Chloroquine

[Bigtex]

This was recently published. https://www.nejm.org/doi/full/10.1056/NEJMoa2019014 IMO, COVID-19 is simple, how one handles the virus is not. There are likely responders to CQ or HCQ. Question is when to administer, how much, for how long and to whom for a positive effect. The only thing I'd be careful of guys is the prolongation of QTc, even in the short term. Many of the nasty sides of this drug are from long term use. Think of it like Anadrol, not something you stay on for a year at time in high doses, however short term is different story. Back to the QTc. A number of drugs can prolong QTc and if you have congenital QTc syndrome or are taking other meds that can add to prolonged QTc (levitra for example) please be careful with CQ or HCQ, esp combined with AZT (also prolongs QTc). Torsades de Points can put you in the ground. We don't need to lose any board members to this. Like everything else we discuss on this board, know what you're dealing with, understand the mechanisms and be vigilant for serious sides.

I agree with you and thank you for posting this study. I have already read this. We as American have the right to read and make up our own minds about our health. Not the government of science or experts. I deal with science and experts every day in my job as a professor of Kinesiology and a former world record holder in powerlifting. I get sick of these guys in white coats telling what works and what doesn't when they have never lifted a weight. Those of us in the trenches know what works and science need to spend their time find out what it works. 1000's of doctors have use this treatment and it worked 100% on truly mild and moderate cases ever high risk people, but late on the results become mixed.

PrEP - 100%, PEP - 100%. Early - 100%, Late - 62%, All -75%

Here is how this particular study was evaluated by peers.

The paper uses the terms mild and moderate, however all patients had serious enough disease to be hospitalized, and 14% were actually randomized in the ICU.

The trial had significant protocol deviations and unusually low medication adherence. Randomization resulted in 64.3% male patients (HCQ) vs. 54.2% (control) which may significantly affect results due to the much higher risk for male patients.

Authors note: "our aim was to exclude patients already receiving longer and potentially therapeutic doses of the study treatments" in explanation for why the study protocol was changed to exclude patients with previous use of the medications >24hrs. Analyzing these patients rather than excluding them may have revealed effectiveness with early use as shown in other studies.

The trial initially required enrollment within 48 hours of admission and was changed to remove this requirement, this change is likely to reduce effectiveness because enrollment was moved later, compared to the time the disease became serious enough for hospitalization.

As I have said, the 1st 5-6 days of the onset of symptoms is critical to get treatment. Do not wait until you have to be hospitalized. This stage is in NO WAY....mild or moderate.

But thank you for posting the study.

Remdesivir is approved and touted by Dr Fauci who has financial interests in Gilad. In three months it went from $70 a dose to over $3000. Does it have side effects?

https://articles.mercola.com/sites/...er-kidney-failures-occur-in-covid-drug-trials

 

[tommyguns2]

My mother was suffering from stage IV lung cancer this past year, and also had arthritis, so she was already taking Plaquenil (HCQ) for the arthritis, and they had no problem with her taking it. Tons of old people with many other serious conditions take HCQ with no problem. Whether it works or not for COVID can be argued (I think it works to reduce the symptoms by reducing the viral load), but to say that it's a dangerous medication to take is just silly.

If everyone took it, death rates would plummet and COVID, while serious, would no longer be freaking everyone out. We can't have that prior to November. Once Biden wins, we can declare COVID no longer a big deal. Outrageous.

 

[tommyguns2]

One last thing. In that USA Today article about Ohio governor, it looks like the Ohio gov asked the state pharmacy board to rescind its ban on HCQ, not the other way around. He indicated it should be between doctor and patient. He's still an idiot, just not for this.

 

[Bigtex]

One last thing. In that USA Today article about Ohio governor, it looks like the Ohio gov asked the state pharmacy board to rescind its ban on HCQ, not the other way around. He indicated it should be between doctor and patient. He's still an idiot, just not for this.

Yes after the head of the FDA finally came out and said that quite a few weeks before banning it. Hahhaha.....I gree he is still and idiot.
https://www.msn.com/en-us/news/poli... (FDA) Commissioner Stephen Hahn said Tuesday.

