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Hydroxychloroquine + azithromycin combination being touted as a Corona treatment

bo0li5eumx12kp

https://www.mediterranee-infection.com/hydroxychloroquine-and-azithromycin-as-a-treatment-of-covid-19/

Short and to the point

https://techcrunch.com/2020/03/19/french-study-finds-anti-malarial-and-antibiotic-combo-could-reduce-covid-19-duration/

All very preliminary but encouraging.

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thebaz

Interferon treatment in the UK sounds promising :-
https://www.theguardian.com/science/2020/mar/19/prospects-treatment-coronavirus-drugs-vaccines

Not sure if it is adminstered directly into lungs or pill format.

begbysback

Eliezer Shrilling Grassland wrote: »

Via Luke O'Neills twitter account:

"Many drugs are being carefully tested against COVID19. 4 standouts optimism high: 2 that kill the virus- Remdesivir (anti-Ebola)and combo Ritonavir/Lopinavir (anti-HIV), and 2 anti-inflammatories to protect lungs (hydroxychloroquine (anti-malaria) and tocilizumab (anti-IL6)"

Don't know about the others but that HIV drug combo makes you feel like you've been hit by a freight train.
Seriously heavy drug.

Don't know why we're not hearing more reports of their actual use.

The HIV drugs also cost well over 1000 currency for a months supply.

Im baffled too as to why more isnt being discussed about drug treatment of COVID19 - theres no doubts its going on in countries, when I questioned the HSE consultant in the AMA thread on their exaggerated death forecast in Ireland I got the below as a source for the predictions - what I consider to be strange is this specifies non pharmaceutical intervention, as if there was nothing available - I find it bizzare to be honest that nobody as yet has produced a larger scale report than the french one about drug treatments. Ive no doubt the Chinese have such reports, but dont seem to be sharing them, or at least us public are not told about them.

I would hate to think that the large discrepancies in death numbers when comparing countries is caused by lack of shared information about a treatment.

https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

irishgeo

Interesting reading.

Another interesting idea is plasma from cured patients.Any word what the italians did with the tonne of plasma china sent them?

bfa1509

Wibbs wrote: »

I wonder does this mean in some patients opportunistic bacteria are part of the disease process?

This is all I could think of when you said "opportunistic bacteria"

[Deleted User]

I don't think the addition of azithromycin actually benefits recovery. It doesn't actually make sense from the data and it doesn't make sense pharmacologically.
Hydroxychloroquine is the real deal.

Also, Keletra doesn't work.

threeball

I think I heard yesterday that Novartis produced 200000 doses of hydroxy available free of charge so it must be gathering momentum.

Montage of Feck

So your saying drinking gin and tonic will prevent the virus?

bo0li5eumx12kp

Via Luke O'Neills twitter account:

"Many drugs are being carefully tested against COVID19. 4 standouts optimism high: 2 that kill the virus- Remdesivir (anti-Ebola)and combo Ritonavir/Lopinavir (anti-HIV), and 2 anti-inflammatories to protect lungs (hydroxychloroquine (anti-malaria) and tocilizumab (anti-IL6)"

Don't know about the others but that HIV drug combo makes you feel like you've been hit by a freight train.
Seriously heavy drug.

Don't know why we're not hearing more reports of their actual use.

The HIV drugs also cost well over 1000 currency for a months supply.

CIARAN_BOYLE

begbysback wrote: »

Do you have a source that specifies which conditions this won’t work on, and why?

I'd have to go digging for a proper answer but here's the top of my head one.

It's not that they wont work it's that it's dangerous for people.

It reacts badly with insulin so diabetics cant take it.

I believe they wont prescribe it for anyone with kidney problems or heart problems for it's current problems. Given that the proposed dose for covid 19 is higher than the current dose (anti malaria and autoimmune) I'd imagine this would be more dangerous.

Wibbs

Anti malarials seem to be harsh drugs as a general thing? Though better than getting a full dose of malaria so risk/benefit comes into it.

deathbomber

BorneTobyWilde wrote: »

Would a doctor here prescribe it ? Can one go pick it up at Chemist /

yes it is a well known drug, i was given a prescription for it before i went travelling in asia for 6 months about 12 years ago, i never took it, no need etc, from what i recall, it is not a drug you just pop as it can be quite hard on the body/possible side effects

begbysback

CIARAN_BOYLE wrote: »

This isn't the solution.

