Ivermectin -- I'm hearing it can be useful even in dire, not-much-hope ICU COVID cases.

[Halftime Hope]

There is another case report on TrialSiteNews on YouTube, in which the family of an ICU patient had to sue a hospital to continue IVM treatment when a patient was given IVM in the ICU, got markedly better, was transferred to a stepdown unit, and the new docs wouldn't continue the meds.  

Anyhow, this report echoes what I heard Dr. Ratjer say about their experience in Broward County, that ivermectin turned around some of their critically ill patients.  

I just thought someone might need that bit of information, so you can tuck it away in case needed. 

[Corraleno]

There are a lot of ivermectin studies in progress, but few of them have completed and published results, and many have significant issues such as lack of placebo control (in some cases, ivermectin is compared to other drugs such as HCQ, but not to a placebo group), extremely small size, or they use a combination of drugs that make it difficult to tease out the effect of the ivermectin.

For example, a tiny study in Spain with only 24 participants, split evenly between treatment and control groups, showed no significant difference in outcome. An even smaller "study" in Bagdad involved giving a combination of ivermectin, HCQ, and azithromycin to 16 people, all of whom were healthy at the end of 4 weeks. (Not sure that even qualifies as a "study.") A large study in Bangladesh with 400 total participants combined ivermectin with doxycycline. I haven't seen their results in publication, but the data that are listed on clinical trials.gov show 3 deaths from all causes in the placebo group and no deaths but 10 "adverse events" in the treatment group. There was no group that received either ivermectin only or doxycycline only, so no way to tell how much each of those contributed to the outcomes. I also didn't see any indication that they matched for severity of symptoms or underlying conditions, only for sex and age. There was also a small study in Brazil (n=45) that supposedly competed last fall, but I haven't been able to find any results for that.

Placebo-controlled studies of ivermectin (alone) are currently in progress in Italy (n=100), Argentina (n=500), Japan (n=240), Peru (n=68), Brazil (n=64), UK (n=24), Bangladesh (N=72, in 3 groups of 24), and Pakistan (n=60, in 4 groups of 15).

Studies that are planned but not yet started include Temple University (n=200), Gambia (n=1200), and Brazil (n=294), 

[TravelingChris]

I know that my hospital group says they do have monoclonal antibodies, Reverstavir and also the steroid.  I know that one thing I will get my dh if he gets it is blood thinning medications since so many of the issues involve blood clots. 

[Drama Llama]

Nothing to see here I read that backwards.

Edited January 24, 2021 by BaseballandHockey

[TravelingChris]

1 hour ago, BaseballandHockey said:

I don't understand how a hospital can not have steroids.  They are a very common medication used to treat a lot of conditions. 

The protocols for Dexamethasone for covid are for inpatient use only,.  Is it possible that what they're saying is that they aren't offering it for outpatient use?  

I said they have all these medications at the hospital.    I could not remember what the name of that specific steroid was.  They were answering a question from a reporter about what medications were being used at our local hospital.

[PrincessMommy]

6 hours ago, kand said:

I’m still hoping to see a large, double blind placebo study so we can learn whether it actually helps or not. A problem is that, like with hydroxychloriquine, ivermectin has this fervent group of believers who want it to be widely used based on anecdotes alone. I’m seeing people saying it would be immoral to do a placebo controlled study because we already know it works. But we don’t, because of the lack of good studies. It’s also problematic when people latch onto something as a wonder drug to the point it becomes hard to take them seriously. Because, the truth is that it might really work, but when people are insistent without evidence that it cures everyone or has “only 1/5000 chance of not working” and are also pushing other medications that have been shown not to work, it’s hard for it not to seem like snake oil. Which does a disservice if it’s something actually helpful. People need to be scientific about this. We can’t just throw things at it without finding out what actually works and what doesn’t. The new study on colchicine looks hopeful. It’s another inexpensive medication that would be amazing if it works. Fortunately so far, no one is pedaling it like snake oil, so hopefully we will find out more about its effectiveness.

I also saw some good things this week about the monoclonal treatments given to people before they are really sick. That one is more expensive, but apparently they are plentiful right now because they’re not getting used enough. 
 

eta: now that more info has been released on the colchicine trial, it sounds too early to get really excited about that. 
 

