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Hydroxychloroquine fails in veterans study

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by guest1146168 guest1146168 (Member) Nurse

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

20 hours ago, HeartlandRN said:

Study finds no benefit, higher death rate in patients taking hydroxychloroquine for Covid-19

A veteran's trial of hydroxychloroquine fails. Not only did recipients not improve but actually had a > 20% Greater Death Rate.

This is a travesty. Why was this study decided to be done on our veterans?

https://www.cnn.com/2020/04/21/health/hydroxychloroquine-veterans-study/index.html

It was a retrospective study.

Quote

COVID-19 treatment hydroxychloroquine showed no benefit, more deaths in VA virus study

“We performed a retrospective analysis of data from patients hospitalized with confirmed SARS-CoV-2 infection in all United States Veterans Health Administration medical centers until April 11, 2020,” the researchers explained. Some 97 patients had been treated with just hydroxycholoroquine, 113 were treated with hydroxycholoroquine and the antibiotic azithromycin and 158 received “standard supportive management” for COVID-19.

The two primary outcomes analyzed in the study were death and the need for ventilation.

About 28 percent who were given hydroxychloroquine plus usual care died, versus 11 percent of those getting routine care alone. About 22 percent of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival...

... Hydroxychloroquine made no difference in the need for a breathing machine, either.

“In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19,” the researchers said. “An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.”...

https://www.foxnews.com/science/covid-19-hydroxychloroquine-showed-no-benefit-more-deaths-va-virus-study

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

The study:

Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19

METHODS: We performed a retrospective analysis of data from patients hospitalized with confirmed SARSCoV-2 infection in all United States Veterans Health Administration medical centers until April 11, 2020.

Patients were categorized based on their exposure to hydroxychloroquine alone (HC) or with azithromycin (HC+AZ) as treatments in addition to standard supportive management for Covid-19. The two primary outcomes were death and the need for mechanical ventilation...

RESULTS: A total of 368 patients were evaluated... ... Compared to the no HC group, the risk of death from any cause was higher in the HC group...

CONCLUSIONS: In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19. An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs...

https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf

HandsOffMySteth

Has 3 years experience.

" These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs."

"This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.”

I find the fact that they used veterans for the study concerning as well. If this was done at the VA, which has many elderly veterans, it seems high risk.

Edited by juniper222

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

Why the study was done:

... Despite limited and conflicting data on the use of hydroxychloroquine in patients with Covid-19, the U.S. Food and Drug Administration has authorized the emergency use of this drug when clinical trials are unavailable or infeasible. Hydroxychloroquine, alone or in combination with azithromycin, is being widely used in Covid-19 therapy based on anecdotal and limited observational evidence...

... Multiple prospective, randomized trials of hydroxychloroquine are now underway and will, in due course, provide valuable information about safety and efficacy. However, given its increasingly widespread use, not only as therapy but also as prophylaxis for Covid-19, there is a great and immediate need to obtain insights into the clinical outcomes among patients currently treated with hydroxychloroquine, particularly because of the non-negligible toxicities associated with its use...

... Therefore, we conducted a retrospective analysis of patients hospitalized with Covid-19 in all the Veterans Health Administration medical centers across the United States to analyze the associations between hydroxychloroquine and azithromycin use and clinical outcomes. The findings of this nationwide study of one of the most complete national datasets in the United States can accelerate our understanding of the outcomes of these drugs in Covid-19 while we await the results of the ongoing prospective trials..

https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf

2 hours ago, herring_RN said:

It was a retrospective study. 

Duly noted, herring_RN. I was busy trying to get my husband's blood pressure down to apply the detailed attention I should have. . Needless to add, he's a veteran.

Edited by HeartlandRN