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Hydroxychloroquine

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Dustin Lobner

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Don't want to open a huge can of worms, apologies in advance...

A coworker of mine brought up that apparently the Lancet, which originally published data showing hydroxychloroquine doesnt work for Covid, had to retract that paper because something was wrong with the research or whatever.

I'm going to do my own research on it, but there are people here smarter than me that will know better than I ever will. Anyone have an up to date understanding of the science here?
 

hball55

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Too many doctors have spoken out on the efficacy of hydroxychloroquine when taken early and the results were all good. If former President Trump had never supported its use, the use of hydroxychloroquine would probably have received overwhelming support.
 

Funkworks

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According to Medical News Today, the WHO ‘strongly’ against hydroxychloroquine use for COVID-19 prevention.

Remember there are people out there who make decisions based on what they find in the lab, not on reports filtered by politicians. There’s nothing to apologize for, it’s a molecule.
 

prfesser

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Don't want to open a huge can of worms, apologies in advance...

A coworker of mine brought up that apparently the Lancet, which originally published data showing hydroxychloroquine doesnt work for Covid, had to retract that paper because something was wrong with the research or whatever.

I'm going to do my own research on it, but there are people here smarter than me that will know better than I ever will. Anyone have an up to date understanding of the science here?
I haven't read the paper nor the reviewers' remarks, but that will be needed to understand the withdrawal. Withdrawing a paper is done when the editors and/or reviewers agree that (for example) the conclusions do not fit the results as they should. If it's possible to revise the paper, the reviewers specify what should be done. If the principal investigator(s) don't want to do those things---or can't---then the paper is usually withdrawn or the editor says "nope". More often, the PI revises the paper to address reviewer concerns.

When editors AND reviewers agree on the nature of the revisions needed, and the PI refuses to revise, usually the paper is (usually) not published. The PI may decide to submit the paper to one of the less-stringent** publishers.

Do not go to "news" sources for that information. Scientists tend to be both specific and conservative in their conclusions. News sources, not so much, since they are interested in drawing the readers.

Best -- Terry
**In the last few decades, legions of so-called professional publications have sprung up, taking advantage of "page charges" (several hundreds per page to be paid by the PI) and paywall publications in order to make a bundle. PIs sometimes publish in these journals to pad their tenure packets.
 

kuririn

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OK, to answer the OP's original question.
From what I've read (I'm not a scientist or medically trained person) The Lancet published a study showing hydroxy was not an effective therapeutic and that it had serious risks. But two authors of the study had conflicts of interest (financial). They had stakes in a drug that was a competitor as a therapeutic. Also one of the authors refused to allow an evaluation of the patient files by a review team citing patient confidentiality. This lack of transparency led to the retraction.
They should have vetted the study more thoroughly before publishing it.
Unfortunately this fiasco was used as fuel to stoke the flames of conspiracy theorists.
Namely that hydro is being wrongly criticized as ineffective when it is actually the seventh wonder of the world, and that it is being done for political purposes.
Good thing most people have the common sense not to believe the politicians and media hacks and they recognize crap when they see it. The WHO and NIH halted studies of hydro, the FDA revoked an emergency use authorization for it, and Dr. Fauci said its' inefficacy was pretty clear. So who is to be believed, medical experts or politicians and talk show hosts? You decide.
Check out the second article in Funkworks' link above for insight as to how hydro has been politicized.
Adios.
 
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Dustin Lobner

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OK, to answer the OP's original question.
That's about what I expected. The coworker in question went down the "the Lancet covered it up to make Trump look bad" rabbit hole. I'll look into it, this was about what I expected though. Thanks.
 

