Anecdotal evidence hydroxychloroquine works from doctors in different locations

[AnxiousNoMore]

Stories of this medication are starting to come in:

https://theduran.com/france-sanctions-chloroquine-after-78-of-80-patients-completely-recover-from-covid-19-within-five-days/

https://www.reddit.com/r/worldnews/comments/frieqi/dr_vladimir_zelenko_has_now_treated_699/

I imagine there will be lots of news from doctors in NY and other places in the next weeks.
Don't try this at home with products containing it though, because it is toxic so only a doctor can determine a safe amount.

[AnxiousNoMore]

Brazil's cult of hydroxychloroquine. The unwanted Covid drug that politicians won't let go away.
https://www.msn.com/en-us/news/world/brazils-cult-of-hydroxychloroquine/ar-BB17kQlA                                                       Brazil has imported millions of doses of the drug, and a survey released Sunday by the Medical Association of Sao Paulo State showed that fifty percent doctors in the state felt pressure to prescribe the unproven drug.

[mkh9]

They can have it.
mkh9

[AlbertinaG]

There are different studies some say it works and for some, it doesn't. Hydroxychloroquine has helped some patients and it gives relives that why everyone is looking for it and trying to get the best result from it.

[Paxiled]

Again, let me emphasize, there is no evidence anyone has been helped or that it has given any relief.  The only way to tell if this is so is to give some equally situated people the drug and some not, so you would know it was the drug that helped and not just the person getting better.  Anything else is solely anecdotal, and the anecdotal data isn't consistent, with some docs saying they think it helped and some saying it didn't.  I saw an interview with someone who recovered after reaching the ventilator stage, which is not common, and he was given the drug, but he was quite honest and said neither he nor his doctors have a clue whether the drug helped or not.  It is what it is, when someone is dying, you can't do a double blinded study.  It's unethical.  It's cruel.  But it has to be done unless this disease is a one and done disease and never comes back.

[CurfewX]

You're right, Pax.  No review board would approve of a double-blind study that involves withholding potentially life-saving treatment from one group.  What can be done is to test two equally-promising treatments against each other, and I hope that's what can happen, at least in dire cases.  So many of the hydroxychloroquine studies have been stopped due to lack of evidence of efficacy, and undesirable side effects.  I saw one study's results showed worse outcomes for those treated with the drug.
Here's a good, very current article outlining some of the challenges: https://www.scientificamerican.com/article/heres-what-we-know-about-the-most-touted-drugs-tested-for-covid-191/

[AnnieBrooke]

The trouble with saying "it has helped some patients" is that there isn't any proof that it did or didn't. Say someone gets Covid-19 and is given a drug being considered as possibly helpful, and the next day feels better. One can't conclude the drug was responsible, it might have just been time for the virus to be done in that patient. Say someone else gets Covid-19 and is given a drug, and continues to have the same symptoms. One can't even conclude that the drug didn't help, maybe it kept things from being worse.  Say a doctor decides to give a drug to a group of fewer than ten sick patients, but first, kicks the two sickest off the list. The other patients get better. Even that isn't proof that the drug did it; it might have been time for them to get better.  

People really want to believe *something* will help. Someone in that mindset will read questionable reports and unfounded claims and give credit to any anecdotal story that someone was helped, and discount any story where someone wasn't helped. It's human nature to disagree with things if we don't want them to be true. But none of this is proof.

[AnxiousNoMore]

We might get some preliminary data about how well the Ebola drug, remdesivir, seems to be working out in the next weeks when Gilead releases the data on this small preliminary trial. This study did not involve a placebo, so there will be question marks. There are other trials going on so it will be a while before the med is totally proven.
"Mullane said during her presentation that data for the first 400 patients in the study would be “locked” by Gilead yesterday, meaning that results could come any day."

https://www.statnews.com/2020/04/16/early-peek-at-data-on-gilead-coronavirus-drug-suggests-patients-are-responding-to-treatment/
I am not claiming anything with this post, just noting that this med is getting a lot of doc's attention so the they and the FDA will be making the judgements.

[Paxiled]

I have been hearing for awhile, Anxious, that this much more than quinine drugs does show some serious promise -- the stock market, for whatever that's worth, is interested.  I also learned last night that one company has already completed Phase 1 on a vaccine, which is way ahead of any0ne else, but who knows what that means either?  It's a smaller pharmaceutical company which means it can work fast but probably can't make enough of it if it does work, so that will also be interesting.  I also heard something else of interest on the BBC.  A specialist who has been treating folks in very hard hit Italy believes too many people were put on ventilators, which is why the death rate is so high.  The article has been published, but it's just one doctor.  His belief is that ventilators are too strong for most of those with Covid, whose lungs are still quite functional as compared to the very stiff organ usually treated with a ventilator, and so the ventilator is just too powerful.  His experience is keeping people on more minimal oxygen aid keeps their lungs strong until they recover instead of possibly damaging them by completely breathing for them.  Wonder if this will pass muster.

