|
The Rise and Fall of Hydroxychloroquine for the Treatment and Prevention of COVID-19
[PMC] - The efficacy and safety of hydroxychloroquine (HCQ) for the prevention and treatment of COVID-19 has received great attention, and most notably, the enthusiasm for HCQ has been one of politicization rather than science. Laboratory studies and case series published early in the pandemic supported its efficacy. The scientific community raced to conduct observational and randomized evaluations of the drug in all stages of the disease, including prophylaxis, early treatment, and advanced disease. Yet a divisive media response affected recruitment, funding, and subsequent enthusiasm for continuing scientific investigations.
| Not just the media has been divisive. All those politicians, and the science professionals who have supported them, shouting about “settled science” will one day have a place in science textbooks next to Piltdown Man and Trofim Lysenko. |
Of the more than 300 HCQ trials registered, fewer than 50% report having recruited any patients, and most trials might fail to achieve any useful portions of their intended sample size. Multiple observational studies and two large randomized trials have demonstrated HCQ does not offer efficacy against COVID-19 in hospitalized patients.
| As expected. HCQ was originally presented as part of a treatment protocol to be used as a prophylactic upon exposure and immediately upon the onset of symptoms to reduce the progress of the disease so that hospitalization would not become needed. HCQ is one of several ionophores that pull zinc ions into the cell, where the zinc inhibits reproduction of RNA viruses like Covid-19. The original treatment package included HCQ, zinc, azithromycin for its anti-inflammatory effect, and vitamins D and C which strengthen the immune system. Aspirin was later added to reduce the formation of damaging tiny blood clots. Once the immune response has progressed to the point of cytokine storm, the actual infection no longer matters. |
Prophylaxis studies and early treatment studies provided heterogeneous results and are plagued by low event rates and poor study outcome monitoring. Emerging high-quality evaluations of prophylaxis and early treatment do not support a role for HCQ in these populations.
| “Emerging”? That sounds like a premature conclusion. |
The story of HCQ for COVID-19 has followed a pattern of initial enthusiasm supported by poor quality evidence, followed by disappointment based on more rigorous evaluations. The experience of HCQ in the COVID-19 era calls for the depoliticization of science away from media glare.
| Depoliticization would be really nice. Especially at the NIH, CDC, FDA, and WHO. |
Posted by: g(r)omgoru 2021-09-03 |
