Really not helpful in this circumstance. Pretty sure Trump routinely appears with experts of various sorts.
Coronavirus: Some Clinical Trial Data
Trump has fired anyone who remotely disagrees with him and has chosen instead to surround himself with sycophants and morons. Barry et al — President Donald J. Trump seeks and recruits people more competent than himself a very high standard and does not suffer incompetence in his organizations. The US Presidency is such that it it more difficult to enforce that policy within government culture inculcated with deception.
Still, he acts and acts quickly to assemble teams for success. If you really believe that Pence was a judicious choice, I think you might be letting politics override any scientific inclination you might have. Now read this and let us know what you think on competence and decision making!
In seriousness, we have here an exemplary Trumpian argument. Do this unblinkingly, immediately, with total authority: evidence is for losers. While your opponent is responding, move on to a different baldly false statement or say something rankly offensive.
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It disorients those of us with a scientific bent. I wonder why are you skeptical on remdesivir? To my superficial understanding the biggest problem would be insufficient PK to target a respiratory virus as it was optimized for hemorrhagic viruses. Am I missing something? In their Nature paper from last year doi They also showed that it has a long half life in peripheral blood monocyte cells PBMCs.
Human dosing is mg on d1 and then mg IV qd subsequently, again suggesting that PK is not an issue. It does have efficacy, just not enough to merit it progressing. The two Mabs in the other arms of that trial were far superior which is still a little bit of a surprise, but the data is the data. A disappointment to be sure. That said, biologists only leave std deviations off a graph when the data sucks. There can be no error bars on qualitative data. The data in the French study are incredibly problematic. Not clear what error rates are at that site and with that assay, or what the threshold is for scoring positive.
Thanks for linking to twitter thread — provides crucial analysis. Red flags all over the place; this needs serious scrutiny. What about reports that Losartan may be beneficial? Still not clear to me how the virus is being distributed by asymptomatic patients but it seems to be.
Is there any reason to believe favipiravir might be just as effective in viral clearance as mono therapy without alpha interferon? So they tried this?? Please keep on being a voice for reason. People appear to have very uninformed ideas about the difference between an attractive molecule and a medicine. Most, the majority, almost all hypothetical treatments wind up not working. Some brilliant guy with shaggy hair who just thinks up a miracle drug is only found in the movies. In real world, it is done by teams of shaggy technicians with brilliant hair, working under the inspired leadership of project manager — who is covering his butt, servile and paranoid in equal measure.
The dropouts in the treatment arm are a major problem for interpreting the data. So I would be extremely cautious on the hydroxychloroquine data. At the moment it looks ambiguous to me. Also it would be much more interesting to see the actual viral titers in the patients rather than percentage of patients as the endpoint. 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 days 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 days; finally, one patient stopped the treatment on day3 post-inclusion because of nausea and was PCR-positive on days It seems disconcerting that that 4 people in the treatment group dropped out due to progression to ICU or death, while none of that happened in the control group.
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But the people in the treatment group were older Hydroxychloroquine is also used to suppress autophagy. Is that help WRT fighting a viral infection? Or would combination therapy with something that promotes autophagy, such as Ambroxol, be useful? Azithromycin also blocks autophagy!
Looking at the Gautret paper. Am I the only one that is far more interested for Pre exposure prophylaxis? This would be a gamechanger since it transforms the disease completely. As long as you take your meds you cannot get sick. Low doses of AZ are routinely given to asthmatics for preventing exacerbations.
I would like to see if mefloquine works for this — it would be an ideal pre-exposure prophylaxis agent — mg once or twice weekly maybe with azithromycin mg twice weekly the PK for mefloquine is great for this type of prescription — controlled trial in emergency medical workers would be easy to set up and fast to get results — assuming these anti malaria meds for for this virus.
Do you know of any trials planned on these targets? Azithromycin is a macrolide antibiotic with well-described anti-inflammatory properties which can be attributed, at least partially, to its action on macrophages. Most of the anti-inflammatory effect documented in studies of azithromycin is in vitro.
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We need to look harder at the three deaths in elderly patients receiving azithromycin in the Rouault study to affirm or rule out cytokine storm. Agree someone independent should replicate the French hydroxychloroquine results which follow earlier Chinese testing as well in a larger, much better trial. Italian group claims they cannot find any record of the chloroquine results in the clinical trial registry. We sought for evidence of such data in the trial registries we reviewed and found none. Zinc should be looked at more. Zinc is known to inhibit the viral RNA polymerase and the chloroquine acts as a zinc ionophore to rapidly transport zinc ions through cell membranes into the cytoplasm where they are needed.
For most normal healthy people, there is no need for ionophores, our natural zinc transporter proteins are good enough for the job. Keeping zinc levels well maintained by zinc supplementation will indeed help prevent the rapid multiplying of viruses. Many people have seen the effects of zinc lozenges to beat the common cold. Thank god for glowing testimonials for sketchy cures made by people named after the purported cures. Thank god for glowing trolling done by people named after a math variable… What a contribution!
It is perfectly reasonable to propose that zinc and chloroquine could have synergistic effects. Synergy does not require individual efficacy. Considering the properties and MoA at work it is something at least worth looking into. At least one animal study has found zero effect of dietary zinc on CoV etiology. Different one, though. Jones is already pushing zinc aggressively, probably because he has pallets of a slow moving supplement that contains a bit of zinc gathering dust in his warehouse.
Azi is a pretty obvious choice to co-dose. Chalk up another spectacularly bad call for Vallance, Witty and Slaoui.
152 comments on “Chloroquine, Past and Present”
JP would have known better. Clinical evidence also does not support the use of steroids for Covid Lancet 7 Feb Steroids have many many effects, but a primary one is anti-inflammatory. Hence, as others as noted, we need to be careful about recommending treatments without good data, particularly when available data suggests the treatment could make patients worse. So at best this small non-random open label study means nothing more than more research is needed ….
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There is a paper doing the rounds about a soluble derivative of aspirin with in vitro activity against SARS2 and potential for inhalation administration when they say potential, note the IV dose would be lethal…. It is a Furin protease, and has been used to successfully treat feline infectious peritonitis, which is caused by the coronavirus FeCoV.
Is carrimycin a man made macrolide?