[mkh9]

I agree. Now that all the data have come out there is NO evidence that Hydroxy chloroquine has any beneficial effect on Covid19 patients. No evidence that it prevents anything. By the way Hydroxychloroquine is a very dangerous drug. My friend went blind from it. She was on it for a long time any monitored closely by an opthamologist. But still she has permanent retinal damage. During her time on the drug she also go so low in platelets she had to have a transfusion. She was misdiagnosed by a prominent rheumatologist, specialist. It turns out they didn't really do much testing on her to diagnose Lupus. She had a biopsy done any very limited lab work. So she is paying the price for trusting this doctor.  I am a licensed microbiologist which also includes immunology, molecular biology, chemistry etc.
To those on this drug I hope you have had extensive testing to determine if you are really positive for lupus, not just a biopsy.  Regarding the biopsy method the doctor cannot determine if you have rosacea vs. Lupus based on that alone. Now my friend is on no medications and has nothing. It was just contaminated water and allergy to various products. Beware. Stay safe, everyone. Wear a mask AND stay 6 feet away from people is the best way to prevent Covid19.
mkh9

[AnxiousNoMore]

The only positive study in the last 3 months about this med was this observational one that appeared in CNN last week, so you can read the whole article if interested. Note that this was not a controlled study and researchers not involved with the study were critical of it, so a lot of follow up would have to be done to verify any of its findings, but all the articles I have read say that the world's researchers have moved on from this politicalized drug. The White House hasn't however!
A team at Henry Ford Health System in southeast Michigan said Thursday their study of 2,541 hospitalized patients found that those given hydroxychloroquine were much less likely to die. Henry Ford team did not randomly treat patients but selected them for various treatments based on certain criteria.
"As the Henry Ford Health System became more experienced in treating patients with COVID-19, survival may have improved, regardless of the use of specific therapies," Dr. Todd Lee of the Royal Victoria Hospital in Montreal, Canada, and colleagues wrote in a commentary in the same journal.
"Finally, concomitant steroid use in patients receiving hydroxychloroquine was more than double the non-treated group. This is relevant considering the recent RECOVERY trial that showed a mortality benefit with dexamethasone." The steroid dexamethasone can reduce inflammation in seriously ill patients.

[AnxiousNoMore]

The Florida governor was touting it today too and claimed most of the recently infected in his state are aged 21. I wonder how many people believe the former.

[Paxiled]

Seriously, Anxious, he was still touting this drug today?  It is true that most of the people being infected in the current stage of our surge are younger than in the earlier stage.  Now, most are exactly 21?  Unlikely.  Florida is not known as a youthful state.  I've been hearing under 40, not that young.  I've also been hearing that with all the emphasis on better care (which as far as I can tell from listening to interviews with physicians treating actual patients on the news, which you can see every day and every night on TV, listen to them every day on the radio, and read them every day in the newspaper, it's not at all based on that drug, which they don't mention at all so I don't believe they are using it.  They do mention steroids a lot to manage inflammation and blood thinners to manage the clots and a little bit of mention of remdesivir but not a whole lot as all it appears to do is shorten hospital stays a very short amount.  Which is better than not having that.  They also mention having patients lying prone, not using ventilators unless absolutely necessary and when using them using them quite differently than before so they aren't as destructive.  Basically, they've gotten a lot better at this, learned from earlier mistakes that killed people, and the patients are younger and stronger.  But contrary to certain recent statements about most people having no problem who get it, there are still large numbers who are showing significant lung damage and other organ damage on diagnostics and nobody knows if this will be permanent or last a few months or what.  Not dying isn't the only bad thing that can happen in life.  But again, I haven't heard an actual practicing doc mention quinine drugs at all in months.  Peace.

[Paxiled]

Meant dying isn't the only bad thing.  Oops.

[auntiejessi]

I'm in Florida. We don't believe anything he says.

