Covid-19

[bobbiemcgee]

Or the FDA shouldn’t have wasted them since we know they may have saved lives…

Who ordered them? FDA under who? They are all garbage now, long since expired.

[GIMMFD]

The key to the success of using HCQ is starting it's use during the early onset of the infection. My understanding is that many of the studies that concluded that HCQ didn't work were mostly given to people late in the game when the drug proved to be ineffective. Given early is when the drug saw success.

Per the study: Patients were excluded if they required an intensive care unit (ICU) level of care on admission or at the start of HCQ or L/R therapy (whichever came first), had received HCQ or L/R as home medications for other indications or for COVID-19 within the last 30 days, were enrolled in clinical trials for sarilumab versus placebo or clazakizumab versus placebo, had taken any drug not Food and Drug Administration (FDA) approved for the treatment of COVID-19 (except azithromycin) with the intent to treat COVID-19 within 30 days before admission, received less than 48 hours of HCQ or L/R during admission, or were pregnant.

Our primary endpoint was 28-day mortality from the date of admission and time to death. Our secondary endpoints included progression to severe disease, treatment response, and treatment-related ADE. Progression to severe disease was assessed by the need for ICU admission, development of hypotension requiring vasopressor support, or need for escalation of oxygen supplementation to endotracheal tube or extracorporeal membrane oxygenation. Treatment response was assessed by time to defervescence, time of supplemental oxygen requirement, and length of stay in the ICU and/or hospital. We report the outcomes for the full study cohort, patients receiving HCQ or L/R or both (treatment group), and patients who received supportive care only (supportive care group). We also compared patients who died with survivors to identify potential risk factors for mortality.

Of 935 patients with COVID-19 who were admitted to the hospital during March 2020, a total of 296 were excluded (Fig. ​(Fig.1).1). Requirement of ICU level of care on admission or at the start of treatment with L/R or HCQ or both was the most common reason for exclusion (153/296; 51.7%). A total of 639 consecutive patients with a confirmed COVID-19 test who were initially admitted to acute care services in March 2020, and either died or were discharged before the cut off day of May 8, 2020, were included in the analysis. The median time to first dose of HCQ from the time of admission was 1 day (IQR, 1–2 days), with a median total inpatient duration of therapy of 5 days (IQR, 4–6 days).

We excluded patients who required ICU level of care on admission or at the start of COVID-19 treatment, making our cohort unique compared with other recently published retrospective studies from the early pandemic in New York Hospitals.

Comparatively, time to initiation of COVID-19 off-label antivirals from symptom onset was shorter in our study, reflecting real word practice before randomized trials, where the need to consent, randomize, and wait for other study logistics before initiation of therapy was not a factor in patient care.

In a randomized, double-blind, placebo-controlled trial of 423 patients with COVID-19, medication ADE occurred in 43% (92/212) of participants receiving HCQ versus 22% (46/211) receiving placebo (P < 0.001).18 Of the HCQ-related ADE, gastrointestinal symptoms were the most commonly reported, with 31% (66/212) reporting upset stomach or nausea, 24% (50/212) reporting abdominal pain, diarrhea, or vomiting, and no patients experiencing cardiotoxicity.


My thoughts: I will say they did admit that treatment groups would be those that are more likely to progress to severe disease, since that is the whole purpose of off-label use and theorized treatments, and there's obviously limitations since nothing is perfect, but if we're going by theory and what was being done in the early stages of the pandemic, I think this study did do well in trying to control as many variables as possible.

[Strange Brew]

[QUOTE=xu82;705841]Please don’t make me go back and try to figure this out. Which shots? Of what? Why? I’m pointing at me and thinking I missed something, not being accusatory. When I said “serious question”, I meant it as a serious question.

Are we talking HCQ?

.[/QUOTE

Yes.

[noteggs]

Who ordered them? FDA under who? They are all garbage now, long since expired.

Like Lloyd said, companies like Sanofi, Novartis, Bayer and Mylan (and others) donated 100 millions of doses of HCQ for treating covid across the globe including here in the US. Those companies can manufacture the drug for pennies on the dollar. Also, shelf life for HCQ is 3 years, so not sure how they can be expired already?

Also Lloyd is correct in that we reallocated it for other uses. Could be wrong, but I assume many doses went to undeveloped countries who rely on it for treating diseases like malaria. Kinda like what the Biden administration is doing with the unused vaccines. What if HCQ was more effective and we didn’t react to market demand? We would still be hearing how Trump killed thousands.

Listen I hate wasteful spending, but definitely can make exceptions if others countries can save lives. Honestly, this is a strange thing to be concerned about considering we are accumulating 4 billion dollars in interest debt daily.

[bobbiemcgee]

Shelf life vs. expiry date on the bottle. Isn't efficacy reduced monthly? Some say 7% a month.

[noteggs]

Shelf life vs. expiry date on the bottle. Isn't efficacy reduced monthly? Some say 7% a month.

I’m sorry Bobbie, but you have lost me. Are you suggesting the drug companies gave us short dated supplies of HCQ? To your last point - totally depends on the drug. Some lose efficacy more quickly and some can maintain integrity for 15 years later than the expiration date. Please update me on what you know about HCQ in this regard.

[xu82]

I’m sorry Bobbie, but you have lost me. Are you suggesting the drug companies gave us short dated supplies of HCQ? To your last point - totally depends on the drug. Some lose efficacy more quickly and some can maintain integrity for 15 years later than the expiration date. Please update me on what you know about HCQ in this regard.

On a barely related note, my wife will go thru our spices (and everything else) and throw out what is “expired”. I was SURE we had crushed red pepper flakes! They won’t kill you, they just won’t be as spicy. AND, if you DO throw it out, put it on the damn list!

Rant over, thank you for listening. :-)

And happy holiday weekend to everyone!

[GIMMFD]

Shelf life vs. expiry date on the bottle. Isn't efficacy reduced monthly? Some say 7% a month.

Meh, not the best study, but was curious about this: Drug expiry debate: the myth and the reality, I'll further dig to find out more.

[xudash]

Meh, not the best study, but was curious about this: Drug expiry debate: the myth and the reality, I'll further dig to find out more.

Which brand did you use, if you don’t mind me asking.

[GIMMFD]

Which brand did you use, if you don’t mind me asking.

I never prescribed it actually, since that was end of medical school, and the hospitals I worked in, or my sister's hospital, I couldn't tell you since it was just given as whatever was in the hospital pharmacy, so most likely the cheapest one. Haha I know that's not very helpful, so I do apologize.