 

[5.0]

5.0....Ohio has an idiot for a Governor, Thank goodness the Ohio pharmacy board reversed this decision


Agreed, I've had family and friends there for yrs. I also see that he wants to ban alcohol sales, good luck with that one

 

[Bigtex]

Agreed, I've had family and friends there for yrs. I also see that he wants to ban alcohol sales, good luck with that one

Didn't we try prohibition a long time again and it didn't work so well.

 

[ogre]

Good to know.I'm 59 and the wife is 65 with health issues.Thank God for underground lab's.Yes I got mine ready just in case.

 

[BackAtIt]

BT, W6 is the smartest on the board...Shouldn't we listen to him?...

.

 

[Wilson6]

I agree with you and thank you for posting this study. I have already read this. We as American have the right to read and make up our own minds about our health. Not the government of science or experts. I deal with science and experts every day in my job as a professor of Kinesiology and a former world record holder in powerlifting. I get sick of these guys in white coats telling what works and what doesn't when they have never lifted a weight. Those of us in the trenches know what works and science need to spend their time find out what it works. 1000's of doctors have use this treatment and it worked 100% on truly mild and moderate cases ever high risk people, but late on the results become mixed.

PrEP - 100%, PEP - 100%. Early - 100%, Late - 62%, All -75%

Here is how this particular study was evaluated by peers.

The paper uses the terms mild and moderate, however all patients had serious enough disease to be hospitalized, and 14% were actually randomized in the ICU.

The trial had significant protocol deviations and unusually low medication adherence. Randomization resulted in 64.3% male patients (HCQ) vs. 54.2% (control) which may significantly affect results due to the much higher risk for male patients.

Authors note: "our aim was to exclude patients already receiving longer and potentially therapeutic doses of the study treatments" in explanation for why the study protocol was changed to exclude patients with previous use of the medications >24hrs. Analyzing these patients rather than excluding them may have revealed effectiveness with early use as shown in other studies.

The trial initially required enrollment within 48 hours of admission and was changed to remove this requirement, this change is likely to reduce effectiveness because enrollment was moved later, compared to the time the disease became serious enough for hospitalization.

As I have said, the 1st 5-6 days of the onset of symptoms is critical to get treatment. Do not wait until you have to be hospitalized. This stage is in NO WAY....mild or moderate.

But thank you for posting the study.

Remdesivir is approved and touted by Dr Fauci who has financial interests in Gilad. In three months it went from $70 a dose to over $3000. Does it have side effects?

https://articles.mercola.com/sites/...er-kidney-failures-occur-in-covid-drug-trials

BigTex you are correct regarding early treatment. That has been one of my arguments with any of these treatments relative to COVID-19. I think of it like influenza and oseltamivir or herpes and valacyclovir, it you treat very early in the course of the viral outbreak you have a much better chance of having a meaningful impact on the outcome of the infection. I'm still not convinced the virus itself is the root of all of the damage, I believe it is our individualized responses to the virus. Treating someone with an antiviral long after the viral replication has likely peaked in our bodies makes little sense. It's like giving someone a radiation suit after they've been exposed. If you mitigate viral replication early, you'll likely limit the bodies response to infection. There has been suggestion that viral load plays a role in the severity of the disease, if true then, obviously minimizing the exposure is step one, but once that takes place, step two is minimized in vivo replication. No one seems to get that. Treat them after they're in the hospital or ICU with an antiviral just doesn't make any sense yet they keep trying and expect a different outcome, or come out and say, well look this doesn't work, well no shit look at your study design. What question are you trying to answer? I'm not saying HCQ doesn't work or pushing one study or another. We really don't know, my point was we need to look at these different treatments and be aware of the possible side effects. Elevated liver enzymes < 5x UNL for a few days isn't anything I'd lose sleep over unless it consistently results in progressive damage or liver failure long after the drug is withdrawn. The prolongation of QTc, that's something that gets my attention because you won't feel it or know it. I just wanted people to know that it should be on your radar screen if you decide to take CQ or HCQ. Beyond that it is a choice in individual has to make if they think or know they've been exposed. I wouldn't take it as a prophylaxis long term "just in case", however. That is where the risk of longer term sides increase. https://www.nejm.org/doi/full/10.1056/NEJMe2020388 "Although participant-reported side effects were significantly more common in those receiving hydroxychloroquine (40.1%) than in those receiving placebo (16.8%), no serious adverse reactions were reported. " and "In a small-animal model of SARS-CoV-2 infection, prevention of infection or more severe disease was observed only when the experimental antiviral agent was given before or shortly after exposure. " Pretty much sums it up. HCQ is relatively safe esp if one is careful with dosing and is not taking other drugs that prolong QTc or has congenital prolonged QTc syndrome, and the most important point in this article, you have to treat early if you have any hope of mitigating the outcome of the viral infection. Not after hospital admission.