[AnnieBrooke]

I assume you would say he's not entirely a shoo-in for re-election, then? lol

[AnxiousNoMore]

Brazil President Jair Bolsonaro; “I’m perfectly well,” Bolsonaro told journalists in a live interview on Tuesday, after announcing his positive test. He’s taking hydroxychloroquine, an anti-malaria medicine that he has touted as being effective against the virus

[mkh9]

A lot of junk news out there. Be careful what you believe. As I recall they are giving Remdesivir as treatment for serious cases regardless of not having a placebo now. It is standard treatment . But as mentioned above, it shortens the duration and is far from a cure. Now they are also saying that they are going to possibly give anti-coagulants as standard treatment for serious cases because there was a pathologist that saw the damage this bug does. The Remdesivir is undergoing trials while the latter was an observation and doesn't mean they will actually do this. But, if someone gives consent they can give you a drug I think. So, just adding to this conversation.
mkh9

[AnxiousNoMore]

paxiled - "Seriously, Anxious, he was still touting this drug today? " Navarro touted it a few days ago too - maybe a smokescreen so Trump can move on to new claims.

[CurfewX]

It's not just "junk news," though there is a ton of that to go around.  A compounding problem is that people don't understand the hierarchy of scientific evidence, and that a single case-control study doesn't "prove" anything.  Some of my friends have been touting a new study that did show some improvement among patients using hydroxychloroquine, citing it as "proof" that the drug works.  Unfortunately, they have missed that meta-analyses and systemic reviews are at the top of the evidence pyramid, and none of those show benefit from this drug, and most show undue harm.  
Here are a few that are pre-pubs, but will likely get published barring any analytic errors:
https://www.medrxiv.org/content/10.1101/2020.05.14.20101774v2
https://www.medrxiv.org/content/10.1101/2020.04.14.20065276v4

[Paxiled]

Anxious, actually, Trump is making new claims already.  He's saying the US has done better than any other country and that 99% of everyone who gets it has no problems.  Yet, every time I see an ER doc interviewed, they are completely terrified and demoralized that this country can't get this right and the possible long-term consequences of having had this disease.  They obviously don't know yet, hopefully the body repairs the damage over time.  As for Florida, Annie, I fear Florida will continue to be Florida and will reelect the guy.  Alas.

[AnxiousNoMore]

France study says no effect on people who took it within 48 hours of hospitalization.  https://www.cnn.com/2020/04/15/health/new-french-study-hydroxychloroquine/index.html
More study data coming next week.


Also this reporter interviewed some doctors in NY hospitals;
"...hydroxychloroquine, the anti-malaria medication that President Trump has hailed as a possible “game changer.” Most patients at both hospitals I visited have been receiving hydroxychloroquine, sometimes combined with the drug azithromycin, but people are still dying in large numbers. Some doctors think that these drugs help if administered early, but I spoke to no one on the front lines who believed they were a game changer."
https://www.nytimes.com/2020/04/11/opinion/sunday/coronavirus-hospitals-bronx.html?utm_source=pocket-newtab

[mkh9]

Yes the results are not coming out good for hydroxy choloroquine. But they still looking at it. The antibody treatment Remdesivir is looking good for use in
The very ill . It has bad side effects of liver toxicity.

[Paxiled]

I have heard this all along from Dr. Fauci.  Several experts I've seen interviewed believe Remdesivir and another anti-viral have much better potential, but alas, all drugs are toxic and can put more strain on the immune system.  It's the immune system reaction killing people, so I wonder if tamping that down in those most severely hit might be an out of the box short-term way to treat those who have reached the point of hospitalization.  No idea if this could be done, as the immune system is also what saves us from it, but it is what's causing the fever and the lung congestion.  Sigh.

[mkh9]

They have done limited studies on hydroxychloroquine or Plaquinil,  There are some clinical trials that have started. I believe they are using Azithromycin with it. They are using high dose. There are also trials on the anti-malaria drug Chloroquine. The dose is different for both and they are not the same drug.  So far they are only using Plaquinil  on the very ill since the side effects can be very harsh. Some get very low platelets and bleed and you can get retinal toxicity and go blind. But I think in the short term dosage it may be okay but there is no data to prove one way or the other that  I know of. I do know my friend lost her eye sight due to Plaquinil. She was being closely monitored by an eye specialist and she was on long term (years) of Plaquinil. But another friend of mine was on it for a short time. About a month or maybe two and she got bleeding through the mouth. So you don't want to take it without the advise of a physician.
mkh9

[AnxiousNoMore]

My spouse has lupus so is stuck taking Plaquinil so I got overly optimistic when I heard about the Zelenko result and I was so excited that I didn't notice the France patients were not on the same med when I googled for more info on Zelelnko. Thanks for setting me straight.
She mentioned being  on less than the trial dose and has been wondering if infection occurs if there will be a benefit from already having the med in her system despite being at the lower dose. But more importantly we have been wondering if lupus patients will continue to get their fill. Online articles describe patients being rationed at the drugstore because doctors are prescribing for their family stockpile. Oh well, these are signs of the times that we are getting used to in some ways, shortages and questions that answers may never come for, while we wait for the dark days to pass.

