Hydroxychloroquinine updates (and other potential treatments)

[pacearrow02]

Yo, who pissed in your cheerios this morning?

So because I interrupted your party of putting down Trump and anyone who supports him means someone pissed in my Cheerios.

Who pisses in your Cheerios every day?

[Galway Eagle]

Well some have treated one voice in Fauci as the voice of the entire medical community so sure 🤷‍♂️

Fauci who is the head of NIAID vs a professor in the epidemiology department.

There's a key word difference in their titles. It's dishonest of you To say that a professor speaks for an entire department and I'd expect better of a marquette affiliated individual.

[Hards Alumni]

So because I interrupted your party of putting down Trump and anyone who supports him means someone pissed in my Cheerios.

Who pisses in your Cheerios every day?

I'm suggesting someone pissed in your cheerios because your jimmies are clearly rustled.  You're really going to let MU82, TSmith34, and Jockey get under your skin?

Lighten up, Francis.

[MU82]

And you calling him President Pandemic along with 99% of your posts are aimed at bridging the divide right?

And Trumps opinion that this "could" be a game changer falls in line with the thoughts of the epidemiology department at Yale so to try and spin Trump's encouragement/excitement of the possibility  of it working to help (not cure) as a bad thing is partisan and counterproductive imo.

Everything your emperor does is political or has an ulterior motive, usually to glorify and/or enrich himself.

Enjoy bending the knee and kissing his ring.

[forgetful]

Your friend hydroxy isn't down and out yet.

https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwaa093/5847586

Quite frankly, that article is trash. It essentially reads as "what do you have to lose". It cites the two French studies, done in a hospital setting, as evidence for outpatient care.

No studies have been able to replicate the French studies, and individuals who have reviewed the methodology used have highlighted significant design flaws that limit validity and reproducibility. The studies have been refuted.

He then cites Zalenko, and the article highlights that his 1450 patients were not tested for COVID, they were diagnosed based on symptoms. So they don't even know if the people he was treating had COVID, or were even exposed to it. It has been noted elsewhere, that there haven't even been 1450 COVID patients in Zalenko's entire treatment area. Of his group around 1000 resolved symptoms quickly (yeah, because they didn't have COVID). Anyone that cites Zalenko's work is being academically dishonest.

He then cites a Brazil study that had to be stopped because of patients dying from treatment...he casually leaves this aspect out when his whole story is "what have you got to lose".

Its trash, which is why it is published as an opinion piece.

[GooooMarquette]

I once worked with a clinical investigator who was studying a drug that had shown limited efficacy with a serious illness, but also had some very serious side effects. He had gotten word from the company that FDA was likely to disapprove the application, and came to ask me for advice on how he might get them to change their minds. After listening to the limited efficacy data and the frightening list and incidence of side effects, I asked him: "If your mom had this condition, would you recommend the drug to her?" He paused, got a subdued look on his face, and walked out. True story. I have similar stories from my years on an IRB (the ethical review board for clinical research), where there was disagreement on whether to approve a study with troubling preliminary information, and that question often stopped people in their tracks.

So I'm curious if any of the people who still support the use of HCQ are actually taking it, as opposed to just using it as a talking point. Heck, even POTUS claims to have stopped using it...if he was ever really using it at all.

Anyone?

[TSmith34, Inc.]

Quite frankly, that article is trash. It essentially reads as "what do you have to lose". It cites the two French studies, done in a hospital setting, as evidence for outpatient care.

No studies have been able to replicate the French studies, and individuals who have reviewed the methodology used have highlighted significant design flaws that limit validity and reproducibility. The studies have been refuted.

He then cites Zalenko, and the article highlights that his 1450 patients were not tested for COVID, they were diagnosed based on symptoms. So they don't even know if the people he was treating had COVID, or were even exposed to it. It has been noted elsewhere, that there haven't even been 1450 COVID patients in Zalenko's entire treatment area. Of his group around 1000 resolved symptoms quickly (yeah, because they didn't have COVID). Anyone that cites Zalenko's work is being academically dishonest.

He then cites a Brazil study that had to be stopped because of patients dying from treatment...he casually leaves this aspect out when his whole story is "what have you got to lose".

Its trash, which is why it is published as an opinion piece.

I'm curious Pace, does this change your view at all?

[forgetful]

I once worked with a clinical investigator who was studying a drug that had shown limited efficacy with a serious illness, but also had some very serious side effects. He had gotten word from the company that FDA was likely to disapprove the application, and came to ask me for advice on how he might get them to change their minds. After listening to the limited efficacy data and the frightening list and incidence of side effects, I asked him: "If your mom had this condition, would you recommend the drug to her?" He paused, got a subdued look on his face, and walked out. True story. I have similar stories from my years on an IRB (the ethical review board for clinical research), where there was disagreement on whether to approve a study with troubling preliminary information, and that question often stopped people in their tracks.