 

[Ouroboros]

Does anyone know how quinine sulfate compares to chloroquin? From what I understand chloroquin is just the synthetic version of quinine

 

[Snake]

Not to put you on the spot, Mike, but I’d really like to hear Mike RN’s opinions on this topic...

 

[Bigtex]

Does anyone know how quinine sulfate compares to chloroquin? From what I understand chloroquin is just the synthetic version of quinine

We do know that quinine is used to treat malaria. However, quinine is alkaloid derived from cinchona bark, Chloroquine on the other hand is a 4-aminoquinoline drug. I have never seen any study or heard any reports of quinine being used. I know before we got the chloroquine, my wife and I both used a mixture she made from cinchona bark.

Wilson 6. There are something like 70 studies on record using chloroquine. 51 of the show benefits and no side effects, 16 of them the opposite. Seems much more emphasis has been put on the few negatives. The positive outcomes out weight the negative out comes by about 5:1 you have to think there is some validity to the positives. Then the job of the FDA is to read both and decide whether or not any reported negatives out weight the benefits of the drug in order to release it. This was done over 50 years ago as chloroquine was released. In fact, The pharmacies steadily dispensed an average of 383,685 prescriptions for hydroxychloroquine (HCQ) per month in the USA alone. The negative studies oddly started coming out after Trump announced this drug worked. Makes eye brows raise, huh?

As I mentioned, when I got my unwanted ticket to Vietnam we were all given Chloroquine to protect us from malaria. No one had any side effects and as far as we were concerned the side effects of a pill is the last thing that will kill you. Since then 1000's have been treated for malaria, prevented malaria, treated for HIV-1, lupus and rheumatoid arthritis, for years, and despite any side effect it is still being used. Only recently have the side effects been of any concern. Why? Tylenol......you can buy that anywhere but does it have serious side effects? It is pretty big killer of Americans,in fact 450 people die each year taking this "safe" drug. One of the most serious side effects associated with the long-term use of this medication is liver failure. leading to liver transplant or death. Kind of a concern but it is still sold over the counter. In fact, 783,936 per year die from taking prescription medication. So why are we not concerned with this? Do the risks out weight the benefits?

As a patient, we have the right to control the outcome of our health. We get to make the decision, no research, not the FDA, not politicians and not doctors. We have the final say. It is our job to properly educate ourselves and make that decision. The literature is surely out there. Trust me Wilson 6, I have been faced with numerous life or death situations in my like and had to react or not have that decision. I am 65, high risk group....had I gotten sick I stood a good chance of not living through it. Is it worth the chance to avoid any risk? Like I said, I am not willing to just cave in and die and instead will do all I can to survive. My wife is the same way. So we took the chance and over a week later my wife is 100% and I have not show any symptoms. Neither of us had any side effects.....how do I know about the QT prolongation risk......at my age I have an EKG hooked up to my cell phone. I monitored out hear rate. My heart rate also is 65bpm normally, never changed. I was trained in grad school to read EKG's so I know well what a long QT looks like. It just wasn't there, nor with my wife.

If you are standing on a bridge over water and a nut with a knife is running at you going to cut your head off, what do you do.......fight, lay down and die or jump off the bridge and hope there is enough water so you can swim to safety. Even a lion will jump and take the path of least resistance.