Kelly

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Trying to clear a few things up:
  • The Lancet published an article which was critical of hydrochloroquine (HC), saying that it caused cardiac issues. The article was based on data provided by a company called Surgisphere, a data analytics firm which pulls anonymized data from patient health records.
  • One of the article's authors was a principle in Surgisphere.
  • Much of the initial opposition to HC by the WHO, and by the US press eager to jump on any story that makes Trump look bad, was based on this article.
  • Shortly after publication of the article, some valid questions arose about the methodology and data used in the research, prompting a third-party review. Stating a requirement for client/patient confidentiality, Surgisphere refused to provide source data to reviewers. Based on this inability to review source data, The Lancet chose to retract the article. It was not withdrawn.
  • The Lancet is not a fly-by-night operation which publishes garbage in exchange for page charges; it is one of the world's oldest and most reputable medical journals, having been in existence for nearly 200 years.
Possibly related, there was an interesting study done on media coverage of COVID-19 by the US and foreign press ("Why is all Covid-19 news bad news?"). The study found that while foreign coverage of the pandemic was much more balanced (54% negative), in the USA the reporting was almost entirely (91%) negative. While the foreign press was keeping its readers informed about topics such as reopenings and the coming vaccines, etc. the American media seemed fixated on a single topic: In the US, stories discussing Trump and hydroxychloroquine were more numerous than all stories combined that covered work on COVID-19 vaccines. We really didn't hear much about vaccines at all until after the election was over. It's almost as if the press had no interest in informing us, and instead chose to paint as bleak a picture as possible in the months preceding the election.
 

Dustin Lobner

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I'm pretty much a free market capitalism type guy, but I've always wondered what it would be like if we had a government funded news org. Not "the only news org" (like a dictatorship) but just one news org that didn't need to generate income via clickbait article titles. Maybe that'd help keep the for profit news orgs honest...or maybe not, because many people generally just want their views confirmed by whatever source they find.
 

kuririn

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It's been several months since hydroxychloroquine made the news. Several large, randomized, double blind clinical trials have been completed and the results are in. A convenient summary is provided in this article:
An Update: Is hydroxychloroquine effective for COVID-19? (drugs.com)

Excerpt:
Bottom Line
  • The use of hydroxychloroquine in randomized trials for the treatment of hospitalized patients with COVID-19 has not been shown to have a benefit in reducing death.
  • In addition, concerns exist over the benefit of the drug compared to its safety risk, especially with regard to abnormal heart rhythms.
  • Multiple worldwide public health organizations, including the FDA, NIH and WHO recommend against use of hydroxychloroquine as a treatment for hospitalized patients with COVID-19 based on studies showing a lack of effect and possible serious side effects.
People are going to believe what they're going to believe. I'm sure they can find articles of small trials that state that hydro is beneficial. Probably small, non randomized and not double blind.
I'm reminded of the phrase "Don't confuse me with the facts".
And the single mindedness of anti-vaxxers and flat earthers.
And we do have a government funded non profit news organization. It's called NPR, and they are well respected in the industry. Here's what they have to say about hydro:
No Evidence Hydroxychloroquine Is Helpful In Preventing COVID-19, Study Finds : Shots - Health News : NPR

Anyhoo, I'm done. I feel my face turning blue. 😁
 

Mike Haberer

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I'm pretty much a free market capitalism type guy, but I've always wondered what it would be like if we had a government funded news org. Not "the only news org" (like a dictatorship) but just one news org that didn't need to generate income via clickbait article titles. Maybe that'd help keep the for profit news orgs honest...or maybe not, because many people generally just want their views confirmed by whatever source they find.
It's not funded by the government, but PBS is what you are talking about. It's what we watch for national and global news for the most part.
 

cwbullet

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Too many doctors have spoken out on the efficacy of hydroxychloroquine when taken early and the results were all good. If former President Trump had never supported its use, the use of hydroxychloroquine would probably have received overwhelming support.
It is safe and “might” work. Data is conlifcting. There are much better treatments for moderate to severe coming out. For severe we have one that is 60-80% effective if given prior to intubation. Why the wide range? We are still crunching numbers.

For mild disease? The problem with most of the studies that show it works is bias. They overload the data with young folks. New studies are pending where they look at only 60-80. These studies are key to showing it might work.

You would have to show me the study. Anectdotle statements from physicians will not get me to start prescribing routinely. I use it when the patient is properly screen, understands the risks, and requests it. Most of the research showing it work, including several formt he lancet have been retratcted. Then again, so have atleast on showing it was dangersous.

Most of my patients are low to mdoerate risk and there is no reason to prescribe it. The risk is higher than the benefit in this group.
 

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