So I'm curious if any of the people who still support the use of HCQ are actually taking it, as opposed to just using it as a talking point. Heck, even POTUS claims to have stopped using it...if he was ever really using it at all.

Anyone?

In my experience there are 3-things that can get many extremely educated and intelligent individuals to throw out all reason and logic: pride, religion, and politics.

When it comes the HCQ, two of those are at play pride and politics. I've discussed HCQ with some people I consider extremely intelligent, that advocate they would still take it. They agree that the studies say it shouldn't be taken, but quickly retort, "can you really trust those studies, they are clearly biased." They are unable to point to what is "clearly biased." It is simply that it disagrees with their pride and politics.

Early in my career I learned that during peer review, you should always read your reviews, then wait several days before starting to address them. Time to let the "pride" calm down, and rationally think through what they said. Usually you realize that they aren't "out to get you" but that you have flaws that need to be addressed. Pride is a powerful beast.

The other thing I learned early in my career. Is that if you are working in uncharted territory, where you are the first breaking new ground and making discoveries, you are going to get some things wrong. There are two ways to proceed: Welcome all data as progress towards a greater understanding. Accept criticism and realize that it is ok to be wrong, and that is part of scientific progress. The other is to attack all those who disagree with you in defense of your pride. The latter stifles science.

I try to teach all students this important fact in one of my courses, where we review literature, including an early paper by a Nobel Prize winner, whom I know very well. Brilliant man, but his paper is absolutely 100% wrong. Based on modern approaches, his errors seem obvious, but with the tools of his day, very hard to discover the error. I ask my students, who don't really know who the individual is, and only know of the modern tools, "was he doing bad science?" Without a doubt, they all say yes. I then inform them of who he is, and that his discovery, although his idea was wrong, pioneered an extremely important area of research, and opened doors that would have been closed to everyone if he didn't publish that paper. He's not embarrassed at all about being incorrect, because for him, the data speaks for itself.

tl,dr: Pride and politics are more powerful than reason in many people.

[ZiggysFryBoy]

I have consistently said it would be great if this (or any other) treatment actually works to save lives, but before touting it as the miracle cure or giving it willy nilly to everyone we should test to see if it actually works. Here is the very first post I made on the subject, which was well after Fox/Trump began touting it:

But again this was turned into a divisive wedge issue and anyone that said, "hey, shouldn't we test to see if this actually works first?" was pilloried as just wanting to see Trump fail. Rick Bright was fired for resisting efforts to take taxpayer dollars and shovel them to politically connected companies for an unproven drug. The anti-science Know Nothings were going to pour money and resources into this no matter what.

As far as your links, I'll let people with more science backgrounds like Goo and forgetful weigh in. I reiterate, if this or any other drug works, it would be great, but the results to date from other studies and observations have been poor.

As to your description of the Trump, I think "ORANGE" and "BAD" are accurate adjectives, but I'm not sure about "MAN".

P.S. I am under no illusion that anything I or anyone else says will sway your vote. I've been around the interwebs too long to think that is a possibility and seen that verifiable facts don't really have any power of persuasion. I give Trump credit for being absolutely accurate about one thing: he really could shoot somebody on 5th Avenue and not lose a single vote.

Man, totally agree with your wisdom.  I'm converted to your cause.  Your theories intrigue me, i wish to subscribe to your journal.

[TSmith34, Inc.]

Man, totally agree with your wisdom.  I'm converted to your cause.  Your theories intrigue me, i wish to subscribe to your journal.

I am under no illusion that anything I or anyone else says will sway your vote. I've been around the interwebs too long to think that is a possibility and seen that verifiable facts don't really have any power of persuasion. I give Trump credit for being absolutely accurate about one thing: he really could shoot somebody on 5th Avenue and not lose a single vote.

[ZiggysFryBoy]

Right on, brother!  I'm on your side now!

[pacearrow02]

I'm curious Pace, does this change your view at all?

I'd be interested to hear what you think my view is on hydroxy?  Cause I've been pretty consistent all along that I'm cheering for it to work and I'm holding out hope there's still a spot for it in keeping things at bay.  So no that hasn't changed. 

[Galway Eagle]

I'd be interested to hear what you think my view is on hydroxy?  Cause I've been pretty consistent all along that I'm cheering for it to work and I'm holding out hope there's still a spot for it in keeping things at bay.  So no that hasn't changed.

there's holding out hope and then there's ignoring the vast majority of the medical community searching for fringe opinions to hang onto...

[pacearrow02]

Fauci who is the head of NIAID vs a professor in the epidemiology department.

There's a key word difference in their titles. It's dishonest of you To say that a professor speaks for an entire department and I'd expect better of a marquette affiliated individual.

I have no affiliation to Marquette.  Until this morning I had no idea this was a mubb board with a side discussion about covid. 

[Galway Eagle]

I have no affiliation to Marquette.  Until this morning I had no idea this was a mubb board with a side discussion about covid.

