The Drug That Mr. Trump Did Not Receive At Walter Reed (Allegedly).

InTheEnd

TheDataAreTheDataVille


Lost in all the excitement of the past week was the appearance of a  paper published in the New England Journal Of Medicine titled: "Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19."

The paper reports on a randomized, controlled clinical trial of 4,716 hospitalized patients with a primary endpoint of death at 28 days. You can find the abstract with the specifics at the bottom of the post.

Once again, for informed, expert analysis on this topic (which is not my field), we turn to drug development guy Derek Lowe:

...I’m not in a mood to be subtle. Hydroxychloroquine treatment for coronavirus does not work. It is not beneficial, and in fact appears to be actively harmful. As far as I’m concerned, administering it to infected patients now constitutes medical malpractice. I have no interest in goalpost-moving efforts to say that they didn’t administer zinc or azithromycin, or they picked the wrong patients or the wrong loading dose or whatever. No. This is special pleading, and it is not backed up by any hard data. None of the countries or regions where HCQ was enthusiastically adopted, with or without the addition of zinc, azithromycin or what have you have seen discernable benefits. It. Does. Not. Work...


Enough said?

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In the same post, D. Lowe also weighs in on another recent paper in the NEJM, and concludes that the latest clinical trial supports the earlier conclusion from A. Fauci that the anti-viral treatment remdesivir is moderately beneficial.

In case anyone is wondering about those 'HEK 293' cells that were originally derived from human fetal tissue in the 1970's that currently have the public prints in a tizzy...Well...Those cells, which have since been modified by many labs, were originally developed by a Canadian, Frank Graham, while he was a post-doc in the Netherlands in the 1970's. These cells are really are an invaluable tool in biomedical research the world over because it's very easy to get genes into them that can then be expressed (i.e. turned on) so that you can test their function, alone or in combination with other genes.

Added the 'allegedly' to  the header....Just in case...Interestingly, according to news reports the current President of the United States apparently did receive zinc in his VIP cocktail (see bottom of this report)....Hmmmmm.

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Abstract

BACKGROUND

Hydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease 2019 (Covid-19) on the basis of in vitro activity and data from uncontrolled studies and small, randomized trials.

METHODS

In this randomized, controlled, open-label platform trial comparing a range of possible treatments with usual care in patients hospitalized with Covid-19, we randomly assigned 1561 patients to receive hydroxychloroquine and 3155 to receive usual care. The primary outcome was 28-day mortality.

RESULTS

The enrollment of patients in the hydroxychloroquine group was closed on June 5, 2020, after an interim analysis determined that there was a lack of efficacy. Death within 28 days occurred in 421 patients (27.0%) in the hydroxychloroquine group and in 790 (25.0%) in the usual-care group (rate ratio, 1.09; 95% confidence interval [CI], 0.97 to 1.23; P=0.15). Consistent results were seen in all prespecified subgroups of patients. The results suggest that patients in the hydroxychloroquine group were less likely to be discharged from the hospital alive within 28 days than those in the usual-care group (59.6% vs. 62.9%; rate ratio, 0.90; 95% CI, 0.83 to 0.98). Among the patients who were not undergoing mechanical ventilation at baseline, those in the hydroxychloroquine group had a higher frequency of invasive mechanical ventilation or death (30.7% vs. 26.9%; risk ratio, 1.14; 95% CI, 1.03 to 1.27). There was a small numerical excess of cardiac deaths (0.4 percentage points) but no difference in the incidence of new major cardiac arrhythmia among the patients who received hydroxychloroquine.

CONCLUSIONS

Among patients hospitalized with Covid-19, those who received hydroxychloroquine did not have a lower incidence of death at 28 days than those who received usual care. (Funded by UK Research and Innovation and National Institute for Health Research and others; RECOVERY ISRCTN number, ISRCTN50189673. opens in new tab; ClinicalTrials.gov number, NCT04381936. opens in new tab.)

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