The drug is counter indicated for certain conditions for a reason. So it wont work on everyone.

It is however a potential solution. If the doctors find it works for some people that's great. That's 5-60% of the people in serious condition that can be whacked with it so they take up icu beds for less time.

That means icu can go further.

It's not a answer all solution that will fix the problem.

Do you have a source that specifies which conditions this won’t work on, and why?

CIARAN_BOYLE

begbysback wrote: »

If this is the solution, then there is still an issue where a person of high risk contracts the virus, by the time symptoms start getting bad, do they really have 6 days. I haven’t read the full report as yet, does it say to what degree the symptoms improve.

I guess mass testing, in conjunction with this combination of drugs, for those who contract the virus would need to be applied together to completely eradicate from this island.

This isn't the solution.

The drug is counter indicated for certain conditions for a reason. So it wont work on everyone.

It is however a potential solution. If the doctors find it works for some people that's great. That's 5-60% of the people in serious condition that can be whacked with it so they take up icu beds for less time.

That means icu can go further.

It's not a answer all solution that will fix the problem.

Sweet.Science

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-continues-facilitate-development-treatments

begbysback

I guess that’s expected, and why FDA can’t just say yeah go ahead. The sample group were most likely at critical stages, and organ damage already done, Im thinking a more accurate sample would be where the symptoms aren’t critical, and a larger group of course.

EDit

begbysback wrote: »

If this is the solution, then there is still an issue where a person of high risk contracts the virus, by the time symptoms start getting bad, do they really have 6 days. I haven’t read the full report as yet, does it say to what degree the symptoms improve.

I guess mass testing, in conjunction with this combination of drugs, for those who contract the virus would need to be applied together to completely eradicate from this island.

This part might answer your question to a degree “ A total of 26 patients received hydroxychloroquine and 16 were control patients. Six hydroxychloroquine-treated patients were lost in follow-up during the survey because of early cessation of treatment. Reasons are as follows: three patients were transferred to intensive care unit, including one transferred on day2 post-inclusion who was PCR-positive on day1, one transferred on day3 post-inclusion who was PCR-positive on days1-2 and one transferred on day4 post-inclusion who was PCR- positive on day1 and day3; one patient died on day3 post inclusion and was PCR-negative on day2; one patient decided to leave the hospital on day3 post-inclusion and was PCR-negative on days1-2; finally, one patient stopped the treatment on day3 post-inclusion because of nausea and was PCR-positive on days1-2-3.“

So 3 patients who received hydroxychloroquine still went into ICU (after between 1 and 3 days of treatment) and 1 patient died after 2 days of treatment even though clear of the virus.

begbysback

If this is the solution, then there is still an issue where a person of high risk contracts the virus, by the time symptoms start getting bad, do they really have 6 days. I haven’t read the full report as yet, does it say to what degree the symptoms improve.

I guess mass testing, in conjunction with this combination of drugs, for those who contract the virus would need to be applied together to completely eradicate from this island.

BorneTobyWilde

Would a doctor here prescribe it ? Can one go pick it up at Chemist /

bo0li5eumx12kp

EDit wrote: »

As a follow up, here is the French paper: https://www.mediterranee-infection.com/wp-content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf

Pffff

"...At day6 post-inclusion, 100% of patients treated with hydroxychloroquine and azithromycin combination were virologicaly cured comparing with 57.1% in patients treated with hydroxychloroquine only, and 12.5% in the control group...."

Early stages, small trials and that just explains what the graph demonstrates, but hell it's reassuring to see something like that in writing.

"....Of note, one patient who was still PCR-positive at day6-post inclusion under hydroxychloroquine treatment only, received azithromycin in addition to hydroxychloroquine at day8-post inclusion and cured her infection at day-9 post infection..."

Combination therapy is obviously the effective route.

"...severe QT prolongation induced by the association of the two drugs has not been established yet but should be considered..."

Prolonged heart rate vs respiratory failure.

Kind of seems like a no-brainer.

Cheers for finding the full link. I ran the original through sci-hub and couldn't get anything.

begbysback

One quote I heard was 5c per pill, think that was the hydrothingy one

Gretas Gonna Get Ya!

