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  • #31
    Meanwhile....

    Utah went all-in on an unproven Covid-19 treatment, then scrambled to course-correct

    Propelled by that hype, as well as mounting fears of the oncoming pandemic, the state pursued a sweeping — and eyebrow-raising — policy that would have let pharmacies dispense the unproven medications to patients with Covid-19 without a prescription. Utah, which took perhaps the most aggressive strategy with the drugs of any state, also put in an order for $800,000 worth of chloroquine and hydroxychloroquine to build a stockpile, and considered buying millions of dollars more.

    “The use of an unproven therapy in this way could be a grave mistake medically,” Andrew Pavia, the chief of pediatric infectious diseases at the University of Utah, wrote on March 22 to Miner and the lieutenant governor after finding out about the standing order.

    He stressed that the state should wait for solid evidence before recommending the drugs, particularly to people who weren’t that sick. Hospitalized patients might be treated with hydroxychloroquine — cases where the potential benefits outweighed the risk — but patients shouldn’t take the medications at home without a physician’s oversight, Pavia said. “There is as yet no real evidence of clinical benefit for these drugs,” Pavia wrote. “Wide use of unproven therapies in outpatients and low risk patients exposes them to potential harm with little evidence of benefit.”

    Observational studies found no benefits, and the FDA issued its warning about heart rhythm problems. Prescriptions tapered off — a relief to people who take them for autoimmune conditions.


    https://www.statnews.com/2020/05/18/...ourse-correct/


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    • #32
      Originally posted by Conor Dary View Post

      Why are you acting so silly on this?

      Drug promoted by Trump as coronavirus ‘game changer’ increasingly linked to deaths


      Clinical trials, academic research and scientific analysis indicate that the danger of the Trump-backed drug is a significantly increased risk of death for certain patients. Evidence showing the effectiveness of hydroxychloroquine in treating covid-19 has been scant. Those two developments pushed the Food and Drug Administration to warn against the use of hydroxychloroquine outside of a hospital setting last month, just weeks after it approved an emergency use authorization for the drug.

      Alarmed by a growing cache of data linking the anti-malaria drug to serious cardiac problems, some drug safety experts are now calling for even more forceful action by the government to discourage its use. Several have called for the FDA to revoke its emergency use authorization, given hydroxychloroquine’s documented risks.


      “They should say, ‘We know there are harms, and until we know the benefits, let’s hold off,’ ” said Joseph Ross, a professor of medicine and public health at Yale University, who added that the original authorization may have been warranted but new evidence has emerged about the drug’s risks.

      “I’m surprised it hasn’t been revoked yet,” said Luciana Borio, who served as director for medical and biodefense preparedness of the National Security Council and was acting chief scientist at the FDA.


      https://www.washingtonpost.com/polit...9ad_story.html

      And your medical qualifications are?
      Just asking asking as I am aware of Bambam's medical background.

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      • #33
        political commentary removed.... don't do it again
        Last edited by gh; 05-19-2020, 09:56 PM.

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        • #34
          Originally posted by Tuariki View Post

          And your medical qualifications are?
          Just asking asking as I am aware of Bambam's medical background.
          Don't be silly..I can read..I've only quoted sources that quote doctors and medical journals....my personal opinion or qualifications is irrelevant...

          Replying all drugs have side effects is hardly much of an an answer...especially for an apparently healthy person.....why not chemotherapy for C19 then? Radiation treatment?
          Last edited by Conor Dary; 05-19-2020, 10:52 PM.

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          • #35
            Any reasonably healthy person using hydroxychloroquine to prevent COVID is both dumb and an asshole, since it is causing supply problems with lupus sufferers and other people with legitimate need of the drug. And if any of those reasonably healthy folks using hydroxychloroquine to prevent COVID have major adverse side effects it will not break my heart even a little bit . . .

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            • #36
              This is a truly heart warming thread, just seeing some of my dearest friends and most impassioned posters express such deep and sincere concern for the president's health. This is a true break through.

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              • #37
                Meanwhile....this was written by an MD....

                https://www.theatlantic.com/health/a...MzU0NzA5NzkyS0

                Comment


                • #38
                  Originally posted by Tuariki View Post

                  And your medical qualifications are?
                  Just asking asking as I am aware of Bambam's medical background.
                  There are no qualifications that raise anecdote to the status of evidence. Only well constructed large scale trials conducted by experts in the field and subject to rigorous peer review can do that. And even those are hard to achieve in the urgent hothouse of a pandemic.

                  The original small scale trial (26 patients) that started this phenomenon was conducted by Didier Raoult. His study was immediately condemned by his peers for numerous failures of just about every aspect of scientific process required to produce reliable evidence. There does not appear to be any well constructed, large scale study since then supporting its use.

