necessary"? Why "should" someone try to understand rather than judge? What's the actual rationale for it? What is the mutually agreed desired result of acting in those ways?
- mattboardman 4y ago>why is empathy necessary? I don't really have an objective answer for you. I do find personal value in empathy, I get less mad when I can understand why someone did something I disagree with. It doesn't change what they did nor does it excuse it. >What is the mutually agreed desired result of acting in those ways Harmony.
- troutwine 4y agoKeeping just to the utilitarian perspective, cooperative strategies in humans overwhelmingly have better outcomes in both individual well-being and output (innovation, manufacturing, zero-sun games). Cooperation is extremely hard to achieve and sustain without some empathy for your peers. Similarly, judgement runs counter to group cohesion, except in the divergent strategy of establishing an Us/Them dynamic, sustainable in the short term but leading to homogeneity, worse outcomes. Tossing the utilitarian perspective, being transactional and self-serving in your daily life tends to get you invited to less parties.
- shawnz 4y agoI think it will be easy for you to come up with some possible answers to these questions if you have some charity for their argument.
- brookst 4y agoPeople who pride themselves on lacking empathy are kind of trapped because no one can explain in a way that doesn’t require some empathy to understand.
- joenot443 4y ago>Why is empathy “necessary” This is a philosophical question that man has sought to answer since the Stone Age. Much smarter people than us have dedicated their lives to the study of ethics and come up with wildly differing ideas, I don’t think you’re going to find an objective answer here.
- mint2 4y ago[flagged]
- thrwawy74 4y agoI agree with you. There were several agencies putting out responsible messaging and trying to keep public trust. Ultimately it was a failure. Millions of people didn't trust the gov and turned to alternatives like this. I'm not sure why you're being downvoted. Key figureheads undermined public trust.
- fwungy 4y agoThe government's information was obviously was filled with inconsistencies that were obvious to anyone with the slightest prior mistrust of them. Ivermectin has a long history of safe and beneficial usage in the developing world, billions of doses. Yet it was actively discouraged as "horse medicine" here. Anyone with experience or relatives in the developing world would immediately question the veracity of such a discouragement.
- dragon-hn 4y agoIt was discouraged (correctly in hindsight) because there was no evidence it would do anything for Covid. It was called horse medicine because the unfortunate people that fell for the kooks resorted to vet sources for it because doctors correctly refused. I can’t believe the revisionist history on this.
- jimmaswell 4y agoI don't see it as necessarily relishing, just a dark joke.
- emccue 4y ago^
- dang 4y agoPlease don't post unsubstantive and/or flamebait comments to HN. It's not what this site is for, and destroys what it is for. If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
- electric_mayhem 4y ago[flagged]
- cpr 4y agoNo, it's available in generic form.
- sgtnoodle 4y agoA lot of modern health woes are turning out to be caused by inflammation, and HCQ is a relatively safe, cheap immunosuppressant. It makes sense that it would help out. As far as conspiracy theories go, it's been profitable for various parties to suppress knowledge of it over the years, as they can't patent it then sell it for extreme markup. I myself take a $10k/month immunosuppressant to treat a condition that HCQ is also effective for.
- Traubenfuchs 4y ago> it's been profitable for various parties to suppress knowledge of it over the years, as they can't patent it then sell it for extreme markup Just like NAC, which the FDA tried to outlaw from being sold as supplement when it‘s a completely harmless, proven-beyond-doubt miracle drug for anything between significantly reducing bipolar disorder symptoms, preventing symptomatic flu and reducing covid mortality.
- caeril 4y agoFun fact: The FDA also just banned NMN as a supplement so that it can be patented, marketed, and sold as a longevity drug exclusively by Metro Biotech. Wonderful people over there at the FDA, looking out for the public's best interest.
