
France, Italy, Belgium stop hydroxychloroquine use for Covid-19 on safety fears - pseudolus
https://www.reuters.com/article/us-health-coronavirus-hydroxychloroquine/france-bans-hydroxychloroquine-to-treat-covid-19-amid-safety-concerns-idUSKBN233197
======
lbeltrame
A shame, since the Lancet paper has problems[1][2] in particular related to
the baseline of the HCQ-treated vs non-HCQ treated patients. And by admission
of the authors themselves, it is not a substitute of a RCT.

And this before the results of the Minnesota trial are out. At this point I
hope those are negative, so that it does not show that countries are
overreacting.

[1]
[https://statmodeling.stat.columbia.edu/2020/05/25/hydroxychl...](https://statmodeling.stat.columbia.edu/2020/05/25/hydroxychloroquine-
update/) and related posts

[2]
[https://twitter.com/StevePhillipsMD/status/12638995692528967...](https://twitter.com/StevePhillipsMD/status/1263899569252896771)

PS: The title is misleading. The ban is on the use on severe diseases, not all
of them, according to the text in the news.

~~~
acallaghan
If it had any effect on covid-19, it'd be very obvious by now. There isn't
some massive conspiracy here, it just doesn't work. The reason trials have
stopped is because France, Italy, Belgium & the UK have seen worse outcomes
generally, directly because of it.

I don't get the 'it needs to be taken _before_ symptoms!' argument - like we
can possibly give a immunosuppressant with non-negligible side-effects (e.g.
arrythmia) to billions of people with no scientific evidence of it working on
covid _at all_.

~~~
zackees
It HCQ doesn't work, why is it the common first line of defense used
internationally? Why does scholar.google.com list so many papers showing that
it's effective?

~~~
ceejayoz
Because it's a highly effective and widespread _malaria_ (and RA/lupus)
treatment?

~~~
vixen99
The dose for malaria is 200mg. It's the higher doses that are associated with
heart arythmia in covid patients. According to a trial reported in
[https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s129...](https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-018-1188-2)

"No serious cardiac adverse effects were recorded in malaria clinical trials
of 35,548 participants who received quinoline and structurally related
antimalarials with close follow-up including 18,436 individuals who underwent
ECG evaluation."

"Chloroquine is the most widely used antimalarial drug in history. It has a
terminal elimination half-life of one month and an annual consumption of
hundreds of tonnes for over 50 years, so it may be the drug to which humans
have been exposed to most. Despite producing consistent QT prolongation, the
only case reports of TdP and sudden death have been for its use for non-
malaria indications such as systemic lupus erythematosus or rheumatoid
arthritis, where high doses are used for much longer than in malaria
treatment, or in overdose"

~~~
marvin
Unless I'm mistaken, this paper refers to _chloroquine_ , not
hydroxychloroquine.

They are often conflated in the media and colloquial reporting.

------
OneGuy123
"coronavirus is what happens when you put the reproducibility crisis in charge
of the planet"

~~~
0xcafecafe
Can someone please elaborate on this? What is the "reproducibility crisis" in
this case?

~~~
xapata
"Most published research findings are false" (not reproducible)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/)

~~~
whydoyoucare
This is an excellent read: [https://slatestarcodex.com/2014/12/12/beware-the-
man-of-one-...](https://slatestarcodex.com/2014/12/12/beware-the-man-of-one-
study/) \-- basically says one has to be very skeptical of trusting a study
that suits the narrative, and how studies can be cherry-picked to align with
your narrative.

------
Alex3917
Meh. It wouldn't surprise me if these trials are being run by the makers of
Remdesivir or some other drug, and they're purposely killing folks to make
their treatment look more effective. It's a pretty common tactic in the pharma
industry for drug makers to do trials with enormous doses of their competitors
products to make them look more dangerous by comparison, and given that this
whole thing has turned into a multi-billion dollar cash grab I would assume
that that's what's happening here unless proven otherwise.

It's the same thing with famatodine, where someone observed that folks taking
it for heartburn have a lower risk of death. So rather than doing an RCT with
giving folks 10mg orally (a normal dose), someone started doing an RCT with
like 140mg injected.

