No Hydroxychloroquine Benefit in Randomized COVID-19 Trial

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Posting several articles re overseas studies reporting no hydroxychloroquine benefit in COVID disease. Will be interesting to see if current US scientific studies reach same conclusion, especially since US has increased # positive Covid-19 cases and over 35,000 deaths. Karen

Medscape Medical News

Marcia Frellick

April 16, 2020

China: No Hydroxychloroquine Benefit in Randomized COVID-19 Trial

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Hydroxychloroquine (HCQ) does not help clear the SARS-CoV-2 virus or relieve symptoms for COVID-19 patients more than standard care alone and has more side effects, a randomized controlled trial of 150 hospitalized adults in China suggests.

However, two experts caution that because of confounding, the trial is unable to answer convincingly the question of whether HCQ can benefit COVID-19 patients.

Wei Tang, with the Departments of Pulmonology and Critical Care Medicine at Ruijin Hospital, in Shanghai, China, and colleagues enrolled patients with COVID-19 from 16 treatment centers in China in February. They posted their findings on the medRxiv preprint server, but their paper has not been peer reviewed. A coauthor told Medscape Medical News the work has been submitted to a journal....

https://www.medscape.com/viewarticle/928798?src=wnl_edit_tpal&uac=35065FT&impID=2349039&faf=1

England: Oxford COVID-19 Evidence Service Team
Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences

April 14, 2020

Hydroxychloroquine for COVID-19: What do the clinical trials tell us?

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VERDICT

Current data do not support the use of hydroxychloroquine for prophylaxis or treatment of COVID-19. There are no published trials of prophylaxis. Two trials of hydroxychloroquine treatment that are in the public domain, one non-peer reviewed, are premature analyses of trials whose conduct in both cases diverged from the published skeleton protocols registered on clinical trial sites. Neither they, nor three other negative trials that have since appeared, support the view that hydroxychloroquine is effective in the management of even mild COVID-19 disease.

https://www.cebm.net/covid-19/hydroxychloroquine-for-covid-19-what-do-the-clinical-trials-tell-us/

Study of Trump-touted chloroquine for coronavirus stopped due to heart problems, deaths

Elizabeth Weise

USA TODAY

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A double-blind research study of a drug touted by President Donald Trump early on to treat coronavirus found it to be so dangerous at high doses the trial was shut down after six days.

The study on chloroquine, conducted in Brazil, found one-quarter of the patients taking the anti-malaria medication developed potentially deadly changes in the electrical system regulating their heartbeats. While a small and imperfect study, it highlights the compelling need for more rigorous data....

...Many medical centers, including the University of California, San Francisco, Harvard, the Mayo Clinic and the University of Washington are not prescribing either drug for COVID-19 outside of clinical studies or in very specialized cases.

"It was reasonable, based on data we had a week ago, to use hydroxychloroquine," said Andrew Badley, an infectious disease specialist at the Mayo Clinic in Rochester, Minnesota. "We now have the Brazilian trial, and there are other trials that have been submitted for review. As those results become available, we may or may not need to modify our thinking....

https://www.usatoday.com/story/news/2020/04/15/coronavirus-chloroquine-test-halted-drug/2983129001/

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Specializes in retired LTC.

TY for the update.

I maintain a certain interest in the use of hydroxycholoroquine for C19.

So sad that preliminary info predicated the horrific death and injury to that elderly husband & wife duo who consumed that chloroquine-type drug (for fish tanks). They thought they were self-treating prophyllacticly (sp?).

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Nope. Fake news. this stuff should work.

Trump said: “I feel good about it. That’s all it is, just a feeling, you know, smart guy. I feel good about it.”

He is a smart guy, and it makes him feel good.

It seems absurd that you would cite the Centre for Evidence-Based Medicine n this discussion. As he said, our president is a smart guy, unlike those idiots.

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Gosh I really don't want to touch this.. ummm, so yah, better leave this alone.. What I will say is that for some reason this drug has now become a required count dispensed med where I work. It wasn't before so umm, yah...

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Specializes in Psych.

What about remdesivir?

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Specializes in CCRN - CMC - CSC.

Recent news reports suggest that remdesivir trials are more optimistic than the hydroxychloroquine. My hospital has been enrolling patients in the trials for remdesivir, and although I see patients who are in the trial, not sure if they're getting the treatment or the placebo. Our unit only has 3 or 4 positive Covid patients in the ICU, most have been discharged/downgraded. So maybe it's working? But still too early to know....

The safety profile of remdesivir is known due to prior studies, so its not "off the list" of recommended medications like hydroxychloroquine is.

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Specializes in NICU, PICU, Transport, L&D, Hospice.
7 hours ago, hh.BSN.RN.ccrn said:

Recent news reports suggest that remdesivir trials are more optimistic than the hydroxychloroquine. My hospital has been enrolling patients in the trials for remdesivir, and although I see patients who are in the trial, not sure if they're getting the treatment or the placebo. Our unit only has 3 or 4 positive Covid patients in the ICU, most have been discharged/downgraded. So maybe it's working? But still too early to know....

The safety profile of remdesivir is known due to prior studies, so its not "off the list" of recommended medications like hydroxychloroquine is.

Are we supposed to assume that Gilead will produce millions of doses, at minimum profit margin to treat this infection...quickly?

When they rolled out this drug for Ebola wasn't it so expensive that subsidies were necessary?

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Apparently testing has not stopped and there are ongoing studies on hydroxychloroquine.

https://clinicaltrials.gov/ct2/results?cond=Coronavirus&term=&cntry=&state=&city=&dist=

Studies 24,39,57,63,76,85,88,98,99

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Specializes in CCRN - CMC - CSC.
On 4/19/2020 at 9:31 AM, toomuchbaloney said:

Are we supposed to assume that Gilead will produce millions of doses, at minimum profit margin to treat this infection...quickly?

When they rolled out this drug for Ebola wasn't it so expensive that subsidies were necessary?

Heh, at minimum profit margin? we’ll see..... but again, too early to say whether it can be used to treat the infection. If not, whether they can produce millions of doses doesn’t really matter. I don’t know about the cost and subsidies, so can’t comment on that... just sharing what I’ve seen!

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I realized that Dr. Vladimir Zelenko’s 3 drug regime and his outcomes are anecdotal, but I don't they should be completely dismissed.

He is a family practice Dr and orthodox Jew. In this newest video he states that he has treated
1450 patients in his community. He divided them into low risk (about 1000...no drugs, mild cases, stayed home) and high risk,
400 patients. The high risk group he treated quickly with Hydroxychloroquine, zinc, azithromycin. Out of the high risk group:
2 died
4 on ventilator... recovered
5 in hospital.. but recovering

It sounds like patients have to be treated very quickly, before they are severely sick.

He states that they are starting a trial in hospital on Long Island.

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