I wish this were true given your dishonest attempt to give more authority To a fringe opinion by labeling it as the opinion of Yale. It's not true though

[pacearrow02]

I wish this were true given your dishonest attempt to give more authority To a fringe opinion by labeling it as the opinion of Yale. It's not true though

So sad right

[GooooMarquette]

In my experience there are 3-things that can get many extremely educated and intelligent individuals to throw out all reason and logic: pride, religion, and politics.

When it comes the HCQ, two of those are at play pride and politics. I've discussed HCQ with some people I consider extremely intelligent, that advocate they would still take it. They agree that the studies say it shouldn't be taken, but quickly retort, "can you really trust those studies, they are clearly biased." They are unable to point to what is "clearly biased." It is simply that it disagrees with their pride and politics.

Early in my career I learned that during peer review, you should always read your reviews, then wait several days before starting to address them. Time to let the "pride" calm down, and rationally think through what they said. Usually you realize that they aren't "out to get you" but that you have flaws that need to be addressed. Pride is a powerful beast.

The other thing I learned early in my career. Is that if you are working in uncharted territory, where you are the first breaking new ground and making discoveries, you are going to get some things wrong. There are two ways to proceed: Welcome all data as progress towards a greater understanding. Accept criticism and realize that it is ok to be wrong, and that is part of scientific progress. The other is to attack all those who disagree with you in defense of your pride. The latter stifles science.

I try to teach all students this important fact in one of my courses, where we review literature, including an early paper by a Nobel Prize winner, whom I know very well. Brilliant man, but his paper is absolutely 100% wrong. Based on modern approaches, his errors seem obvious, but with the tools of his day, very hard to discover the error. I ask my students, who don't really know who the individual is, and only know of the modern tools, "was he doing bad science?" Without a doubt, they all say yes. I then inform them of who he is, and that his discovery, although his idea was wrong, pioneered an extremely important area of research, and opened doors that would have been closed to everyone if he didn't publish that paper. He's not embarrassed at all about being incorrect, because for him, the data speaks for itself.

tl,dr: Pride and politics are more powerful than reason in many people.

Very well said, and a great lesson for your students.

Your post reminded me of a quote: "A person who never made a mistake never tried anything new." Einstein.

[TSmith34, Inc.]

Right on, brother!  I'm on your side now!

God, I hope not

[ZiggysFryBoy]

God, I hope not

Your persuasion powers are very effective.

[pacearrow02]

https://amp.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine?__twitter_impression=true

What a mess this whole things has become.  Now appears there are signs of significant data errors in the Lancet study and a couple others that were used as evidence to shut down hydroxy trials.

I no longer have the energy to argue for or against the use of this drug but am incredibly discouraged by the general discourse and "unbiased" efforts of our medical community in giving the public honest analysis and hope that they're working to find a fix to this virus

[Skatastrophy]

https://amp.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine?__twitter_impression=true

What a mess this whole things has become.  Now appears there are signs of significant data errors in the Lancet study and a couple others that were used as evidence to shut down hydroxy trials.

I no longer have the energy to argue for or against the use of this drug but am incredibly discouraged by the general discourse and "unbiased" efforts of our medical community in giving the public honest analysis and hope that they're working to find a fix to this virus

From the article you just linked:

"An independent data audit is currently underway and we trust that this review, which should be completed within the next week, will tell us more about the status of the findings reported in the paper by Mandeep Mehra and colleagues."

[pacearrow02]

From the article you just linked:

"An independent data audit is currently underway and we trust that this review, which should be completed within the next week, will tell us more about the status of the findings reported in the paper by Mandeep Mehra and colleagues."

Right, but the horse has left the barn at this point.  People have shut down trials and the public has made up there mind based off questionable data that was peer reviewed but now appears to be questionable at best.

Just feel like before this stuff gets published this review should have been done.

[Skatastrophy]

Right, but the horse has left the barn at this point.  People have shut down trials and the public has made up there mind based off questionable data that was peer reviewed but now appears to be questionable at best.

Just feel like before this stuff gets published this review should have been done.

It looks like some of the data was categorized incorrectly per region. I'm not sure that's enough, even on the face of it, to call the results into question. 

[Frenns Liquor Depot]

Right, but the horse has left the barn at this point.  People have shut down trials and the public has made up there mind based off questionable data that was peer reviewed but now appears to be questionable at best.

Just feel like before this stuff gets published this review should have been done.

Pace I heard a stat yesterday that is apt here.  This drug was used heavily in NYC—60% got it was the stat quoted.  NYC was not a great outcome From a death perspective. 

Conversely Drs have quickly pivoted treatment to apply more blood thinners. Despite the research not yet published.  Because it is improving outcomes.   

If this was a great treatment we likely would have doctors speaking out and using it heavier.  It's just not the case.  No ones fault, we move forward. 

[jesmu84]

https://investor.lilly.com/news-releases/news-release-details/lilly-begins-worlds-first-study-potential-covid-19-antibody