[Paxiled]

The experts on TV have confirmed there is diversion going on of this drug somewhere along the line and there is danger of it not being available for the only conditions it has been proven to treat, which doesn't include corona.  Quinine comes from a toxic plant in South America, and it's even more toxic when you isolate it.  So they do have to be careful with this stuff.  It was used in China, and the data from there at least shows it not only didn't do much but those who took it actually fared worse, but that could be because they were sicker to begin with.  This isn't likely to be that useful.  Other drugs are being manufactured now that have much more potential, but by the time they exist hopefully this current surge will be past.  But it will be available maybe when it comes back in the fall.  Peace, all.

[mkh9]

Actually, the newer clinical trials are being done on Hydroxychloroquine  plus Azithromycin. So far the trials are looking good at the right dose. There are other trials as well that are antibody based. That may come out in the fall. I hope the best for everyone. it is such a heavy thing to take in.
mkh9

[AnxiousNoMore]

I know these 2 doctors claims do not have any credibility yet but just thought I would bring up a point.
https://www.france24.com/en/20200329-french-expert-says-second-study-shows-malaria-drug-helps-fight-coronavirus
https://www.snopes.com/fact-check/zelenko-669-coronavirus-patients/
The articles I have been reading today including the Rudy Guiliani notation, interchange the words hydroxychloroquine and Chloroquine in the same articles as if they were the same drug. So like Trump, I'm not owning my earlier mistake anymore, lol.

[Paxiled]

But keep in mind the current studies are too small to be useful and can't be randomized -- it would be unethical to give the drug to someone with the virus and not give it to someone else with the virus and compare the results.  That can only be determined from actual practice, because different docs are using different practices, but it's very hard to compare results when the patients involved are suffering very different levels of the illness.  This is going to remain anecdotal until the current surge is over, and by then better options that are being worked on will hopefully be available but we have to be conscious of the fact that this virus is very similar to the common cold and the common cold still has no known cure and no real treatment.  You just wait it out.  The hope is that because so far this virus isn't mutating like the flu and colds do, a vaccine and treatment will be more likely to be found.  Docs also have to be very careful because both of those drugs cause heart problems in about 10% of the people who take them besides other more benign side effects, and so some people who get these drugs will die of the drugs, not the virus.  That happens, all drugs are toxic, but it does make it hard for docs to decide what to do.  What appears to be happening is if a patient is quite severe, nothing so far is really working well including ventilators, so there's not much to lose but at that point drugs probably won't work either.  I'm not trying to be pessimistic, just restating what I've heard on the news from experts in the field, who are on TV every day and every night.  What we know works is social distancing, but if the whole nation doesn't do it at the same time we might not get the benefit.  Hard to know, really.  Some areas really haven't been hit, and when people say, well, they will in time, don't believe that either, because that hasn't happened anywhere else in the world so it might not happen here either.  Peace, all.  

[Paxiled]

And I only say this because of what Anxiousnomore is concerned about, which is, those with lupus and other conditions who we know the drug helps are in fact finding it difficult in some places to get it.  That's what I'm concerned about if the data on corona is unreliable and we know other things that work.  

[AnxiousNoMore]

"The Lupus Research Alliance and other organizations in rheumatology have urged the FDA to address the shortages and the past few days have brought some good news including: commitment from the FDA to preserve the supply of hydroxychloroquine for patients already taking it as well as a dramatic increase in the manufacture of these drugs and donations by a number of pharmaceutical companies."
https://www.lupusresearch.org/march-26-statement-lupus-research-alliance-puts-plaquenil-hydroxychloroquine-shortage-into-perspective-for-lupus-community/

[Paxiled]

Anxious, I recently read that the problem is, India makes the vast majority of this generic drug, but the ingredients almost all come from China which is obviously having severe supply chain issues.  Because too many doctors have hoarded the drug for their own use and because so much was given to covid patients without a whole lot of evidence they helped, there is now a shortage that can't be fixed unless the US reinstates its own ability to produce the drugs, which it used to have in Puerto Rico but those plants are all gone now.  So it's all India, which is shut down too, and China, which is slowly opening up again but with no guarantee that will last as it's getting new cases again, but not so many that it's considering shutting down completely again.  This disease as well as the trade wars that were going on before this happened demonstrate, I think, the advantages of not concentrating production of anything we need in just one place.

[mkh9]

Anxiousnomore,
I just clicked on the article you said to look at Hydroxycholorquine (Not to be mistaken as chlolorqune which is a anti-malarial drug).  The original poster removed the article. So I think it was a fabricated story.
mkh9