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CousinIT

(9,218 posts) Fri May 22, 2020, 08:48 AM May 2020

Antimalarial drug touted by President Trump is linked to increased risk of death in COVID patients

Source: Washington Post

A study of 96,000 hospitalized coronavirus patients on six continents found that those who received an antimalarial drug promoted by President Trump as a “game changer” in the fight against the virus had a significantly higher risk of death compared with those who did not.

People treated with hydroxychloroquine, or the closely related drug chloroquine, were also more likely to develop a type of irregular heart rhythm, or arrhythmia, that can lead to sudden cardiac death, it concluded.

The study, published Friday in the medical journal the Lancet, is the largest analysis to date of the risks and benefits of treating covid-19 patients with antimalarial drugs. It is based on a retrospective analysis of medical records, not a controlled study in which patients are divided randomly into treatment groups — a method considered the gold standard of medicine. But the sheer size of the study was convincing to some scientists.

“It’s one thing not to have benefit, but this shows distinct harm,” said Eric Topol, a cardiologist and director of the Scripps Research Translational Institute. “If there was ever was hope for this drug, this is the death of it.”

Read more: https://www.washingtonpost.com/health/2020/05/22/hydroxychloroquine-coronavirus-study/

96,000 hospitalized patients on six continents is a LARGE test sample. And it clearly shows this drug is NOT helpful (and is in fact deadly) in treating COVID19

15 replies

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Antimalarial drug touted by President Trump is linked to increased risk of death in COVID patients (Original Post) CousinIT May 2020 OP

Well, I am SHOCKED! SHOCKED I tell you! nt Atticus May 2020 #1

T-rump weissmam May 2020 #2

America Corgigal May 2020 #4

He only CLAIMS to take it, there is no proof that he does take it bucolic_frolic May 2020 #5

Not to defend the use of the drug, I think it is bogus and I wouldn't take it, Chainfire May 2020 #3

The study did attempt to allow for the patients' conditions muriel_volestrangler May 2020 #6

Where'd you get the idea it wasn't a controlled study? Here's the actual methodology. displacedtexan May 2020 #11

Read the Details of the Study Roy Rolling May 2020 #7

Hydroxychloroquine fatalities- it's real. And it's not new. mpcamb May 2020 #8

"It's one thing not to have benefit but this shows distinct harm," Trump, "What do you have to lose" Botany May 2020 #9

hey, Donnie, if one dose is good, TWO ought to be TWICE as good! lastlib May 2020 #10

Has a study been published about the use of HCQ as a prophylactic? AJT May 2020 #12

The cure really *IS* worse than the disease! Initech May 2020 #13

I'm convinced now SCantiGOP May 2020 #14

Double up on your dosage, Donald. SergeStorms May 2020 #15

Atticus

(15,124 posts)

1. Well, I am SHOCKED! SHOCKED I tell you! nt

Reply to CousinIT (Original post)

Fri May 22, 2020, 08:52 AM

May 2020

weissmam

(905 posts)

2. T-rump

Reply to CousinIT (Original post)

Fri May 22, 2020, 08:58 AM

May 2020

will probably still take it

Corgigal

(9,291 posts)

4. America

Reply to weissmam (Reply #2)

Fri May 22, 2020, 09:11 AM

May 2020

can only wish.

He’s like that one elderly coupon who won’t leave the trailer when. a cat 5 hurricane is projected to hit. Normally, the reason is because someone lived through one 30 years ago, it wasn’t that bad. I always feel for the kids of these couples.

bucolic_frolic

(43,044 posts)

5. He only CLAIMS to take it, there is no proof that he does take it

Reply to weissmam (Reply #2)

Fri May 22, 2020, 09:16 AM

May 2020

either making money, paying off a debt, or it's some kind of projection

Chainfire

(17,467 posts)

3. Not to defend the use of the drug, I think it is bogus and I wouldn't take it,

Reply to CousinIT (Original post)

Fri May 22, 2020, 09:11 AM

May 2020

but I wonder if it was only administered when the patients already had one foot in the grave? If given to people who were unlikely to survive, the results may be skewed. The key to my question is the admission that it was not a controlled study. Anecdotal evidence, even on a large scale is still anecdotal.

The problem with drug studies and drug development is they just take scientific method and time to render rational conclusions.

muriel_volestrangler

(101,265 posts)

6. The study did attempt to allow for the patients' conditions

Reply to Chainfire (Reply #3)

Fri May 22, 2020, 09:23 AM

May 2020

Verified data from an international registry comprising 671 hospitals in six continents were used to compare patients with COVID-19 who received chloroquine (n=1868), hydroxychloroquine (n=3016), chloroquine with a macrolide (n=3783), or hydroxychloroquine with a macrolide (n=6221) within 48 h of COVID-19 diagnosis, with 81 144 controls who did not receive these drugs. The primary outcome was in-hospital mortality and the occurrence of de-novo non-sustained or sustained ventricular tachycardia or ventricular fibrillation was also analysed. A Cox proportional hazard model accounting for many confounding variables, including age, sex, ethnicity, comorbidities, other medications, and COVID-19 severity, showed a significant increase in the risk of in-hospital mortality with the four treatment regimens compared with the control group (hazard ratios [HRs] of 1·335 [95% CI 1·223–1·457] to 1·447 [1·368–1·531]). Analyses using propensity score matching by treatment group supported this result. The increased risk of in-hospital mortality was similar in men (1·293 [1·178–1·420] to 1·408 [1·309–1·513]) and women (1·338 [1·169–1·531] to 1·494 [1·334–1·672]). The incidence of repetitive ventricular arrhythmias ranged from 4·3% to 8·1% in patients treated with a 4-aminoquinoline, compared with 0·3% in the control group (p<0·0001).