Also adding, I notice a strong anti-vaccine bias amongst people championing ivermectin online. They tend to say we shouldn’t be risking injecting dangerous mRNA technology when we have this cheap miracle cure. Again, it makes it hard to take seriously, which is too bad, because we really don’t know one way or the other on ivermectin and perhaps it could be useful. But people need to start being scientific about this stuff if they want to be taken seriously. 

except the AMA has quietly reversed its stance on hydroxychloriquine.  In Nov. 2020 they rescinded their statement calling for physicians to stop prescribing Hydrox...  They now are allowing physicians to prescribe and pharmasists to fill prescriptions but that drs. are supposed to notify the patient that "studies are ongoing." 

https://www.ama-assn.org/system/files/2020-10/nov20-handbook-addendum.pdf

Refer to Resolution 506:

I expect they will do the same with ivermectin eventually.   It is easily available outside of the US without a perscription.  

As to your bolded insulting statement.  One of the basic tenents of science is to question and inquire.  Insinuating that people are unscientific because they are questioning the status quo and trying to educate themselves as much as they can is not helpful.  It's just a way to shut down the conversation. 

[Drama Llama]

2 hours ago, TravelingChris said:

I said they have all these medications at the hospital.    I could not remember what the name of that specific steroid was.  They were answering a question from a reporter about what medications were being used at our local hospital.

Sorry, I read it backwards.  My brain inserted a “not” that was not there.

[TCB]

I do not think there is a magic bullet. Y’all just move from one to another (some of y’all). For goodness sake look into it properly, but quit accusing those of us slogging our guts out, trying to save these people, of all these crazy conspiracy theories!

Have you ever even seen a really sick Covid patient? It is a dreadful, horrible disease, and if I have to hear, one more time, how one person, someone knows, took xy or z and got better, I feel like I will scream. For goodness sake, have mercy. Wait until there is actual good evidence before declaring something a miracle drug. 
 

Edited January 24, 2021 by TCB

[wathe]

NIH most recent statement on Ivermectin.

The COVID-19 Treatment Guidelines Panel (the Panel) has determined that currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19.

and

However, most of the studies reported to date had incomplete information and significant methodological limitations, which make it difficult to exclude common causes of bias.

The quality of the data regarding ivermectin is very poor. 

 

 

[Corraleno]

8 hours ago, PrincessMommy said:

except the AMA has quietly reversed its stance on hydroxychloriquine.  In Nov. 2020 they rescinded their statement calling for physicians to stop prescribing Hydrox...  They now are allowing physicians to prescribe and pharmasists to fill prescriptions but that drs. are supposed to notify the patient that "studies are ongoing." 

https://www.ama-assn.org/system/files/2020-10/nov20-handbook-addendum.pdf

Refer to Resolution 506:

I expect they will do the same with ivermectin eventually.   It is easily available outside of the US without a perscription.  

As to your bolded insulting statement.  One of the basic tenents of science is to question and inquire.  Insinuating that people are unscientific because they are questioning the status quo and trying to educate themselves as much as they can is not helpful.  It's just a way to shut down the conversation. 

The statement that the AMA "reversed" its stance on HCQ, as claimed by Rush Limbaugh and widely reported in RW media, is FALSE.  The resolution you refer to was proposed by a delegate from Georgia, but it was rejected by the AMA. Their original position, that there is no scientific evidence for the benefit of HCQ as a treatment for covid, still stands:

[quote]"Limbaugh accused the AMA of "knowingly lying about hydroxychloroquine." But as the Poynter Institute reported, the AMA never retracted its statement on the drug. The Published Reporter and other websites that spread similar claims have walked back their reports, and the AMA addressed the matter on Twitter.

"In March, AMA urged caution about prescribing hydroxychloroquine off-label to treat #COVID19," the AMA wrote, with a link to Poynter’s Covering COVID-19 newsletter by Al Tompkins. "Our position remains unchanged. Evidence-based science & practice must guide these determinations." [/quote]
Factcheck: Does the AMA now support hydroxychloroquine

I'm not sure why it would be considered "insulting" to suggest that "people who are trying to educate themselves as much as they can," as you suggest, should stick to scientific facts. I would add that it's also worth fact-checking random claims by folks like Rush Limbaugh before presenting them as truth. 

[Halftime Hope]

22 hours ago, kand said:

I’m still hoping to see a large, double blind placebo study so we can learn whether it actually helps or not. A problem is that, like with hydroxychloriquine, ivermectin has this fervent group of believers who want it to be widely used based on anecdotes alone. I’m seeing people saying it would be immoral to do a placebo controlled study because we already know it works. But we don’t, because of the lack of good studies. It’s also problematic when people latch onto something as a wonder drug to the point it becomes hard to take them seriously. Because, the truth is that it might really work, but when people are insistent without evidence that it cures everyone or has “only 1/5000 chance of not working” and are also pushing other medications that have been shown not to work, it’s hard for it not to seem like snake oil. Which does a disservice if it’s something actually helpful. People need to be scientific about this. We can’t just throw things at it without finding out what actually works and what doesn’t. The new study on colchicine looks hopeful. It’s another inexpensive medication that would be amazing if it works. Fortunately so far, no one is pedaling it like snake oil, so hopefully we will find out more about its effectiveness.

