Cuomo: "Everybody wants Hydroxychloroquine to work." He says it's become extremely politicized. Said "maybe it works," but can't confirm. Says if the Federal government gives us more, we will dispense more.
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https://www.cnn.com/2020/04/15/health/new-french-study-hydroxychloroquine/index.htmlNot only is there zero peer reviewed controlled clinical evidence in the malaria drugs being effective against COVID-19, but the fear amongst the medical community is that the heart damaging side effects of these drugs may be much more of a concern than any possible benefit.
Does anyone know how these heart-related side effects are managed with lupus and rheumatoid arthritis patients? These drugs are apparently used frequently enough that there were major concerns about those existing patients not having access to these medications if they were used for COVID-19 patients instead. The supply concerns were serious enough that some limits were placed on the use of these medications for COVID patients. What is different about the side effects for these existing patients?Not only is there zero peer reviewed controlled clinical evidence in the malaria drugs being effective against COVID-19, but the fear amongst the medical community is that the heart damaging side effects of these drugs may be much more of a concern than any possible benefit.
Isn't COVID-19 causing heart damage as well? Is it worse with or without the drugs? Just curious.Not only is there zero peer reviewed controlled clinical evidence in the malaria drugs being effective against COVID-19, but the fear amongst the medical community is that the heart damaging side effects of these drugs may be much more of a concern than any possible benefit.
My Mom is 80 and has RA for many years and is prescribed 200mg Hydroxychloroquine daily. She is required to visit the Ophthalmologist yearly, for a retinopathy evaluation, which can occur with high doses of medication or greater than 5 years use of the medication. I have never heard of heart related issues that she is screened for because of the meds.Does anyone know how these heart-related side effects are managed with lupus and rheumatoid arthritis patients? These drugs are apparently used frequently enough that there were major concerns about those existing patients not having access to these medications if they were used for COVID-19 patients instead. The supply concerns were serious enough that some limits were placed on the use of these medications for COVID patients. What is different about the side effects for these existing patients?
Thanks.
I would assume the difference is within the margin of error, that is the most simple explanation.The study is generally negative towards Hydroxychloroquine, but the actual results were somewhat positive. For instance, "Looking just at deaths, 2.8% of the patients who took hydroxychloroquine died, and 4.6% of the patients who did not take it died. That difference was also not found to be statistically significant."
For the more statistically knowledgeable people here, I am curious as to why this would be insignificant. Nearly a halving of the death rate would be significant to me. I know they have probability error bars, but this is something that merits more research and not arm waving to me.
Later edit minutes after post. Wrote my post while jwa did his. Sorry for the repetitious part, but my post, partly, has a different angle than jwa.
There is much less cardiac stress for a person with lupus under control than one on a vent with double pneumonia caused by a severe infection. The cardiac issues with HQ would be much more of a problem with C19.Does anyone know how these heart-related side effects are managed with lupus and rheumatoid arthritis patients? These drugs are apparently used frequently enough that there were major concerns about those existing patients not having access to these medications if they were used for COVID-19 patients instead. The supply concerns were serious enough that some limits were placed on the use of these medications for COVID patients. What is different about the side effects for these existing patients?
Thanks.
The Vanderbilt research appears to be HQ only, no mention of zinc or erythromycin. Perhaps that is just the editor/writer but if so it is disappointing as most say you need the combo for success.
It is common in scientific papers to see differences that seem qualitatively important but are not statistically significant. In other words, we cannot say for sure that this pattern is "real" or if it is a mirage (i.e. essentially an artifact of the data)."Looking just at deaths, 2.8% of the patients who took hydroxychloroquine died, and 4.6% of the patients who did not take it died. That difference was also not found to be statistically significant."
For the more statistically knowledgeable people here, I am curious as to why this would be insignificant. Nearly a halving of the death rate would be significant to me. I know they have probability error bars, but this is something that merits more research and not arm waving to me.
.
As I'm sure you are aware from your work, if you cannot say that a finding is statistically significant, you cannot be sure if that pattern is real, or just a function of variability with the experimental population. You cannot exclude the possibility that this treatment could work, but the current data does not show that it is effective.PSU2UNC,
Here is an interesting quote from the article. “Looking just at deaths, 2.8% of the patients who took hydroxychloroquine died, and 4.6% of the patients who did not take it died. That difference was also not found to be statistically significant.” Seems that a 64% difference is substantial. That said the study pool size is very small and doesn’t address diversity of the pool for age, sex, co-morbidity, etc...
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Chi, please stop posting HCL or CQ only studies, we get it, and we called this days ago that these articles would start coming out. What would be meaningful would be combo studies and anectodotes, that is what is in question, especially relevant is the triple combo. Let the chips fall where they may with that, but unfortunately these HCL only articles are nothing but political.
PSU2UNC,
Here is an interesting quote from the article. “Looking just at deaths, 2.8% of the patients who took hydroxychloroquine died, and 4.6% of the patients who did not take it died. That difference was also not found to be statistically significant.” Seems that a 64% difference is substantial. That said the study pool size is very small and doesn’t address diversity of the pool for age, sex, co-morbidity, etc...
As I'm sure you are aware from your work, if you cannot say that a finding is statistically significant, you cannot be sure if that pattern is real, or just a function of variability with the experimental population. You cannot exclude the possibility that this treatment could work, but the current data does not show that it is effective.
Attempting to link "independent" causal variables (like smoking) are very different from a druge study (hopefully you know that). One is epidemiological and the other experimental. Yes, it is true that we do not know for sure that smoking exacerbates SAR-Cov-2. But we cannot do experiments that test that hypothesis.Thank you for reiterating what I said in my post. Let’s take all the data globally, combine it, comb through it, and segment treatment type and population diversity. Then we can comment on what the study means. The politics have gotten in the way of this entire treatment and people have simply tried to stomp it or support it because of who suggested it.
