claycarver wrote:Are you thinking that the 5 studies Risch cited in his Journal article (and the 7 others he mentions) are invalid or likely oversold somehow? I'm sure your friends would be aware of the studies he cites and have come to different conclusions than he has, but I'd like to know why.
Per one of my friends at NIH, all the peer reviewed studied with control groups don't look promising right now. He says there were some credible claims and preprints suggesting that patients treated with HCQ had better outcomes, but that none of these had control groups, and that based on the results of better designed studies that produced good data, he thinks it's likely that other factors like selection bias explained the good results in the earlier preliminary research.
And second, do you think the risks of the drug are being oversold? It's said to be dangerous, but I was never told that when I was made to take it before my trip overseas to stave off malaria. I get that it might be ineffective (and taking it without cause EXACERBATES (NOT exasperates) a shortage) but I'm skeptical of the claim that it's dangerous.
NIH friend: "Dangerous is a relative term. It's more about lack of evidence for efficacy. If we had evidence for efficacy, nobody would be talking about danger or side effects."
Take it with a grain of salt - it's just one person giving his opinion.
I believe that I am the only published Professor of Medicine posting in this thread.
Slax - Your severe skepticism regarding Risch’s article is well taken. Your friend at NIH is spot the **** on. NOT ALL STUDIES ARE EQUAL. Many of the studies cited by Risch were GARBAGE.
Threrf23 & Clay - Apparently, neither of you bothered to read my last couple of detailed posts regarding HCQ - including peer-reviewed/randomized/prospective/controlled studies published in the NEJM & the Annals of Internal Medicine (the best of the best) demonstrating the lack of efficacy of HCQ in OUTPATIENTS (meaning that these were QUALITY STUDIES - not the garbage Risch cited). Therefore, I have copied & pasted below 2 of my recent posts with all of the links included. I suggest you actually read them.
(ALSO, if you happen to be someone who has a prolonged QTc interval & then get exposed to HCQ +/- azithromycin, you MOST DEFINITELY have an increased risk of a potentially lethal form of ventricular tachycardia called torsade de pointes (I have already posted about this at least 10 mother **** times in our 2 COVID threads [WITH REFERENCES]).
Copied & pasted my post from 7/21/2020:
HCQ failed to improve outcomes in early or mild COVID-19, according to two recent studies.
One trial, published by Clinical Infectious Diseases on July 16, randomized 293 outpatients with recently confirmed SARS-CoV-2 infection and less than five days of symptoms to either hydroxychloroquine or no antiviral treatment. No significant differences were found in the mean reduction of viral load at day 3 or at day 7, risk of hospitalization, or time to complete resolution of symptoms. “Our findings provide the scientific community and policymakers with essential insights on the inefficacy of [hydroxychloroquine] as a therapeutic candidate for SARS-CoV-2, at least in similar settings and conditions to ours,” the authors wrote.
The other trial, published by Annals of Internal Medicine on July 16, included 423 outpatients with laboratory-confirmed or probable COVID-19 randomized to either hydroxychloroquine or placebo. There were no significant differences in changes in symptom severity over 14 days, or in rates of hospitalization or mortality, both of which were rare. An accompanying EDITORIAL highlighted failures on the part of the producers, publishers, and consumers of scientific research during the “saga” of hydroxychloroquine. “The scientific community needs to do a good bit of stock-taking and soul-searching about its performance in meeting the challenges of the pandemic and how it will meet these challenges in future pandemics that are certain to emerge,” the editorialist wrote.[/i]
My comment on the second study (in response to some stuff you guys wrote after my last detailed post regarding this paper): Comparison of the values on their face is MEANINGLESS. Why? The p values were not just insignificant. They were freaking light years insignificant. They would have to enroll a ridiculously MASSIVE number of patients in a very likely UNSUCCESSFUL attempt to confirm that the trends in favor of HCQ were actually statistically significant.
These authors, the Annals of Internal Medicine & the ACP are all top of the line. The editorial I originally posted provides critical context. NOTHING WHATSOEVER ‘reeks of agenda.’ The original HCQ studies from France & wherever were disgracefully poor publications & then moronic & ignorant politicians & media took over & reprehensibly publicized the drug.
https://acpinternist.org/weekly/archives/2020/07/21/1.htmCopied & pasted my post from 7/23/2020:
And I have published plenty over the years - albeit in endocrine.
1. I would potentially agree with you if the non significant p values ‘just missed’ at 0.055 to 0.06 - rather than being off the charts statistically insignificant.
2. The editorial I posted earlier accompanying that study in the Annals of Internal Medicine was excellent & provided excellent context & a summary of the HCQ trials/fiasco/cluster **** to date. https://www.acpjournals.org/doi/10.7326/M20-5041
3. The other recent paper published on 7/16/2020 in Clinical Infectious Diseases (which I also included in my earlier post - https://www.acpjournals.org/doi/10.7326/M20-5041
) with similar efficacy endpoints showed ZILCH significance - WITHOUT any ‘positive appearing trends’.
4. The original + French study was pure trash & in the more recent + Henry Ford Hospital study, many more patients in the HCQ group also received dexamethasone (which has been found to be highly efficacious - which certainly casts doubt on the reported + findings).
5 I will wait to see the published, peer reviewed results of the remaining numerous ongoing HCQ trials, but, IMO, this drug is a loser.
6. Oh yeah, and a significant number of patients prolong their QTc intervals putting them at risk for lethal torsade de pointes/V Tach - severely damaging the risk benefit analysis. https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7211688&blobtype=pdf
7. Although I am VERY much to the right on many non-COVID matters & I am acutely aware of the flagrant anti-DJT bias of the MSM, the politicization of HCQ was primarily performed by the WH & Fox.
And then there was this paper PUBLISHED TODAY in the NEJM
- 0 efficacy of HCQ in hospitalized Covid-19 patients, https://www.nejm.org/doi/full/10.1056/NEJMoa2019014?query=RPPS Clay, the word you want to use is EXACERBATE - NOT EXASPERATE.
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