- Tuna-Fish 4y agoNo. Interestingly, the root cause of all these positive correlations might be the same. One thing that Hydroxychloroquine is undeniably good at is that it's a very effective dewormer. Anything that is either caused or made worse by worms, or by the immune system going haywire because of worms, will be improved by Hydroxychloroquine. So, it helped against covid (in key populations) because one of the key interventions against covid will kill you if you also have worms. So in places like Bangladesh and Pakistan where intestinal worm infections are common, covid outcomes improve because the worms got killed. If this[0] is correct (and it is a very new result, so might as well not be), the positive correlation might well be that your immune system stays calmer if you have no worms. [0]: https://www.cell.com/cell/fulltext/S0092-8674(22)01463-5 https://www.cell.com/cell/fulltext/S0092-8674(22)01463-5
- christkv 4y agoIf this is true they already have several big patient groups taking it on a daily basis for the rest of their life so should be possible to look at if the prevalence of Alzheimers is lower in those groups.
- jeffbee 4y agoIt seems like researchers would be able to gather data from the natural experiment due to some places in the world where this drug is routinely used against malaria.
- actually_a_dog 4y agoI can see an awful lot of potential confounding factors there, though. Life expectancy in most countries in Africa, for instance, isn't even long enough for non-early onset AD to develop. You'd expect less AD just because half or more of the population is going to die from other stuff at 65 or earlier. https://www.statista.com/statistics/1218173/life-expectancy-in-african-countries/ https://www.statista.com/statistics/1218173/life-expectancy-...
- fbdab103 4y agoFrom reading the abstract, it looks like they picked up on this association from arthritis patients.
- mtlmtlmtlmtl 4y agoThat makes me instantly sceptical that the arthritis and/or associated conditions might have played a role. I'm sure they've controlled for that as much as possible, but it's easy to miss some confounding factor since the cause and mechanism of AD is poorly understood. That makes it harder to tease out what confounders to look for.
- AbrahamParangi 4y agoHCQ is a much misunderstood substance as a result of the political furor around it. It is not a miracle drug and it is not useless for all medical purposes. It is a relatively mild anti-malarial drug with some anti-inflammatory properties. It is prescribed for autoimmune disorders in addition to malaria. Its anti-inflammatory/immune regulation effects are probably not that strong but its safety profile is well understood.
- keepquestioning 4y agoNow explain how it could affect Alzheimers
- WaxProlix 4y ago> some anti-inflammatory properties https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214864/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214864/ Lots of literature 1 google/ddg search away for you, but there's an example.
- deleted 4y ago[deleted]
- maerF0x0 4y ago>We additionally show that HCQ exerts dose-dependent effects on late long-term potentiation (LTP) and rescues impaired hippocampal synaptic plasticity prior to significant accumulation of amyloid plaques and neurodegeneration in APP/PS1 mice. iirc (I am not qualified!!) Alzheimers relates to plaques in our brain, and this sounds to me like it fixes a precursor to the plaque accumulation (the loss of plasticity?)
- pelorat 4y agoThe plaques are a side effect of something we don't understand yet. Treating the plaque or slowing it is not a solution, we need to find and fix the cause.
- 4y ago
- JamesBarney 4y agoHCQ associated with a 12% reduced risk of getting Alzheimer's disease.
- actually_a_dog 4y agoYeah, it's interesting that they mention it as a "neuroprotective therapy" rather than any kind of treatment. That suggests that it doesn't do anything to reverse damage, but can only slow (perhaps halt?) the progression of the disease.
- citilife 4y agoHydroxychloroquine is used to treat Lupus by interfering with the communication between cells (not exactly clear in the research tbh). Lupus, Rheumatoid arthritis, and other uses for Hydroxychloroquine appear to be autoimmune responses where the body attacks connective tissue. If Hydroxychloroquine reduces inflammation and reduces immune responses damaging connective tissue I could see it generally useful for incidents where the body damages itself (such as Alzheimer or dementia)
- everdrive 4y agoDo we think that mere inflammation-reduction alone is the explanation here?
- napier 4y agoThere'a nothing "mere" about HCQ's inflammation reduction.
- ffssffss 4y ago> incidents where the body damages itself I don't think this is right, isn't the etiology of Alzheimers still pretty much completely unknown?
- canadiantim 4y agoThat's great news. Alzheimer's and dementia are so such terrifyingly difficult conditions to try and help someone with. Glad we're finding atleast some possibilities to help. Does anyone know of anything others like this?
- ShredKazoo 4y agoI thought I read somewhere that it's easy to overdose on hydroxychloroquine? If so I'd be worried about a forgetful senior accidentally taking a double or triple dose.
