Plenty of HCQ studies in progress, including early use and as prophylaxis

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  • Wed, May 20, 2020 - 04:24pm

    #1
    Winston2020

    Winston2020

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    Plenty of HCQ studies in progress, including early use and as prophylaxis

https://nymag.com/intelligencer/2020/05/what-clinical-studies-actually-say-about-hydroxychloroquine.html

Research on hydroxychloroquine’s use as a preventative is ongoing

Though clinical results currently suggest the drug is dangerous for coronavirus patients, there are still around 50 ongoing trials in the U.S. hoping to provide a clearer picture of the antimalarial’s potential use in the pandemic. Three of these trials are examining whether the drug has any preventative properties — the purported reason that Trump is on hydroxychloroquine.

One study concerning prophylaxis is currently being conducted by researchers at the University of Minnesota, where researchers will provide the drug to around 750 volunteers who are at high risk of contracting the virus to determine if it provides any protection.

Another study of around 15,000 is being led by Duke University, determining if health-care workers who take hydroxychloroquine are less likely to get COVID-19.

Last week, the National Institute of Allergy and Infectious Diseases announced a 2,000-patient study to determine if the drug can “prevent hospitalization and death from COVID-19.”

53 ongoing studies of HCQ:

https://clinicaltrials.gov/ct2/results?cond=Covid-19&term=hydroxychloroquine&cntry=US&state=&city=&dist=

Specifics on two of them:

University of Minnesota COVID-19 Pre-Exposure Prophylaxis Clinical Trial

https://covidprep.umn.edu/

Healthcare Worker Exposure Response & Outcomes of Hydroxychloroquine Trial (HERO-HCQ)

HERO-HCQ Trial

  • Wed, May 20, 2020 - 04:59pm

    #2
    mEd151A

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    Plenty of HCQ studies in progress, including early use and as prophylaxis

It takes time to set up a double-blind study.  Compound the issue with: if a practice/hospital is already doing a study, they will not participate in a second study because of the real risk of ending up with inconclusive results due to “mixing of participants” thus clouding the results of both studies.

With this in mind, has anyone looked back 70+ years for studies which validated the use of anti-malarial meds in the U.S. military in S.E. Asia?  This would address the issues of safety and efficacy regarding anti-malaria drugs.  If the med is safe for use as developed, an off-label use is generally safe.  Off-label efficacy is a little different.

This leads to the HCQ+Zinc+Azythromycin cocktail for the current corona virus.  After cutting through a lot of noise, these have been taken for decades.  The safe dosage is known.

It would be up to the individual, consulting with a trusted physician, to take this treatment as either prophylaxis or post-infection treatment.

My opinion: there isn’t much downside.

A question:  if an individual is concerned about QT/QTc interval lengthening, would adding Magnesium sulfate as an oral  supplement minimize the risk of lengthened QT interval?

 

 

 

  • Wed, May 20, 2020 - 05:58pm

    #3

    sand_puppy

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    Plenty of HCQ studies in progress, including early use and as prophylaxis

I believe that the focusing of attention to the “danger of QTc prolongation” is a kind of deception to muddy the waters of what are basically old, well established and very safe drugs (especially for short term use).  HCQ was first in use in 1946 and chloroquine in the 1920s.

The WHO convened a special advisory panel to address the issue of cardiotoxicity of antimalarials, almost all of which lengthen the QTc.

Conclusions (Page 36, middle):

“What is the frequency of sudden death attributable to the cardiotoxicity of different antimalarial medicines?

….Despite hundreds of millions of doses administered in the treatment of malaria, there have been no reports of sudden unexplained deaths associated with quinine, chloroquine or amodiaquine, although each drug causes QT/ QTc interval prolongation…..”

I really like the suggestion of adding oral magnesium to reduce risk of torsades de pointes.  I know that in the Emergency Department we would treat torsades de pointes, the very rare arrhythmia associated with long QTc, with IV magnesium.

We use many medicines very commonly that prolong the QTc.  Zofran, pepcid, compazine, cipro, Seroquel, Zyprexa.  Infact we often give multiple QTc prolonging meds to people already taking QTc prolonging meds.  It is just VERY common.

Yet the fatal arrhythmia, torsades is very very very rare.

Here a cardiology magazine has an article evaluating the risk of torsade from Hydroxychloroquine and Azithromycin.  They use a scoring system to give arrhythmia risk.

So my assessment matches mEd151A:  there is little downside risk to HCQ/Azith/Zn.

And, since the standard of care is to do NOTHING, even a slight benefit is an improvement.

  • Wed, May 20, 2020 - 08:09pm

    #4
    Krollchem

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    Plenty of HCQ studies in progress, including early use and as prophylaxis

The use of HCQS Zinc and magnesium is incorporated in the Eastern Virginia Medical School COVID-19 disease protocol. “This approach to COVID-19 is based on the best (and most recent) available literature and the Shanghai Management Guideline for COVID.”;
https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf

The latter full Monty COVID-19 protocol has one deficiency which is the lack of use of NAC and glutathione for breaking the clot S-S bonds (see von Willebrand factor issues) in the lung capillary beds.

I regards to your video “Coronavirus: The Battle For Truth Rages On” there were several points that were omitted that could have added clarity:
(1) Heart QTC prolongation issues falsely attributed to HCQS are most likely due to present on induced magnesium deficiencies or Azithromycin;
https://www.ncbi.nlm.nih.gov/pubmed/9064958
https://www.webmd.com/heart-disease/heart-failure/news/20120516/z-pak-heart-attack
(2) Mutations (statistical thermodynamic substitutions) can reduce ACE-2 receptor site affinity but this may increase CD147 and/or GRP78 receptor site affinities;
(3) The bat Coronaviruses RmYN02 and HKU9 contain the RRAR furan cleavage sequence and it is possible that co-infection with one of these viruses and a virus related to SARS-CoV-2 could result in a copy-choice insertion. Such a mechanism does not preclude virologists playing god;
http://virological.org/t/tackling-rumors-of-a-suspicious-origin-of-ncov2019/384/4

  • Wed, May 20, 2020 - 09:17pm

    #5
    Rootman

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    Plenty of HCQ studies in progress, including early use and as prophylaxis

Question:  If (when) a PREP prophylaxis with HCQ, Ivermectine, or even the ‘covid-organics’ preparation from Madagascar, to name a few, WOULD BE quite effective:

 

Would prophylactically taking them prevent infection in a way that no immunity could be achieved?

 

I have some Ivermectine in my medicine cabinet. If it would work (research is still in progress), I am still hesitant to take it prophylactically: I rather build up immunity through mild disease than through a half bake tested vaccine.

  • Fri, May 22, 2020 - 12:55pm

    #6
    Mauriet

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    Plenty of HCQ studies in progress, including early use and as prophylaxis

And then there is the study in the Lancet. “People are worse off with  chloroquine!”

So now have I have to convince my family and friends that it is a statistical study and noooooo zinc!

I hope that Chris will shine a wise light on this.

Kind regards,

Maurits, a big fan

Chloroquine or hydroxychloroquine for COVID-19: why might they be hazardous?

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31174-0/fulltext

 

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