I also saw some good things this week about the monoclonal treatments given to people before they are really sick. That one is more expensive, but apparently they are plentiful right now because they’re not getting used enough. 
 

eta: now that more info has been released on the colchicine trial, it sounds too early to get really excited about that. 
 

Also adding, I notice a strong anti-vaccine bias amongst people championing ivermectin online. They tend to say we shouldn’t be risking injecting dangerous mRNA technology when we have this cheap miracle cure. Again, it makes it hard to take seriously, which is too bad, because we really don’t know one way or the other on ivermectin and perhaps it could be useful. But people need to start being scientific about this stuff if they want to be taken seriously. 

I don't know who you are listening to, but I'll take your word for it.  I'm listening to medical doctors and med school professors who are constantly covering the latest information on both vaccine news and public health measure studies and news, and who are studying prior medical literature to understand all the possible mechanisms of ivermectin (we're talking getting deep into the biochemistry of what is pretty well known), AND relating that to what they, themselves, are seeing in clinical practice.    I've pretty much settled into MedCram, Drbeen (Syed Mobeen), the occasional JAMA (when they are not off on a political tangent), and TWiV (this week in virology.)  TWiV is not for the casual listener -- they are really long-winded. 

So this is what is really helpful:  you treat people, you do the studies, and over months you accumulate data.  The data shows that HQC is useful within a pretty limited window; the data is out on colchecine; polyclonal antibodies are better than monoclonal, and may be moreso as we encounter variants; fluvoxamine is also worth looking at further.   

The overall approach to treatment so far isn't working.  I'm willing to try something different.  

 

[Halftime Hope]

10 hours ago, kand said:

I’m not sure why it would be insulting to anyone except people who want to be unscientific about it. My post makes clear that I think these drugs should be studied well. That statement was referring to people making wild claims about miracle cures and insisting in the same breath that the vaccine is dangerous and is a conspiracy. People who want to study these things to see what does and doesn’t work aren’t the ones I’m calling unscientific. Only the ones who want to make claims with no data to back them up. That’s not science, and saying that it isn’t science isn’t me stating an opinion, it’s that it literally doesn’t meet the definition of science. 

So the loudest voice so far on ivermectin seems to be, collectively, the FLCCC, (Drs. Marik, Kory, et al.) and other practicing physicians who have chimed in, people like Dr. McCullough.  They are men of science, and they clearly think there is enough data that it should be studied in a double-blind placebo controlled study, and they've asked the NIH to do that as fast as possible. 

 

 

 

[Corraleno]

58 minutes ago, Halftime Hope said:

So the loudest voice so far on ivermectin seems to be, collectively, the FLCCC, (Drs. Marik, Kory, et al.) and other practicing physicians who have chimed in, people like Dr. McCullough.  They are men of science, and they clearly think there is enough data that it should be studied in a double-blind placebo controlled study, and they've asked the NIH to do that as fast as possible. 

No one is suggesting that ivermectin and other drugs shouldn't be studied — exactly the opposite. People are just saying that we should wait for the results of those double-blind placebo-controlled studies instead of making claims based on anecdotal information. As I listed above, there are a multitude of RCTs on ivermectin currently underway. If those studies show solid evidence of efficacy, I'm sure everyone here will rejoice in the availability of a cheap, effective treatment for covid. 

[wathe]

NIH on hydroxychloroquine:

https://www.nih.gov/news-events/news-releases/hydroxychloroquine-does-not-benefit-adults-hospitalized-covid-19

There is good evidence to show that it is not effective in hospitalized patients.

[TCB]

I think I was a bit heated in my response on this thread last night. I broke my rule of not posting right after a 12 hour shift at work. 
For me it seems that these claims are often coupled with the suggestion that any dr, who doesn’t immediately leap in and start using them, is automatically assumed to be part of a huge conspiracy to withhold the true cure. That is just so unjust. Everyone I work with is trying, and has been trying for months, to do everything we can to help. The insinuation that people in healthcare are deliberately keeping a “wonder drug” away from patients cuts to the quick.

I’m trying to look at recent stuff about Ivermectin but finding it a bit difficult to sort through. Does anyone have a link to a recent Medcram about it?