Just thinking about it logically, why would you ever give someone a drug that
ostensibly works by blocking viral replication when they've already had the
virus for multiple weeks? It makes zero sense, which tells you there is
something shady going on.

~~~
cm2187
Particularly in the case of a 1950s drug that has been consumed by millions of
people, and which as far as I know was available without prescription until
covid. It’s like saying aspirin is dangerous. Sure. At a certain dosage.

~~~
mariodiana
Exactly. And the dosage being given for COVID-19 patients is comparable to the
dosage given for patients with chronic conditions such as lupus, only the
COVID-19 patients are given the drug for something like a week, while the
chronic patients are given the drug indefinitely.

Meanwhile, drugs like benzodiazepines are basically just dumped on a largely
unwitting populace with the tacit blessing of these very same people who are
fretting about hydroxychloroquine. There is more than simply the disinterested
caution of science going on here.

~~~
core-questions
Shh, don't mention the opiate / benzo crisis. We know this disproportionately
affects Middle America, and therefore is not something we can bring up as a
serious topic of conversation.

------
scottmsul
A cardiotoxicity paper from the WHO in 2017 said the following:

"Despite hundreds of millions of doses administered in the treatment of
malaria, there have been no reports of sudden unexplained death associated
with quinine, chloroquine or amodiaquine, although each drug causes
QT/QTcinterval prolongation. Unfortunately, there are relatively few
prospective studies of the electrocardiographic effects of these drugs."

Link to paper: [https://www.who.int/malaria/mpac/mpac-mar2017-erg-
cardiotoxi...](https://www.who.int/malaria/mpac/mpac-mar2017-erg-
cardiotoxicity-report-session2.pdf)

Link to Chris Martenson's video where I first heard about the 2017 paper:
[https://www.youtube.com/watch?v=rN_YpFhdii4](https://www.youtube.com/watch?v=rN_YpFhdii4)

Chris Martenson is doing an awesome job staying on top of the science in an
apolitical manner.

~~~
klmadfejno
The data from those hundreds of millions of doses were on people who did not
have COVID-19. It's not contradictory to say that the drug does not tend to
cause these effects generally, but does cause these effects in a specific
context. Like, say, a deadly disease wrecking havoc on your oxygen levels.
Maybe it does, maybe it doesn't. Hard to know anything.

~~~
cozzyd
Also, the dosage may be different

------
pjc50
This is essentially the Andrew Wakefield fiasco on speedrun, isn't it?

My skepticism was founded entirely on seeing who was promoting this idea, and
it is slowly being vindicated.

~~~
lbeltrame
> My skepticism was founded entirely on seeing who was promoting this idea

The proponent has no effect on the null hypothesis. What was needed was a RCT:
no results are out for any, at this point.

~~~
take_a_breath
If the snake oil salesman presents a new, improved brand of snake oil,
skepticism is wise.

------
flashyfaffe2
This is what I appreciate in YC feed. You got far more better information
gathered in one than the MSN article shared initially.

~~~
Luc
For better information, I would suggest following the credentialed scientific
experts on Twitter. You can get information straight from the very best people
in their field.

Here, I feel it's a bit of a crap shoot, and half the comments are misinformed
& happy to share it.

~~~
dpoochieni
Haha, damned Poe's law, hope this was sarcasm!

During Galileo's time most credentialed experts believed the sun to spin
around the earth.

~~~
reccanti
I think it’s always good to be wary of relying uncritically on experts.
Nobody’s infallible, but there’s valuable perspective that comes from “person
actively involved in the process” vs. “Armchair Hacker News expert”

------
zabana
Interestingly enough, the french military are still using it to treat their
personnel.

~~~
fratajcz
They have only confirmed ordering some in case it is proven to be useful.
(this was 1 month ago)

[https://factuel.afp.com/oui-larmee-francaise-sest-procure-
de...](https://factuel.afp.com/oui-larmee-francaise-sest-procure-de-la-
chloroquine-elle-invoque-un-achat-de-precaution)

