Hydroxychloroquine and azithromycin versus COVID-19: Grift, conspiracy theories

[SidDithers]

https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/

On Friday, Prof. Didier Raoult posted another study of azithromycin and hydroxychloroquine used against COVID-19. It is a single arm observational study of patients with mostly mild (or even asymptomatic) disease that is painfully uninformative with respect to the question of this treatment’s effectiveness. That didn’t stop America’s Quack Dr. Oz and other grifters from touting Raoult’s study, as well as a handful of “miracle cure” testimonials, to promote the treatment as a cure and attack the FDA.

Last week, I wrote about an experimental treatment for COVID-19 that repurposes old drugs. One version of the treatment uses chloroquine (which is sold under the trade name Aralen and others), an anti-malaria drug that’s also used to treat autoimmune diseases. Another version, the one that at the time was getting the most press, claimed that the combination of hydroxychloroquine (trade name Plaquenil, and it’s a drug which is very similar to chloroquine) and the antibiotic azithromycin (often prescribed in the famous “Z-Pak”) could completely render SARS-CoV-2, the virus that causes COVID-19, undetectable in patients. As I described, it was a horrible, horrible study about which I later found out things that make me suspect that its awfulness could have been due to more than mere incompetence and instead might have been scientific fraud. Meanwhile, the only existing randomized trial of chloroquine in COVID-19 was negative. As I said at the time, that doesn’t mean that the drug doesn’t work, but it does strongly suggest that its effects are probably not dramatic, although it is also possible that the dose used was too low.

Professor Didier Raoult releases another COVID-19 study
With that background in mind, as I was thinking about what to write this week, I wasn’t planning on writing about this particular issue again, but then I observed two developments. First, Professor Didier Raoult, who published the hydroxychloroquine/azithromycin study, published another trial that’s being flogged as evidence that his combination works. Second, in the conspiracy fever swamps on social media and even on traditional media an emerging narrative was being promoted late last week. It came in the form of articles like this one by a local Pacific Legal Foundation member named Kathy Hoekstra, “Michigan’s doctors fight coronavirus, and governor’s office“. First, let’s discuss the new study of azithromycin and hydroxychloroquine, because I know that’s what will likely most interest people. Again, it’s from Raoult’s group and is entitled “Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: an observational study“.

Unsurprisingly, the first thing I noticed about the study is that it is a single arm, unrandomized trial with no control group. Right there that tells you it’s not going to produce good evidence for the efficacy of azithromycin and hydroxychloroquine against COVID-19.

Much more at link. This is the drug or drugs that Trump is heralding, and the FDA has been pressured into issuing an Emergency Use Authorization so they can be used, despite the lack of study and 0 real evidence of their efficacy.

Don't fall for scientific misinformation. Go with sources that have a history of good evaluation of emerging science. David Gorski is a great resource.

Sid

[C_U_L8R]

1. It sure sounds like an Infowars scam... and it kills.

Seems the Magats are culling their own herd.

[jberryhill]

2. More on Chloroquine/Azithromycin. And On Dr. Raoult.

https://blogs.sciencemag.org/pipeline/archives/2020/03/29/more-on-cloroquine-azithromycin-and-on-dr-raoult?utm_source=quora&utm_medium=referral

[SidDithers]

3. Thanks for adding that...

the money quote from your link:

And we’re missing a very important aggregate number indeed: a control group. How would a comparable group of patients have performed in these RNA tests for contagiousness under another standard of care? Even with or without azithromycin, if you can’t stand the thought of not giving them hydroxychloroquine? We don’t know. Without matched controls, and without being able to look at individual patient data, we just don’t know how good this treatment was or frankly if it was any good at all.

Sid

[Brainfodder]

4. Money trail that drug FFS you know damn well it leads somewhere if that asshole pushes it!

DUH!

[jberryhill]

5. In Didier's case, it may be Sanofi

[ismnotwasm]

6. I can't stand medical grifters

Thanks for the article, Sid.

These are the narratives being promoted in the press and on social media. Indeed, Santilli’s story is showing up on the local Fox News broadcast, with a slanted report that makes it sound that the drug combination is definitely what saved him. Were hydroxychloroquine and azithromycin responsible for these handful of “miracle recoveries”? We really have no way of knowing without a randomized clinical trial. One thing is for certain. As is the case for alternative cancer cure testimonials, nothing will convince these patients that the “miracle drug” probably wasn’t what resulted in their improvement, and their stories sound convincing to the medically untrained. Worse, I predict that, even if the clinical trials are clearly negative, these sorts of stories will drive conspiracy theories that “they” (e.g., big pharma) covered up the evidence that these drugs work. Maybe the worst possibility of all is that we will never know for sure if these drugs work because the premature hype precludes completing a decent randomized clinical trial of sufficient power to answer the question definitively because no one will agree to be randomized to placebo. That is a distinct possibility, especially now that the FDA has caved to pressure and approved the use of these drugs against COVID-19 despite the extreme paucity of clinical effectiveness.

[Maru Kitteh]

7. single arm, unrandomized trial with no control group

Why don't we just use some divining rods to help us pick out which crystals are effective?


Ohmygod.

[hatrack]

8. About what you'd expect from Fat Ugly Jude Law & his Forsythia Cure . ..

[LetMyPeopleVote]

9. Post overstates study's '200%' finding on hydroxychloroquine's power vs COVID-19

I saw this bullshit study being cited by some low IQ TFG supporters and knew that it was bogus. This study is so bad and poorly done that only a TFG supporter who is clueless as to science and the scientific process would cite it.

Link to tweet

For example, this is not a peer review study but was taken from a site that does not deal in peer review works

The study is posted on a website that publishes “preprints” — studies that “have not been finalized by authors, might contain errors and report information that has not yet been accepted or endorsed in any way by the scientific or medical community.”....

The study was posted May 31 on medRxiv, a website that publishes studies that have not been fully vetted. This note is posted with the study: "This article is a preprint and has not been peer-reviewed. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice."

he website also says about its "preprint" or "unrefereed" articles: "Before formal publication in a scholarly journal, scientific and medical articles are traditionally certified by ‘peer review.’ In this process, the journal’s editors take advice from various experts — called ‘referees’ — who have assessed the paper and may identify weaknesses in its assumptions, methods and conclusions … Readers should therefore be aware that articles on medRxiv have not been finalized by authors, might contain errors, and report information that has not yet been accepted or endorsed in any way by the scientific or medical community."

The analysis concludes that this study is poorly designed and the conclusions are not supported. Politifact interviewed several real scientists who concluded that this study is flawed and should not be relied on (even by low IQ TFG supporters).

Here is the conclusion about this study

Our ruling
A widely shared social media post stated: "Study: hydroxychloroquine can boost COVID-19 survival chances by nearly 200%."

A study says a certain dosing of hydroxychloroquine and azithromycin "improves survival by nearly 200%" among hospitalized COVID-19 patients who received invasive mechanical ventilation, but the post exaggerates the finding’s significance.

The study is posted on a website that publishes studies that "have not been finalized by authors, might contain errors and report information that has not yet been accepted or endorsed in any way by the scientific or medical community." Experts told PolitiFact the study is poorly designed and that no conclusion about cause and effect should be drawn from it.

For a statement that contains only an element of truth, our rating is Mostly False.

I am amused that the RWNJ believe that this study is meaningful.