[wathe]

Evidence summaries for hydroxychloroquine from UpToDate:

Non-hospitalized patients:

In particular, hydroxychloroquine has received considerable attention as an agent with possible antiviral activity, but trials have not suggested a clinical benefit for patients with COVID-19, including those managed in the outpatient setting [82,83]. Although some observational and unpublished anecdotal reports have suggested a clinical benefit of hydroxychloroquine, those are subject to a number of potential confounders [84], and randomized trials offer higher-quality evidence that hydroxychloroquine has no proven role for COVID-19. As an example, in an open-label trial including 293 patients with mild COVID-19 who did not warrant hospitalization, hydroxychloroquine administered within five days of symptom onset did not reduce viral levels at day 3 or 7 compared with no treatment [82]. In addition, there was no statistically significant reduction in hospitalization rates or time to symptom resolution. The rate of adverse effects, primarily gastrointestinal symptoms, were greater with hydroxychloroquine. (See "Coronavirus disease 2019 (COVID-19): Management in hospitalized adults", section on 'Hydroxychloroquine/chloroquine'.)

Hospitalized patients:

Hydroxychloroquine/chloroquine — We suggest not using hydroxychloroquine or chloroquine in hospitalized patients given the lack of clear benefit and potential for toxicity. In June 2020, the US FDA revoked its emergency use authorization for these agents in patients with severe COVID-19, noting that the known and potential benefits no longer outweighed the known and potential risks [87].

Both chloroquine and hydroxychloroquine may inhibit SARS-CoV-2 in vitro [88]. However, accumulating data from controlled trials suggest that they do not provide a clinical benefit for patients with COVID-19 [89-94]. In a randomized, blinded, placebo-controlled trial of 479 hospitalized patients with COVID-19, hydroxychloroquine did not improve 14-day clinical status or 28-day mortality (10.4 versus 10.6 percent; adjusted OR 1.07, 95% CI 0.54-2.09) compared with placebo; the trial was terminated early because of this lack of benefit [94]. Other large, open-label trials comparing various potential therapies with standard of care also terminated the hydroxychloroquine arms after failing to detect a mortality benefit or reduction in hospital stay [49,89]. In another open-label trial of hospitalized patients who required no or only low-flow oxygen supplementation (≤4 L/min), hydroxychloroquine (with or without azithromycin) did not improve clinical status at 15-day follow-up compared with standard of care [93]. Observational data are somewhat mixed and have methodologic limitations, but overall also suggest no benefit with hydroxychloroquine or chloroquine [95-100].

Studies have highlighted the potential toxicity of hydroxychloroquine or chloroquine [99,101]. One trial comparing two doses of chloroquine for COVID-19 was stopped early because of a higher mortality rate in the high-dose group [101]. QTc prolongation, arrhythmias, and other adverse effects associated with hydroxychloroquine and chloroquine are discussed in detail elsewhere. (See "Coronavirus disease 2019 (COVID-19): Arrhythmias and conduction system disease", section on 'Patients receiving QT-prolonging treatments' and "Antimalarial drugs in the treatment of rheumatic disease", section on 'Adverse effects' and "Methemoglobinemia", section on 'Dapsone and some antimalarials'.)

 

Bolding mine.  Hydroxychloroquine is not a benign drug.  One should not prescribe a drug with known toxicity in the absence of evidence of clear benefit.  The evidence is not there.  Prescribing this drug for covid is , given the current state of the evidence,  likely to do more harm than good.

 

Edited January 24, 2021 by wathe

[wathe]

2 minutes ago, TCB said:

I think I was a bit heated in my response on this thread last night. I broke my rule of not posting right after a 12 hour shift at work. 
For me it seems that these claims are often coupled with the suggestion that any dr, who doesn’t immediately leap in and start using them, is automatically assumed to be part of a huge conspiracy to withhold the true cure. That is just so unjust. Everyone I work with is trying, and has been trying for months, to do everything we can to help. The insinuation that people in healthcare are deliberately keeping a “wonder drug” away from patients cuts to the quick.

I’m trying to look at recent stuff about Ivermectin but finding it a bit difficult to sort through. Does anyone have a link to a recent Medcram about it?

You had the nerve to say what many of us are screaming in our heads.

HCP try very hard to keep the professional veneer intact.  I think it's probably a good thing for the general public to get a peek behind the curtain sometimes.  We're people.  (And we're all going to have a certain amount of PTSD/burnout once this is over.)

[Corraleno]

33 minutes ago, TCB said:

I’m trying to look at recent stuff about Ivermectin but finding it a bit difficult to sort through. Does anyone have a link to a recent Medcram about it?

Mike Hansen has a good, short, current (1/7/21) review of some of the studies so far. His conclusion is that ivermectin seems promising but the studies to date are flawed. He says he remains cautiously optimistic but won't be prescribing it for his own patients until he sees solid RCT results.

 

[TCB]

4 hours ago, wathe said:

You had the nerve to say what many of us are screaming in our heads.