Despite limitations inherent to the observational nature of this study, Mehra and colleagues should be commended for providing results from a well designed and controlled study of the effects of chloroquine or hydroxychloroquine, with or without a macrolide, in a very large sample of hospitalised patients with COVID-19. Their results indicate an absence of benefit of 4-aminoquinoline-based treatments in this population and suggest that they could even be harmful.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2820%2931174-0/fulltext

displacedtexan

(15,696 posts)

11. Where'd you get the idea it wasn't a controlled study? Here's the actual methodology.

Reply to Chainfire (Reply #3)

Fri May 22, 2020, 10:41 AM

May 2020

Anecdotal evidence? Where'd you hear that? The source needs to be reported.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

Methods

We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents. We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2. Patients who received one of the treatments of interest within 48 h of diagnosis were included in one of four treatment groups (chloroquine alone, chloroquine with a macrolide, hydroxychloroquine alone, or hydroxychloroquine with a macrolide), and patients who received none of these treatments formed the control group. Patients for whom one of the treatments of interest was initiated more than 48 h after diagnosis or while they were on mechanical ventilation, as well as patients who received remdesivir, were excluded. The main outcomes of interest were in-hospital mortality and the occurrence of de-novo ventricular arrhythmias (non-sustained or sustained ventricular tachycardia or ventricular fibrillation).
Findings

96 032 patients (mean age 53·8 years, 46·3% women) with COVID-19 were hospitalised during the study period and met the inclusion criteria. Of these, 14 888 patients were in the treatment groups (1868 received chloroquine, 3783 received chloroquine with a macrolide, 3016 received hydroxychloroquine, and 6221 received hydroxychloroquine with a macrolide) and 81 144 patients were in the control group. 10 698 (11·1%) patients died in hospital. After controlling for multiple confounding factors (age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity), when compared with mortality in the control group (9·3%), hydroxychloroquine (18·0%; hazard ratio 1·335, 95% CI 1·223–1·457), hydroxychloroquine with a macrolide (23·8%; 1·447, 1·368–1·531), chloroquine (16·4%; 1·365, 1·218–1·531), and chloroquine with a macrolide (22·2%; 1·368, 1·273–1·469) were each independently associated with an increased risk of in-hospital mortality. Compared with the control group (0·3%), hydroxychloroquine (6·1%; 2·369, 1·935–2·900), hydroxychloroquine with a macrolide (8·1%; 5·106, 4·106–5·983), chloroquine (4·3%; 3·561, 2·760–4·596), and chloroquine with a macrolide (6·5%; 4·011, 3·344–4·812) were independently associated with an increased risk of de-novo ventricular arrhythmia during hospitalisation.

Roy Rolling

(6,908 posts)

7. Read the Details of the Study

Reply to CousinIT (Original post)

Fri May 22, 2020, 09:26 AM

May 2020

It is not a randomized, double-blind type drug study that first comes to my mind. It is an examination of 96,000 medical records.

My personal belief and medical training lead me to accept it as good medical practice and would unequivocally follow the conclusions as valid.

But understand the technical details of the study and be prepared for right-wing ideologues to push back because, in their vast medical knowledge, they prefer another type of study.

Any type of study that proves their already-foregone political conclusions.

mpcamb

(2,868 posts)

8. Hydroxychloroquine fatalities- it's real. And it's not new.

Reply to CousinIT (Original post)

Fri May 22, 2020, 09:27 AM

May 2020

"Covid-19: VA Study Points to Increased Mortality with Hydroxychloroquine"
Apr 23, 2020 Physicians Weekly

Probably should fault the press for letting Jackass run with it so long.
It wasn't 'unproven', it was dangerous, deadly and contraindicated for this last
month.

https://www.physiciansweekly.com/covid-19-va-study-points-to-increased-mortality-with-hydroxychloroquine/

Botany

(70,447 posts)

9. "It's one thing not to have benefit but this shows distinct harm," Trump, "What do you have to lose"

Reply to CousinIT (Original post)

Fri May 22, 2020, 09:29 AM

May 2020

April 9, 2020

Trump again touts unproven drug to treat coronavirus: ‘What do you have to lose?’

That’s what Trump said Sunday during a White House news briefing on the coronavirus pandemic, adding: “I’m not looking at it one way or another. But we want to get out of this. If it does work, it would be a shame if we didn’t do it early.”

“What do I know? I’m not a doctor,” Trump said. “But I have common sense. The FDA feels good about it, as you know, they approved it.”

snip

“We don’t have time to say, ‘Gee, let’s take a couple of years and test it out, and let’s go and test with the test tubes and the laboratories,’ ” Trump said Sunday, claiming that even if it’s not effective against the coronavirus, there’s no harm in trying because “it doesn’t kill people.”

https://www.marketwatch.com/story/trump-again-touts-unproven-drug-to-treat-coronavirus-what-do-you-have-to-lose-2020-04-05