Wibbs wrote: »

Set against that is it's a very cheap drug as drugs go and that's with profits attached. It certainly wouldn't destroy a country's healthcare budget. Never mind the costs of not treating people early before they get to the ICU stage. How many doses would you buy for the cost of one patient in ICU for a day.

If this is a malaria drug, surely it would have to cheap to produce? Most cases of malaria are in desperately poor regions of the world.

EDit

Wibbs wrote: »

Set against that is it's a very cheap drug as drugs go and that's with profits attached. It certainly wouldn't destroy a country's healthcare budget. Never mind the costs of not treating people early before they get to the ICU stage. How many doses would you buy for the cost of one patient in ICU for a day.

Good point. Forgot both of these are generic, so should be relatively cheap. Apparently they are being tested in larger trials with results expected in ~20 days. Fingers crossed the data look good.

Wibbs

EDit wrote: »

Absolutely.

It should also be mentioned (and I really am not trying to be pessimistic, merely realistic) that widespread use of any of these drugs is highly unlikely as the costs associated with treating everyone infected would destroy most countries healthcare budget immediately.

Set against that is it's a very cheap drug as drugs go and that's with profits attached. It certainly wouldn't destroy a country's healthcare budget. Never mind the costs of not treating people early before they get to the ICU stage. How many doses would you buy for the cost of one patient in ICU for a day.

EDit

deathbomber wrote: »

supply would also be a problem a si think it is only manufactured by 1 US company, however i am sure there are ways around it for urgency

Absolutely.

It should also be mentioned (and I really am not trying to be pessimistic, merely realistic) that widespread use of any of these drugs is highly unlikely as the costs associated with treating everyone infected would destroy most countries healthcare budget immediately. Best case scenario IMO, is that it is something that is available for the 20% who get severe infections and as a prophylaxis to protect frontline healthcare workers. Even that would make a massive difference.

deathbomber

supply would also be a problem a si think it is only manufactured by 1 US company, however i am sure there are ways around it for urgency

EDit

As a follow up, here is the French paper: https://www.mediterranee-infection.com/wp-content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf

EDit

I work in this area (Drug approvals) and it’s a complicated and often convoluted process. In certain circumstances, just because a drug is approved in one indication (for one disease) it cannot automatically be approved in another due to different doses or dosing schedules. For example, if all your safety data for drug X in disease A is at a dose of 10mg/ml once a day for a week, but a small study shows that drug X also has efficacy in disease B at a dose of 20 mg/ml twice a day over a 3-week course, you need to make sure that the new dose and schedule is safe in a large pool of patients before you can approve the drug (totally hypothetical example).

In terms of these specifics drugs, they do appear to be promising and could really help those with severe disease, as long as they are safe* Unfortunately, hydroxychloroquine isn’t usually given to patients with heart disease (it has a moderate disease interaction meaning that the recommendation is usually to not use it) and heart disease is one of the risk factors for death with C-19... ie, this might not be the silver bullet for all patients.

*i found and read the French study that is being widely cited. It is small (36 patients) and no safety data are included. I suspect this is a primary reason for the FDA treading carefully.

begbysback

CIARAN_BOYLE wrote: »

It and every other trial has been discussed in the megathread.

I think there was two sided ranting about orange oompa loompas after this was shared. I forget the details.

I’ve banned myself from the mega thread for mental health reasons, there should be a government health warning shown before entering that thread.

CIARAN_BOYLE

Gretas Gonna Get Ya! wrote: »

He's thinking like any normal person on the street would, if they got wind of an effective treatment for this... what are you waiting for, get this thing out there!

I wonder how long the FDA needs in normal circumstances, to safely approve something like this? And can that process be fast-tracked given the urgency of this situation?

The fact that the treatment is approved for other uses means we can fast track and cut the safety portions. So we only need to verify that it actually works on a larger sample.

thomasdylan

RoYoBo wrote: »

I wonder how likely would it be to have this (Plaquinal) prescribed if diagnosed and you asked for it from your doctor? I'd be keen to try it if I got the chance in that situation.

No chance of getting it prescribed now. I don't think GPs will be prescribing it.

It's mainly used for lupus and has lots of side effects.