HCP try very hard to keep the professional veneer intact.  I think it's probably a good thing for the general public to get a peek behind the curtain sometimes.  We're people.  (And we're all going to have a certain amount of PTSD/burnout once this is over.)

I think HCWs everywhere in the world are feeling the anguish. It is hard to deal with, especially going on for so long, and always with the threat of things getting worse. I’m very sorry we are having to experience this.

[TCB]

4 hours ago, Corraleno said:

Mike Hansen has a good, short, current (1/7/21) review of some of the studies so far. His conclusion is that ivermectin seems promising but the studies to date are flawed. He says he remains cautiously optimistic but won't be prescribing it for his own patients until he sees solid RCT results.

 

Thank you! I was trying to sift through and find good info so appreciate the link very much!

[Corraleno]

New MedCram video uploaded today discussing anticoagulants. Summary: results of a huge international study show that therapeutic does of  heparin improve outcomes in moderately severe cases that are hospitalized but not in ICU, but it is not recommended for severe patients in ICU as there was no improvement in that group and the study concluded that it may cause harm in some patients.

ETA: Oops, I meant to post this in the general thread, I'll cross post it over there.

 

 

Edited January 25, 2021 by Corraleno

[TCB]

6 minutes ago, Corraleno said:

New MedCram video uploaded today discussing anticoagulants. Summary: results of a huge international study show that therapeutic does of  heparin improve outcomes in moderately severe cases that are hospitalized but not in ICU, but it is not recommended for severe patients in ICU as there was no improvement in that group and the study concluded that it may cause harm in some patients.

 

 

I think that is going to be somewhat difficult to implement. We have had a number of patients admitted with PEs a while into their Covid course, so not anticoagulating ICU patients will be scary because there is that constant fear that they will go on to develop PEs too. Just shows how important objective studies are.  

[Halftime Hope]

On 1/24/2021 at 2:42 PM, wathe said:

Evidence summaries for hydroxychloroquine from UpToDate:

Non-hospitalized patients:

In particular, hydroxychloroquine has received considerable attention as an agent with possible antiviral activity, but trials have not suggested a clinical benefit for patients with COVID-19, including those managed in the outpatient setting [82,83]. Although some observational and unpublished anecdotal reports have suggested a clinical benefit of hydroxychloroquine, those are subject to a number of potential confounders [84], and randomized trials offer higher-quality evidence that hydroxychloroquine has no proven role for COVID-19. As an example, in an open-label trial including 293 patients with mild COVID-19 who did not warrant hospitalization, hydroxychloroquine administered within five days of symptom onset did not reduce viral levels at day 3 or 7 compared with no treatment [82]. In addition, there was no statistically significant reduction in hospitalization rates or time to symptom resolution. The rate of adverse effects, primarily gastrointestinal symptoms, were greater with hydroxychloroquine. (See "Coronavirus disease 2019 (COVID-19): Management in hospitalized adults", section on 'Hydroxychloroquine/chloroquine'.)

Hospitalized patients:

Hydroxychloroquine/chloroquine — We suggest not using hydroxychloroquine or chloroquine in hospitalized patients given the lack of clear benefit and potential for toxicity. In June 2020, the US FDA revoked its emergency use authorization for these agents in patients with severe COVID-19, noting that the known and potential benefits no longer outweighed the known and potential risks [87].

Both chloroquine and hydroxychloroquine may inhibit SARS-CoV-2 in vitro [88]. However, accumulating data from controlled trials suggest that they do not provide a clinical benefit for patients with COVID-19 [89-94]. In a randomized, blinded, placebo-controlled trial of 479 hospitalized patients with COVID-19, hydroxychloroquine did not improve 14-day clinical status or 28-day mortality (10.4 versus 10.6 percent; adjusted OR 1.07, 95% CI 0.54-2.09) compared with placebo; the trial was terminated early because of this lack of benefit [94]. Other large, open-label trials comparing various potential therapies with standard of care also terminated the hydroxychloroquine arms after failing to detect a mortality benefit or reduction in hospital stay [49,89]. In another open-label trial of hospitalized patients who required no or only low-flow oxygen supplementation (≤4 L/min), hydroxychloroquine (with or without azithromycin) did not improve clinical status at 15-day follow-up compared with standard of care [93]. Observational data are somewhat mixed and have methodologic limitations, but overall also suggest no benefit with hydroxychloroquine or chloroquine [95-100].