As I mentioned, in my line of work, I have listen many years to people in white coats who believe they have far more knowledge about exercise science that I do because they have a lab. When I competed, I was at the top of the game from many years yet I am told what I was doing was not right by exercise scientist. Really? They get insulted when you ask them when the last time they put a bar on their back and actually squatted weight. How many world records do you hold.....yet they want to tell me how to win? There comes a time when science needs to quit being so arrogant and start investing time and effort into finding out why things work. When there are 1000's of observational cases of people being successful and scientist say it can't be happening. find out instead, why it is happening. Which brings me back to my point above......why did all of this negative doubt occur after Trump announce that chloroquine works? Coincidence or worse,

In times like this, reports from doctors who have been successfully treating this virus and those of us who are willing to take that jump are much more valuable. We are the true pioneers on this study. Writing up a paper on it becomes less or a priority when saving lives should be your first. Taking this medication is a personal choice we all deserve to have. I think in the case of this virus we have had enough of listening to the experts. It time we start listening to doctors who have successfully treated this virus and those who actually took it. Especially when we find out scientist have been caught doctoring data to fit their agenda in the 96,000 subject study published in the Lancet. (Mehra et al., The Lancet, May 22, 2020, doi: 10.1016/S0140-6736(20)31180-6) (Peer Reviewed). Did the peers not read the paper?

Mfeukeu-Kuate et al. - No life-threatening modifications of the QT interval was observed in non-severe COVID-19 patients treated ambulatory with HCQ+AZ. 51 relatively young patients 39 +/- 11.

Mercuro et al., JAMA Cardiol., May 1, 2020, - More recent and much larger studies have not shown significant safety concerns, including outpatient RCTs showing no serious adverse events, and even the RECOVERY trial which used an unusually high dose of HCQ (including 237 patients also receiving AZ) reports they "did not show any excess in ventricular tachycardia (including torsade de pointes) or ventricular fibrillation in the hydroxychloroquine arm", and "serious cardiovascular toxicity has been reported very rarely despite the high prevalence of cardiovascular disease in hospitalized patients, the common occurrence of myocarditis in COVID-19, and the extensive use of hydroxychloroquine and azithromycin together."

NIH halts late stage trial reporting no harm and no benefit. 470 patients. Currently no formal study is available so this is not included in the study count. But I hear the media mention this study all the time?

WHO stopped the Solidarity late stage trial of HCQ reporting no benefit. Later news reported "little or no reduction in mortality". The study has not been released yet and few details are available. This trial used an extremely high dose which may be related to the relatively poor results. Currently no formal study is available so this is not included in the study count. Yet we take this as proof?

Dr. Anthony Cardillo CEO of Mend Urgent Care in California - "Every patient I've prescribed it to has been very, very ill and within 8 to 12 hours, they were basically symptom-free," "So clinically I am seeing a resolution." Should this real life observation be ignored?

Dr. Mohammud Alam, an infectious disease specialist NY - "81 percent of infected covid patients he treated at three Long Island nursing homes recovered from the contagion. " Pretty high risk group.

Dr. Stephen Smith, founder of The Smith Center for Infectious Diseases and Urban Health - " I have treated 72 COVID-19 patients, "I have been treating "everybody with hydroxychloroquine and azithromycin [an antibiotic]. We’ve been doing so for a while.”
.
Chloroquine was most widely used in Spain, where 72 percent of physicians said they had prescribed it. President Trump has used it as a preventative measure, and President Bolsonaro of Brazil has also taken it, Boris Johnson was reported to have taken it. Quite a few Congressmen who have tested positive are taking it. Most of those who take it or prescribe it are afraid of what will happen if they admit it in public.

I agree Wilson 6, that we all need to educate ourselves as much as possible and be very careful taking any kind of medication. But the choice has to be individual and we all deserve to have that chance. With 4,700,000 + positive cases and 2, 200,00 + have recovered and 156,042 died, several thousand hospitalized we all have a serious decision to make. I can assure you that masks, washing hands and social distancing only lessen the change and does not prevent it. So what will you do when it is you that has it?