Don’t wait for proof positive, give this combo a test in real world and real time

Two doctors writing in The Wall Street Journal today say a combination of two currently available drugs is helping cure coronavirus in a matter of days instead of requiring 14-day quarantines.

Getty Images via WSJ

A recent French study used hydroxychloroquine — a malaria treatment that has been used since 1944 with little side effect — in combination with azithromycin, brand name Zithromax Z-Pak, to treat a small number of COVID-19 patients. Of those treated with the combo 100 percent were cured by the sixth day of treatment. Of those treated with hydroxychloroquine alone 57.1 percent were cured, write Dr. Jeff Colyer, a practicing physician and chairman of the National Advisory Commission on Rural Health, and Dr. Daniel Hinthorn, director of the Division of Infectious Disease at the University of Kansas Medical Center.

“A couple of careful studies of hydroxychloroquine are in progress, but the results may take weeks or longer,” the doctors report. “Infectious-disease experts are already using hydroxychloroquine clinically with some success. With our colleague Dr. Joe Brewer in Kansas City, Mo., we are using hydroxychloroquine in two ways: to treat patients and as prophylaxis to protect health-care workers from infection.”

They say their experience suggests the drug cocktail be a first-line treatment, but there is a shortage of hydroxychloroquine, which prompts the doctors to call on the federal government to immediately contract with generic manufacturers to ramp up production and release any stockpiles.

A successful treatment could get laid off workers back to work and open shuttered businesses and schools.

Colyer and Hinthorn conclude:

We have decades of experience in treating infectious diseases and dealing with epidemics, and we believe in safety and efficacy. We don’t want to peddle false hope; we have seen promising drugs turn out to be duds.

But the public expects an answer, and we don’t have the luxury of time. We have a drug with an excellent safety profile but limited clinical outcomes — and no better alternatives until long after this disaster peaks. We can use this treatment to help save lives and prevent others from becoming infected. Or we can wait several weeks and risk discovering we didn’t do everything we could to end this pandemic as quickly as possible.

 

11 comments on “Don’t wait for proof positive, give this combo a test in real world and real time

  1. Bruce Feher says:

    Where can we get it?

  2. Anonymous says:

    Don’t waste your time.

    “The WHO scientific panel designing SOLIDARITY had originally decided to leave the duo out of the trial, but had a change of heart at a meeting in Geneva on 13 March, because the drugs “received significant attention” in many countries, according to the report of a WHO working group that looked into the drugs’ potential. The widespread interested prompted “the need to examine emerging evidence to inform a decision on its potential role.”

    The available data are thin. The drugs work by decreasing the acidity in endosomes, compartments inside cells that they use to ingest outside material and that some viruses can coopt to enter a cell. But the main entryway for SARS-CoV-2 is a different one, using its so-called spike protein to attach to a receptor on the surface of human cells. Studies in cell culture have suggested chloroquines have some activity against SARS-CoV-2, but the doses needed are usually high—and could cause serious toxicities.

    Encouraging cell study results with chloroquines against two other viral diseases, dengue and chikungunya, didn’t pan out in people in randomized clinical trials. And nonhuman primates infected with chikungunya did worse when given chloroquine. “Researchers have tried this drug on virus after virus, and it never works out in humans. The dose needed is just too high,” says Susanne Herold, an expert on pulmonary infections at the University of Giessen.

    Results from COVID-19 patients are murky. Chinese researchers who report treating more than 100 patients with chloroquine touted its benefits in a letter in BioScience, but the data underlying the claim have not been published. All in all, more than 20 COVID-19 studies in China used chloroquine or hydroxychloroquine, WHO notes, but their results have been hard to come by. “WHO is engaging with Chinese colleagues at the mission in Geneva and have received assurances of improved collaboration; however, no data has been shared regarding the chloroquine studies.”
    Unless you want to die anyway.

    https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments

  3. Anonymous says:

    Anecdotal and self medicating but this is why the president needs to stfu and let scientists do what they do.

    “couple, both in their 60s, ingested chloroquine phosphate,” one of the anti-malaria drugs that President Trump has mentioned in recent days, according to Banner Health, the hospital system that treated both patients.

    Why it matters: People who self-medicate risk serious side effects or death, and it’s why any messaging about chloroquine and the related hydroxychloroquine should emphasize that these drugs have not been approved to prevent or treat the new coronavirus.”

    https://www.axios.com/chloroquine-coronavirus-death-09c91a91-4fe7-472c-9de9-79b890aa8fff.html?utm_source=twitter&utm_medium=social&utm_campaign=organic&utm_content=1100

  4. Steve says:

    No, sigh, no chloroquine phosphate is NOT the drug being studied. Aquarium cleaning products are not the same thing….period.
    Just like those Iranians who died from drinking industrial alcohol at a suggestion they saw online, ingesting stuff with out a doctors recommendation is just as idiotic as “anonymous” statement.

    Doctors were hoarding the combo drugs, this lead our anti liquor store governor to order they not be prescribed for use in COVID-19 cases. Hopefully that does not apply to compassionate care cases.

  5. If you were a doctor and had a dying patient, what would you say to Sisolak’s prohibition on prescribing hydroxychloroquine and azithromycin for the coronavirus?

  6. Anonymous says:

    Do no harm.

    At least that’s what they’re supposed to say.

    Unfortunately this president doesn’t have the same concern.

  7. […] doctors wrote in The Wall Street Journal recently that the drug in question in combination with another drug has […]

  8. Anonymous says:

    Kill ’em with poison is better? I mean…it might not kill ’em maybe it’ll cure ’em?

  9. Rincon says:

    In order to find out if this stuff works, a number of people are probably going to have to die, because a control group is necessary. If we deny treatment with these drugs to the control group, it makes no sense to allow others to hijack the drugs from legitimate patients who are already on them, putting those patients at risk. A decent preliminary study should take less than two weeks. If the treatment is as good as they say, it may only take a few days, once they actual begin the study. Therein lies the problem. The red tape involved in initiating a study of this sort usually takes months. It should take hours in this case. Where is our CDC? A study should already be under way.

    Since the drugs are already in short supply, the vast majority of patients won’t be able to use them anyway. Private industry is ramping up production and will soon be gouging us for them whether the drugs work or not.

    That’s the ethical side of it. The legal side? I suspect “emergency powers” give our governmental executives all kinds of authority, but who knows?

  10. Steve says:

    Compassionate care is provided to those who will die under existing treatments.
    Since there are no existing COVID-19 treatments, the attending and the patient have the final word in Nevada, even under Sisolak’s latest emergency order.

    But the stuff has to be available for any such care to take place, eh?
    The order prevents so called hoarding by prescription which was taking place in states all over the country.
    On this, Sisolak did good.
    https://www.propublica.org/article/doctors-are-hoarding-unproven-coronavirus-medicine-by-writing-prescriptions-for-themselves-and-their-families

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