Studies have highlighted the potential toxicity of hydroxychloroquine or chloroquine [99,101]. One trial comparing two doses of chloroquine for COVID-19 was stopped early because of a higher mortality rate in the high-dose group [101]. QTc prolongation, arrhythmias, and other adverse effects associated with hydroxychloroquine and chloroquine are discussed in detail elsewhere. (See "Coronavirus disease 2019 (COVID-19): Arrhythmias and conduction system disease", section on 'Patients receiving QT-prolonging treatments' and "Antimalarial drugs in the treatment of rheumatic disease", section on 'Adverse effects' and "Methemoglobinemia", section on 'Dapsone and some antimalarials'.)

 

Bolding mine.  Hydroxychloroquine is not a benign drug.  One should not prescribe a drug with known toxicity in the absence of evidence of clear benefit.  The evidence is not there.  Prescribing this drug for covid is , given the current state of the evidence,  likely to do more harm than good.

 

Just as one should not confound the data an chloroquine with hydroxychloroquine.  

[Halftime Hope]

If anyone wants to sit through the biochem on it, Dr Syed Mobeen has the best videos on ivermectin of anyone thus far, and he's been consistently covering the new, studies, and data, and he's about the only person who is talking with doctors in Asia and covering their published studies.  

I really don't care for Dr Hansen:  he is a bit sensationalistic, and I find that he forms opinions rather hastily. I've been listening to his videos, when he does them, since the beginning of COVID.  I just don't find him as credible.  (YMMV)

 

Edited January 26, 2021 by Halftime Hope

[wathe]

1 hour ago, Halftime Hope said:

Just as one should not confound the data an chloroquine with hydroxychloroquine.  

You are right, they are different drugs, but closely related drugs.  With similar toxicity profiles.   I will amend my statement: Neither chloroquine nor Hydroxychloroquine are not benign drugs.  One should not prescribe any drug with known toxicity in the absence of evidence of clear benefit.  The evidence is not there.  Prescribing either of theses drugs for covid is , given the current state of the evidence,  likely to do more harm than good.

 

[TravelingChris]

1 hour ago, wathe said:

You are right, they are different drugs, but closely related drugs.  With similar toxicity profiles.   I will amend my statement: Neither chloroquine nor Hydroxychloroquine are not benign drugs.  One should not prescribe any drug with known toxicity in the absence of evidence of clear benefit.  The evidence is not there.  Prescribing either of theses drugs for covid is , given the current state of the evidence,  likely to do more harm than good.

 

Not at all similar profiles.    And ha ha ha-- acetomeninephone is much more dangerous that hydroxychloroquine.;  Hydroxychloroquine is a relativelity beinign drug.   It causes stomach issues as you begin with it that disappear within a few weeks.  It very rarely causes retinal damage so all of us on it have to get spacial opthaliogic  exams.  Chloroquine is not anything given on a regualr basis because hydroxychloroquine had a lot less side effects and was equally effecctive.  These drugs have been around since the 50's.  Hydroxychloroquine is the most benign drug for my arthritis that I am on.  The others have much more serious potential side effects.

[Halftime Hope]

9 hours ago, wathe said:

You are right, they are different drugs, but closely related drugs.  With similar toxicity profiles.   I will amend my statement: Neither chloroquine nor Hydroxychloroquine are not benign drugs.  One should not prescribe any drug with known toxicity in the absence of evidence of clear benefit.  The evidence is not there.  Prescribing either of theses drugs for covid is , given the current state of the evidence,  likely to do more harm than good.

 

Wathe, I don't mean to be argumentative, but I have listened to doctors and a pharmacist say, since March of last year, that chloroquine is a much more toxic drug than hydroxychloroquine.  They are very different.  I distinctly remember the frustration of several of the doctors reviewing studies which mixed data from both in studies, and incredulous that China used chloroquine in some of their studies.  The two are not similar, and you're the first person (I have a vague impression that you have medical training?) I've heard equate the two.  

ETA:  The way I wrote the sentence it sounded like I was calling your training into question.  I've re-written to clarify.  I just am unclear on your background. 

 

Edited January 26, 2021 by Halftime Hope

[Serenade]

8 hours ago, TravelingChris said:

.  Hydroxychloroquine is the most benign drug for my arthritis that I am on.  The others have much more serious potential side effects.

Exactly this.  I take hydroxy for my RA as well.  I chose it because it had the least potential for side effects.  I've been on it for a year now.  So far, so good.

[Halftime Hope]

Just now, Serenade said:

Exactly this.  I take hydroxy for my RA as well.  I chose it because it had the least potential for side effects.  I've been on it for a year now.  So far, so good.

Husband, too. Similar experience. And he is very reactive to meds normally, and we were watchful regarding arrhythmia.  I have listened to many doctors who say that--based on their practice in rheumatology or other fields where HCQ is a first step drug--HCQ is SO benign they don't ever do ECGs before prescribing.  Infectious disease docs hand it out to travelers to take as prophylaxis for malaria, too -- I have first hand experience with that as well.  So no, not a toxic drug.  