                  The first randomised study (China) failed to support it but note that it was small (150). A French study (not randomised) failed to support it (180). The largest study (non-randomised, 1,376) in New York didn't find anything to encourage its use.

                  https://www.cidrap.umn.edu/news-pers...oxychloroquine

                  https://www.cuimc.columbia.edu/news/...id-19-patients

                  We are still waiting on outcomes from high quality, large scale, randomised control trials that are currently being undertaken. These are the gold standard, so I'm keeping my mind open. However, I will note that to have no encouraging outcomes at all across multiple trials in multiple locations seems unusual when it was originally promoted as a "cure" by Raoult.

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                  • #39
                    Originally posted by El Toro View Post

                    There are no qualifications that raise anecdote to the status of evidence. Only well constructed large scale trials conducted by experts in the field and subject to rigorous peer review can do that. And even those are hard to achieve in the urgent hothouse of a pandemic.

                    The original small scale trial (26 patients) that started this phenomenon was conducted by Didier Raoult. His study was immediately condemned by his peers for numerous failures of just about every aspect of scientific process required to produce reliable evidence. There does not appear to be any well constructed, large scale study since then supporting its use.

                    The first randomised study (China) failed to support it but note that it was small (150). A French study (not randomised) failed to support it (180). The largest study (non-randomised, 1,376) in New York didn't find anything to encourage its use.

                    https://www.cidrap.umn.edu/news-pers...oxychloroquine

                    https://www.cuimc.columbia.edu/news/...id-19-patients

                    We are still waiting on outcomes from high quality, large scale, randomised control trials that are currently being undertaken. These are the gold standard, so I'm keeping my mind open. However, I will note that to have no encouraging outcomes at all across multiple trials in multiple locations seems unusual when it was originally promoted as a "cure" by Raoult.
                    Great post. So much better than retweeting onto this board.

                    I am home for over four months now. Real information is invaluable.
                    Sunlight is said to be the best of disinfectants

                    Comment


                    • #40
                      A thread on Hydroxycloroquine. What could go wrong?

                      I'm doing an over/under.

                      How many posts until we get content removed for political content?

                      How many posts until the thread gets shut down?
                      Sunlight is said to be the best of disinfectants

                      Comment


                      • #41
                        Originally posted by Master403 View Post

                        Great post. So much better than retweeting onto this board.

                        I am home for over four months now. Real information is invaluable.
                        Just realised that I wasn't clear that the reference to anecdote was bambam's doctor friends being treated not the bit about HCQ having well known side effects that can be risk managed!

                        As he said, it has well known side effects that can to be monitored, it's just that these known problems have cause several studies to pull the pin due to the elevated risk to patients. If it was unethical to continue a study of infected patients due to lack of benefit to offset the risks, where does that leave a doctor then prescribing it to the non-infected for prophylaxis?

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                        • #42
                          I think there's a difference between pulling the pin on a study designed to determine whether widespread use of HCQ is wise, and prescribing it prophylactically to a single individual whom the doctor sees every day, can monitor very closely, and can stop the medication at the slightest sign that something is going wrong. There aren't many doctor/patient relationships like the one we're talking about. I'm not a doctor, and I'm not at all suggesting that I endorse what he and his patient have done, but I don't think that the fact that there are some known side-effects necessarily precludes his decision. His circumstances are almost unique.

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                          • #43
                            Originally posted by tandfman View Post
                            prescribing it prophylactically to a single individual whom the doctor sees every day, can monitor very closely, and can stop the medication at the slightest sign that something is going wrong.
                            But can't it slowly be poisoning his system without symptoms that will only come later, with repeated use?
                            Plus, isn't it irresponsible for someone like him to even 'say' he's on it, since we know MANY people will follow his lead - without the safeguards he has?
                            [like you, I have little medical knowledge, so I am genuinely asking.]

                            Comment


                            • #44
                              The risk of dangerous cardiac arrhythmias from hydroxychloroquine is really low, so low that, in my experience, rheumatologists do not even do any EKG monitoring in lupus patients on the drug. The increased mortality in the very sick people in the VA study may have been cardiac mortality but in that population, their myocardium is probably already very "irritable", if you will, from the profound systemic inflammatory response, and this would significantly increase that risk. That said, the big issue here is that a crappy little "study" by a charlatan "scientist" in France got this whole ball rolling. What we need is a political leader who relies on data, listens to his scientific advisors, and does not simply listen to his "gut feelings" as the world faces its biggest calamity since World War II.

                              Comment


                              • #45
                                Originally posted by Atticus View Post
                                But can't it slowly be poisoning his system without symptoms that will only come later, with repeated use?
                                Plus, isn't it irresponsible for someone like him to even 'say' he's on it, since we know MANY people will follow his lead - without the safeguards he has?
                                [like you, I have little medical knowledge, so I am genuinely asking.]
                                I don't know the answer to your first question. The second question (and the last sentence of DrJay's last post) lead us down a path that could eventually get this thread pulled, so I'm not going to go there.

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