Everyone seems to be willing to accept that smokers have less a threat of death from COVId19 per one publication, did we hear any uproar about those “facts”. Hmmm seems like and interesting juxtaposition.
Attempting to link "independent" causal variables (like smoking) are very different from a druge study (hopefully you know that). One is epidemiological and the other experimental. Yes, it is true that we do not know for sure that smoking exacerbates SAR-Cov-2. But we cannot do experiments that test that hypothesis.
Isn't COVID-19 causing heart damage as well? Is it worse with or without the drugs? Just curious.
PSU2UNC
I know it didn’t seem like what I wrote could be true, but in fact there was a study published about the abnormally low death toll attributed to smokers across the board regardless of comorbidity.
Chi, please stop posting HCL or CQ only studies, we get it, and we called this days ago that these articles would start coming out. What would be meaningful would be combo studies and anectodotes, that is what is in question, especially relevant is the triple combo. Let the chips fall where they may with that, but unfortunately these HCL only articles are nothing but political.
The HCQ group (n=84) resulted in 3 deaths while the non-HCQ group (n=97) resulted in 4 deaths. This is 3.6% death in HCQ group and 4.1% death in non-HCQ group. The 2.8% and 4.6% quoted in the article are the weighted proportions from each group. It is easier to see why no statistical difference when looking at the raw data.
Further, the paper notes that the HCQ and non-HCQ group were well-balanced, but it is notable the non-HCQ group had a high percent for each listed co-morbidity except liver cirrhosis.
HCQ. Non-HCQ
Chronic respiratory issues 5/84 15/97
Chronic heart issues 1/84 5/97
Cardiovascular issues 38/84 56/97
Diabetes 4/84 11/97
Kidney issues 1/84 8/97
Liver cirrhosis 1/84 0/97
Immunodepression 8/84 13/97
So with only one more death in the non-HCQ group given the larger numbers with respiratory, cardiovascular, or heart issues it doesn’t seem like the HCQ group did any better. Certainly nowhere close to saying that the HCQ group had a 60% lower percent of death. The HCQ and non-HCQ groups are closer to be equivalent.
I was wondering if with the paralyzed cilia from smoking with the resultant mucous build up, if the mucus somehow acts as a barrier between the virus and the lung alveoli . IDK but I haven’t heard a reason yet .Three of four countries have noticed this at the macro level. Tobacco smokers seem to be under-represented in the deaths. It hasn't been studied yet -- a question for future years.
I asked a pharma researcher friend about it -- is it possible nicotine is actually helpful? He responded that smoking causes so many changes in the human body, even if tobacco smoking were protective, it would be impossible to tease out why any time soon.
Still, why not add a pack of Camels to the first aid kit along with the quinine, zinc and the horse de-wormer. (just kidding! kidding!)
I’m happy that to the best of my knowledge , we haven’t had a vent shortage anywhere in the USA? Have we ? In Lancaster PA, our hospital hasn’t gone over 16 or so on vents for COVID Pts. We have about 90 vents and 50 anesthesia machines . So we haven’t even come close to a crunch . Hope it stays that way . Max was 16 ish and now at 8 on vents . Gov. W is now mandating that ALL non hospital medical/dental providers send in a detailed list of all PPE, medications , anesthesia machines etc. so they can be confiscated if he deems it so . Gov. Is also now placing some mask and additional requirements on opened businesses. This becomes enforceable 4/19 at 8 pm .NY state predictions and actual. They are now exporting ventilators
Maybe, just maybe, this virus doesn't attack all people 100% the same, and thus different medicines will work different for different people? If all meds worked the same, then we'd only have 1 high BP medicine, 1 cholesterol reducing medicine, 1 ....... Maybe many recover with nothing, but some respond to Actemra, and some respond to hydroxychloroquine, and some respond to the triple therapy, and some respond to Ivermectin, and some respond to skittles up their butt. With this disease and cure, can there really be any all/none/always/never absolute assigned? When I see those words in tweets, I see both ends of the political normal curves hopes and dreams, and not reality.I know Actemra is in trials right now and has shown some promise helping patients with the dangerous “ cytokine storm “ progression which is more often seen in younger, healthier people experiencing serious COVID.
I saw a story about a former NW football standout from the ‘96 squad now a physician who believes Actemra probably saved his life.
With a theraputic, I think the primary goal needs to be keeping a person out of the hospital and off of a ventilator. The thing about meds is that they don’t all work all of the time for everybody. Meds have a “ number to treat “ which means a dozen people might have to take a given med for one to derive a benefit ( and by the way, a number to treat of 12 is often considered reasonable ! ).
I’m happy that to the best of my knowledge , we haven’t had a vent shortage anywhere in the USA?
Does anyone know how these heart-related side effects are managed with lupus and rheumatoid arthritis patients? These drugs are apparently used frequently enough that there were major concerns about those existing patients not having access to these medications if they were used for COVID-19 patients instead. The supply concerns were serious enough that some limits were placed on the use of these medications for COVID patients. What is different about the side effects for these existing patients?
Thanks.
My daughter has been on hydroxychloroquine for about 15 years (lupus). Most likely she is on a low dose (don't recall dosage as she's been out of the house a number of years) as it's being used as a maintenance drug at this point to continue to suppress her immune system. The only issue we were made aware of by her doctors is possible effects on her retina, so annually she gets a visual field test. Her rheumatologist said years ago that it was a great drug with very limited side effects.
Did you mean to post 'vents aren't working ' ?Just saw this today. I have seen a video of a dr who said vents are working so it may be the one she refers to in the video. He also had mentioned a correlation to altitude sickness.