 

 

[Lecka]

This is based on me being an autism parent.

I am going to go with research-based over word-of-mouth because there are a lot of strange people on the Internet, and there are niche doctors around the country doing niche things that are either -- not research-based, or they require so much testing that I don't see how I can take advice from someone whose actual child has gone to a doctor and had testing done, and expect the advice to just work for my child too, and blindly take the same drugs that an actual doctor recommended for a specific child.  

I don't understand how it is okay to make medical opinions on the Internet based on "my doctor said this is a good choice for me in my specific situation."  

And I also don't see how a drug being safe for a patient who walks into a doctors office can be compared to the same drug for a patient in the ICU.  That is just not apples to apples.  

I never doubt people's person reports and personal experiences, but that is a big step away from thinking that it's okay to go from one person's experience to extrapolate that it's the best thing to do.

That is why we have studies.  

I think this needs to be said because the Internet is just a wormhole and there is so much information and so many people saying that a certain drug or medicine is the one that's effective -- and there just has to be a line drawn somehow or it never ends.  

There are fads, too, and while the fads are hot a lot of people are true believers.  Then the fad changes and where are all the people who were doing the hot fad from 3 years ago?  Why isn't anybody doing it anymore?  

It is just always like this.

For people who haven't looked at this kind of thing before covid ------ it is always like this.  

And sure some things will turn out to be good!!!!!!!!!!!!  That is absolutely true!!!!!!!!!!!!!!!

But a lot of things will not be.  

Edited January 26, 2021 by Lecka

[Lecka]

Just for example -- check out Vitamin B12 shots for autism. 

First there were some really small studies saying it was effective.

Then later there were studies saying it wasn't effective unless children had a vitamin deficiency.

But look at the news from when there were small studies -- the news looks just like the news with small studies of covid drugs.  

It could just go either way until there are larger studies.  

[Halftime Hope]

30 minutes ago, Lecka said:

This is based on me being an autism parent.

I am going to go with research-based over word-of-mouth because there are a lot of strange people on the Internet, and there are niche doctors around the country doing niche things that are either -- not research-based, or they require so much testing that I don't see how I can take advice from someone whose actual child has gone to a doctor and had testing done, and expect the advice to just work for my child too, and blindly take the same drugs that an actual doctor recommended for a specific child.  

I don't understand how it is okay to make medical opinions on the Internet based on "my doctor said this is a good choice for me in my specific situation."  

And I also don't see how a drug being safe for a patient who walks into a doctors office can be compared to the same drug for a patient in the ICU.  That is just not apples to apples.  

I never doubt people's person reports and personal experiences, but that is a big step away from thinking that it's okay to go from one person's experience to extrapolate that it's the best thing to do.

That is why we have studies.  

I think this needs to be said because the Internet is just a wormhole and there is so much information and so many people saying that a certain drug or medicine is the one that's effective -- and there just has to be a line drawn somehow or it never ends.  

There are fads, too, and while the fads are hot a lot of people are true believers.  Then the fad changes and where are all the people who were doing the hot fad from 3 years ago?  Why isn't anybody doing it anymore?  

It is just always like this.

For people who haven't looked at this kind of thing before covid ------ it is always like this.  

And sure some things will turn out to be good!!!!!!!!!!!!  That is absolutely true!!!!!!!!!!!!!!!

But a lot of things will not be.  

So that's the interesting thing.  These are situations where people in ICU were given the drug, and it turned around something that was on a downward spiral.  Certainly it would be up to the doctor. Of course.   In the situation in Broward county, it went through the entire IRB approvals process, and they have made it part of their protocol.  But it went to the IRB, because the doctors trying it were having reasonable success with it in the ICU.  

[BeachGal]

NIH recently changed its stance on using ivermectin to treat Covid.

https://covid19criticalcare.com/wp-content/uploads/2021/01/FLCCC-PressRelease-NIH-Ivermectin-in-C19-Recommendation-Change-Jan15.2021-final.pdf

NIH Revises Treatment Guidelines for Ivermectin for the Treatment of COVID-19
Ivermectin is Now a Therapeutic Option for Doctors & Prescribers

NEW YORK, N.Y. — JANUARY 15, 2021

One week after Dr. Paul Marik and Dr. Pierre Kory—founding members of the Front Line Covid-19 Critical Care Alliance (FLCCC)— along with Dr. Andrew Hill, researcher and consultant to the World Health Organization (WHO), presented their data before the NIH Treatment Guidelines Panel, the NIH has upgraded their recommendation on ivermectin, making it an option for use in COVID-19.

