mellowtigger (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
mellowtigger) wrote2020-07-27 08:43 pm
mellowtigger) wrote2020-07-27 08:43 pm
Entry tags:
about hydroxychloroquine
I've been trying (and frequently failing) to check the stories about hydroxychloroquine (HCQ). The Republican liar-in-chief has heavily promoted it, which is reason enough to doubt it. Now, though, a Yale doctor is doing the same, so I figured it's worth a second look.
The best reason I can find for the WHO recommendation against the use of HCQ is a faulty dataset. They added a misclassified hospital into the dataset. I can't find the same review recalculated with the better/repaired dataset. What happened to it? I admit, that's suspicious. Sure. When my local University of Minnesota ran a well-controlled study of patients given HCQ, however, they notice no effect, neither good nor bad.
I finally located a single specific complaint levied by the anti-HCQ camp: that the noted antiviral benefits are not studied in epithelial lung cells, where it is most needed. That information would help the argument, but it doesn't seem like a requirement here. There are also general procedural complaints about lack of randomized, double-blind, placebo-controlled studies, which the Yale doctor simply waves away as unnecessary during this emergency.
But the pro camp insists that hospitals around the world are noticing huge benefits in giving HCQ plus azithromycin (not an antiviral, but an antibiotic) very early after the onset of symptoms. Sure, there could be some kind of synergy effect. But when a doctor at Henry Ford Hospital (the one referenced by the White House trade advisor who is pushing HCQ) looked at some of those combined trial results, she found only "encouraging" observational information, but again lacking the rigor of proper studies.
So, still, the positive benefits might just be an accident of randomization. Those hospitals lucked out in the patients they received, and their treated subjects fared better but not necessarily because of the drug combination.
Why is it that only the observational studies that cut corners are finding positive results, while the rigorous studies are finding no significant benefit? It smells. It smells like somebody has a chance to profit from pushing HCQ onto the market. Like the trade advisor (not a medical expert) promoting HCQ.
Somebody here is selling something. Who would act so unethically?
Update 2020 July 28: Twitter just suspended Trump Junior's account for promoting HCQ nonsense.
The best reason I can find for the WHO recommendation against the use of HCQ is a faulty dataset. They added a misclassified hospital into the dataset. I can't find the same review recalculated with the better/repaired dataset. What happened to it? I admit, that's suspicious. Sure. When my local University of Minnesota ran a well-controlled study of patients given HCQ, however, they notice no effect, neither good nor bad.
"In this randomized, double-blind, placebo-controlled trial of symptomatic outpatient adults with probable or confirmed early COVID-19, a 5-day course of hydroxychloroquine failed to show a substantial clinical benefit in improving the rate of resolution of COVID-19 symptoms in the enrolled clinical trial participants."
- https://www.acpjournals.org/doi/10.7326/M20-4207
- https://www.acpjournals.org/doi/10.7326/M20-4207
I finally located a single specific complaint levied by the anti-HCQ camp: that the noted antiviral benefits are not studied in epithelial lung cells, where it is most needed. That information would help the argument, but it doesn't seem like a requirement here. There are also general procedural complaints about lack of randomized, double-blind, placebo-controlled studies, which the Yale doctor simply waves away as unnecessary during this emergency.
But the pro camp insists that hospitals around the world are noticing huge benefits in giving HCQ plus azithromycin (not an antiviral, but an antibiotic) very early after the onset of symptoms. Sure, there could be some kind of synergy effect. But when a doctor at Henry Ford Hospital (the one referenced by the White House trade advisor who is pushing HCQ) looked at some of those combined trial results, she found only "encouraging" observational information, but again lacking the rigor of proper studies.
"As an observational study, it would have been good to have insights into what factored into the treatments that the patients received. For example, of the patients who received neither drug, why were most of them 65 or older?” Dr. Le pointed out. “Unfortunately, the study authors did not address that."
- https://www.medicalnewstoday.com/articles/does-hydroxycholorquine-cut-covid-19-mortality-expert-urges-caution#Comparing-mortality-rates
- https://www.medicalnewstoday.com/articles/does-hydroxycholorquine-cut-covid-19-mortality-expert-urges-caution#Comparing-mortality-rates
So, still, the positive benefits might just be an accident of randomization. Those hospitals lucked out in the patients they received, and their treated subjects fared better but not necessarily because of the drug combination.
Why is it that only the observational studies that cut corners are finding positive results, while the rigorous studies are finding no significant benefit? It smells. It smells like somebody has a chance to profit from pushing HCQ onto the market. Like the trade advisor (not a medical expert) promoting HCQ.
Somebody here is selling something. Who would act so unethically?
Update 2020 July 28: Twitter just suspended Trump Junior's account for promoting HCQ nonsense.