- deleted 4y ago[deleted]
- BryantD 4y agoI'm not a doctor but it doesn't look highly risky. The usual adult dose for malaria is 2000 mg over the course of two days. Long term usage may be a different matter. I suspect that concerns about safety were because people were using it off brand without medical supervision these last couple of years, which is less safe.
- seanhunter 4y agoTHis is true of most medications and as a result there are a lot of solutions that have been developed to help people ensure they get their drug regime right. Firstly, a lot of people in altzheimer’s care will have full or part-time carers to help[1]. Secondly there are things like “pill organizers”/dossette boxes[2] where the pharmacy will actually dispense the drugs into a container which is designed to make it simple to ensure people take their correct daily dosage of drugs. [1] Here in the UK the national health provides some community care and there are also voluntary organisations. Obviously individuals can also pay privately to have enhanced levels of support. [2] https://en.wikipedia.org/wiki/Pill_organizer https://en.wikipedia.org/wiki/Pill_organizer
- deleted 4y ago[deleted]
- miked85 4y agoWouldn't this be true for almost any medication? I'm not aware of anything unique about this one.
- dtgriscom 4y agoDifferent medications have different ratios between their effective doses and their harmful doses. The smaller the ratio, the more sensitive the results to an overdose. https://en.wikipedia.org/wiki/Therapeutic_index https://en.wikipedia.org/wiki/Therapeutic_index
- benj111 4y agoSo is my evening G&T good for me, or will quinine not work?
- TylerE 4y agoModern tonics contain far less quinine than the “real” stuff. Like 95% less
- benj111 4y agoso i need to have 20 G&Ts then?
- Khelavaster 4y agolike, two quarts of (sugar free) strong tonic water a day.
- kcplate 4y agoI attribute never having contracted Covid-19, Malaria, and scurvy to my daily G&T therapy.
- NikkiA 4y agoReally going all-in on trying to find an off-label use that'll allow them to repatent this, aren't they?
- dariusj18 4y agoOr someone has a lot in stock and wants to offload it ;)
- x86_64Ubuntu 4y agoYes, HN has something of a COVID-19 denialism streak.
- dang 4y agoHN is divided on topics where society at large is divided. It would be strange if it weren't. It's also a highly international forum and divisive topics play very differently in different places. Readers often mistake a comment for something weird and radical coming from a person nearby, when in fact it's an unremarkable comment coming from a person far away. It's unfortunate that this leads to so many brutal online arguments. In person, people instinctively modulate their communication with respect to such variables; online they don't, because the information isn't available and we can't make it available. https://news.ycombinator.com/item?id=23308098 https://news.ycombinator.com/item?id=23308098
- tptacek 4y ago"Re-patent"?
- akiselev 4y agoIt's... complicated but I assume the GP meant new drug product exclusivity [1] which is a process by which a pharmaceutical manufacturer can get a short window of exclusivity for a new approved use without rights over the original patent. That exclusivity is largely for generic manufacturers [2] though and it's separate from the patent patent term restoration [3] the FDA grants to patent holders to help with the time it takes to get to market. "Re-patent" would mean something different like Shire patenting Vyvanse by adding an amino acid cap to amphetamines, changing it enough that it becomes a new drug with a new patent. That would require clinical trials and all the expense that goes with them. [1] https://www.fda.gov/drugs/cder-small-business-industry-assistance-sbia/small-business-assistance-frequently-asked-questions-new-drug-product-exclusivity https://www.fda.gov/drugs/cder-small-business-industry-assis... [2] https://www.fda.gov/drugs/development-approval-process-drugs/frequently-asked-questions-patents-and-exclusivity https://www.fda.gov/drugs/development-approval-process-drugs... [3] https://www.fda.gov/drugs/cder-small-business-industry-assistance-sbia/small-business-assistance-frequently-asked-questions-patent-term-restoration-program https://www.fda.gov/drugs/cder-small-business-industry-assis...
- mortehu 4y agoI post this comment quite frequently on HN, but yet again this is not a randomized controlled trial, but rather an observational study. On top of that, they state several insignificant statistics using the point estimate (e.g. "Hydroxychloroquine initiators had an 8% lower rate of Alzheimer's disease and related dementias compared to methotrexate initiators (95% confidence interval 17% to 0%)" (paraphrased).
