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0 pointsageitgey5y ago0 comments

There are hundreds of trials in various states of completion for hydroxychloroquine [1]. At least 10 of them specifically call out using it in combination with zinc, though some completed trials that don't specifically call it out in the title also used zinc if you read the papers.

There are about 35 trials in various states of completion of remdesivir [2].

If hydroxychloroquine actually does anything, we'll eventually find out. But the cold hard truth is that all the evidence so far is that remdesivir is a weakly effective treatment (shortens length of stay in hospital slightly, not a miracle cure) while hydroxychloroquine hasn't been shown to do much of anything useful in COVID. Both aren't as big a deal as Dexamethasone, which significantly reduces mortality in the sickest patients.

Most facilities have settled on using remdesivir + dexamethasone as the standard treatment for the sickest patients and have totally ditched hydroxychloroquine. Many are still administering zinc and other low-risk treatments like vitamin C and D to patients because while the evidence isn't there, there's no cost or safety reason not to try it.

The problem with talking about hydroxychloroquine is that it has become the rallying cry of the conspiracy theorist, so any talk about it results in someone saying you are "testing it wrong". The most common response is "it is a preventative treatment, not a treatment of already sick people! they are testing the wrong patients in trials!" or "it only works in combination with zinc!" or whatever. The good news is all those combinations are being trialed and if it actually does anything, we'll eventually find out. Whether anyone ever comes up with evidence that hydroxychloroquine does anything useful in COVID patients, it will definitely be one of the most studied drugs ever.

[1] https://clinicaltrials.gov/ct2/results?cond=covid&term=hydro...

[2] https://clinicaltrials.gov/ct2/results?cond=covid&term=remde...

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chrisco2555y ago

Here's a recent study from France on 3700 patients treated with HCQ+AZ and it shows a 66% reduction in hospitalizations: https://www.sciencedirect.com/science/article/pii/S147789392...

ageitgeyOP5y ago

I would love for HCQ to be shown to be effective, but this pre-print study is not super convincing.

First, this is not a randomized trial with a control group. It's a retrospective look at patients in Marseille where they gave HCQ+AZ by default to all patients who would take it and then compared those patients against the small number of people who either refused it or were too at risk of side effects to get it.

If you look at the breakdown of the groups, it's comically unbalanced. Of the 3,737 people they tracked, only 162 didn't receive HCQ or AZ. And the rate of heart disease in those 162 untreated people was 2.7x the rate in the group treated with HCQ+AZ (11.1% vs 4%)! Furthermore, only 28 of the 162 untreated people were in the high risk >= 65 age group. No deaths in any group were reported under the age of 60.

In other words, if you compare a couple tens of people with 2.7x the rate of chronic heart disease to a random assortment of other people, you get numbers that may or may not mean anything.

Meanwhile, there are other studies with proper control groups and balanced patient enrollment that show no benefit of HCQ and lots more studies still in progress that test it in different doses and times of administration. At the end of the day, you have to follow the best evidence.

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