This new designation upgraded the status of ivermectin from “against” to “neither for nor against” which is the same recommendation given to monoclonal antibodies and convalescent plasma, both widely used across the nation. By no longer recommending against ivermectin use, doctors should feel more open in prescribing ivermectin as another therapeutic option for the treatment of COVID-19. This may clear its path towards FDA emergency use approval.

Ivermectin is one of the world’s safest, cheapest and most widely available drugs,” noted Dr. Kory, President of the FLCCC Alliance. The studies we presented to the NIH revealed high levels of statistical significance showing large magnitude benefit in transmission rates, need for hospitalization, and death. What’s more, the totality of trials data supporting ivermectin is without precedent.”

In its ivermectin recommendations update, the NIH also indicated they will continue to review additional trials as they are released. “We are encouraged that the NIH has moved off of its August 27 recommendation against the use of ivermectin for COVID-19,” continued Kory. “That recommendation was made just as the numerous compelling studies for ivermectin were starting to roll in. New studies are still coming in, and as they are received and reviewed, it is our hope that the NIH’s recommendation for the use of ivermectin will be the strongest recommendation for its use as possible.”

Current meta-analyses of studies of ivermectin from around the world show a compelling trend towards the drug’s potent benefits against SARS-CoV-2. Ivermectin, developed in 1975, led to the eradication of a “pandemic” of parasitic diseases across multiple continents and earned the 2015 Nobel Prize for Physiology or Medicine for its discoverers, Dr. William Campbell and Dr. Ōmura Satoshi. In related news, the manuscript written by the FLCCC has been accepted for publication, following a rigorous peer review, in Frontiers in Pharmacology. The full paper will be published within the next couple of weeks, however the preview can be found here.

 

 

[catz]

35 minutes ago, Halftime Hope said:

So that's the interesting thing.  These are situations where people in ICU were given the drug, and it turned around something that was on a downward spiral.  Certainly it would be up to the doctor. Of course.   In the situation in Broward county, it went through the entire IRB approvals process, and they have made it part of their protocol.  But it went to the IRB, because the doctors trying it were having reasonable success with it in the ICU.  

But what else were they using?  The studies that I have seen showed the most success with steroids.  Which are also cheap and readily available.  You can't just look at one piece of the puzzle.  I still haven't seen an double blind data indicating hydrox. is a slam dunk.  A single anecdote or even a few is not a study.  There are more complete studies happening.  I hope ALL the drugs work.   And comparing low dose hydrox use for an otherwise healthy person for RA is different than using it with someone with possible organ failure and blood clots in the ICU. 

I know people who were involved in the hydrox. study at our local U.  Many were initially enthusiastic about it, but ended up disappointed and it not being used at all at our research university.   (double blind prophylactic study, size about  800).   

https://www.nejm.org/doi/pdf/10.1056/NEJMoa2016638

 

[Halftime Hope]

4 hours ago, FuzzyCatz said:

But what else were they using?  The studies that I have seen showed the most success with steroids.  Which are also cheap and readily available.  You can't just look at one piece of the puzzle.  I still haven't seen an double blind data indicating hydrox. is a slam dunk.  A single anecdote or even a few is not a study.  There are more complete studies happening.  I hope ALL the drugs work.   And comparing low dose hydrox use for an otherwise healthy person for RA is different than using it with someone with possible organ failure and blood clots in the ICU. 

I know people who were involved in the hydrox. study at our local U.  Many were initially enthusiastic about it, but ended up disappointed and it not being used at all at our research university.   (double blind prophylactic study, size about  800).   

https://www.nejm.org/doi/pdf/10.1056/NEJMoa2016638

 

So just to clarify, going back to the initial post, in Broward county they were using standard of care and adding ivermectin.  (I'm not talking about HQC, except that people posting here also brought that into the conversation.) 

[TravelingChris]

2 hours ago, Halftime Hope said:

So just to clarify, going back to the initial post, in Broward county they were using standard of care and adding ivermectin.  (I'm not talking about HQC, except that people posting here also brought that into the conversation.) 

And my comments about HQC were not meant as a call to prescribe it for COVID, at all.  Just to clear up some confusion about HQC.

On Facebook, I am on a number of groups dealing with my diseases- one of which is lupus, where HQC is definitely one of the primary drugs.  We have had anecdotal  reports back in late Spring orSummer that people on HQC were gettting COVID and it wasn't a preventative.  Then in NYC, I believe, they had a  fairly small study (less than 200) about outcomes of COVID on lupus and what were the risk factors involved.  Nothing was really clear from that study  except people in their fifties were definitely at higher risk.  Which is why I hope I get my shots next month.