- ed25519FUUU 4y agoIn this case at least the sample is good. 100k people with rheumatoid arthritis, who are likely taking HCQ for the rest of their lives.
- carbocation 4y agoWhen interpreting the observational literature (including my own work) I find it helpful to think like a threat actor: how can this association be broken? Note that this is an article making huge claims about Alzheimer's but is published in Molecular Psychiatry. Given that signal, I'm just going to look at the abstract and not read the full text. Here, the study population is patients with rheumatoid arthritis. This tells you up front that we don't have a typical population, but a highly selected one. The use of HCQ is observational, not randomly assigned. So, how could HCQ look protective even if it had no effect on Alzheimer's biology? 1. Maybe more rheumatoid arthritis patients should be on HCQ. It's a disease-modifying drug, after all. So it may be the case that people with better care, or more wealth, are more likely to be on HCQ. And that could be associated with other lifestyle factors that are never fully accounted for in an observational analysis. 2. Or it could be the case that people with dementia are less likely to have their HCQ prescriptions renewed, so the arrow of causation could even be reversed. Additionally, one could imagine that HCQ might actually protect against Alzheimer's disease in people with rheumatoid arthritis—but not in a general population. That would be very big news, but would require further study. And sure, it could be the case that HCQ reduces Alzheimer's risk in everyone. But you'd need a lot more evidence to buy that.
- surfsvammel 4y agoThis summary right here is what I would like to accompany any medical study that pop up online. Thanks for helping us stay skeptical (doesn’t mean that I’m not hopeful and that the claims is true)
- ummonk 4y agoI think the study is somewhat more robust than you're letting on, since it compares HCQ against an alternative rheumatoid arthritis drug - Methotrexate. It's possible that the choice of prescribed drug itself is correlated with some other confounding factor, but it's certainly less likely to be so compared to HCQ vs nothing. Also, the study itself is clear about the amount of evidence needed to validate whether HCQ actually reduces Alzheimer's risk: "This hypothesis merits testing through adequately powered clinical trials in at-risk individuals during preclinical stages of disease progression."
- kybernetyk 4y ago[flagged]
- bad_username 4y agoWorm dehorser
- 8note 4y agoPresumably they're observing people prescribed the version for people
- deleted 4y ago[deleted]
- rdmirza 4y agoThe main concern here (and most observational studies) is confounding by indication. Specifically, the same reason some people got hydroxychloroquine as opposed methotrexate is the same reason you see differences in the outcome. In this case there’s plausible confounding that needs to be addressed before any conclusion like the title could be drawn. Generally hydroxychloroquine is used in mild rheumatoid, whereas methotrexate is used in moderate-severe disease. Inflammation in rheumatoid (and other inflammatory diseases) contribute to atherosclerosis and plaque buildup. Rheumatoid increases the risk of coronary disease by 1.5-2x. That difference alone could account for the difference in dementia, particularly vascular dementia.
- moloch-hai 4y ago"In mice". And, the effect size is pretty small. The largest effect size I know of, predicting incidence of real dementia in real people (46,000 people over 70), is that a recent Tdap booster predicts a 40% reduction. Nobody knows how or why, or isn't saying. Apparently treatment for herpes has a large effect size, too. It is easy and safe to get both.
- caeril 4y agoLooks like we're running through the same playbook we saw with COVID, and the obesity comorbidities. Being obese in your 30s-50s increases your chance of developing dementia or Parkinson's later in life by somewhere between 500 and 800 percent. Losing the weight is such an OBVIOUS intervention for things like diabetes and CVD risk, but it affects risk factors for nearly every other chronic disease on the list, including something like half of all cancers. And yet, we're researching the type of micro-optimizations indicated in this article. Don't be fat from 30 to 60. That's it. That's the solution. And yet, all I see is: Medically: Masking the symptoms with medication, with not even a cursory nod to improving lifestyle factors. Societally: Wild adoration of Lizzo and "Health At Any Size" ridiculousness.
- pieter_mj 4y agoAlzheimer's and dementia : Diabetes type III.