Daily Hydroxochloroquine now recommended by AMJMED for Covid19 treatment(amjmed.com)
amjmed.com
Daily Hydroxochloroquine now recommended by AMJMED for Covid19 treatment
https://www.amjmed.com/action/showPdf?pii=S0002-9343%2820%2930673-2
6 comments
"The American Journal of Medicine" doesn't, one study published in it does. The title is "Pathophysiological Basis and Rationale for Early
Outpatient Treatment of SARS-CoV-2 (COVID-19)
Infection". It brings no new information regarding Hydroxochloroquine, but instead claims other studies show enough benefits (while not being classical good quality data as usually required) to recommend it in their protocol. Also recommends zinc and azithromycin. Bit of a nothing burger IMO.
Good point, I will edit it to say recommended in the american journal of medicine.
after considerable negative coverage in the news-media, now the American Journal of Medicine has recommended treatment of 200mgof Hydroxochloroquine per day for Covid-19 patients.
The AJM hasn't recommended anything. AJM has published a paper titled "Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection".
It hasn't published it "now". It has published it back in August of 2020.
According to the abstract, "This article outlines key pathophysiological principles that relate to the patient with early infection treated at home. Therapeutic approaches based on these principles include 1) reduction of reinoculation, 2) combination antiviral therapy, 3) immunomodulation, 4) antiplatelet/antithrombotic therapy, and 5) administration of oxygen, monitoring, and telemedicine".
Discussion of the HQC treatment in the article:
Hydroxychloroquine (HCQ) is an antimalarial/anti-inflammatory drug that impairs endosomal transfer of virions within human cells. HCQ is also a zinc ionophore that conveys zinc intracellularly to block the SARS-CoV-2 RNA-dependent RNA polymerase, which is the core enzyme of the virus replication. The currently completed retrospective studies and randomized trials have generally shown these findings: 1) when started late in the hospital course and for short durations of time, antimalarials appear to be ineffective, 2) when started earlier in the hospital course, for progressively longer durations and in outpatients, antimalarials may reduce the progression of disease, prevent hospitalization, and are associated with reduced mortality.
In a retrospective inpatient study of 2541 patients hospitalized with COVID-19, therapy associated with an adjusted reduction in mortality was HCQ alone (hazard ratio [HR] = 0.34, 95% confidence interval [CI] 0.25-0.46, P <0.001) and HCQ with azithromycin (HR = 0.29, 95% CI 0.22-0.40, P <0.001).23 HCQ was approved by the US Food and Drug Administration in 1955, has been used by hundreds of millions of people worldwide since then, is sold over the counter in many countries, and has a well-characterized safety profile that should not raise undue alarm. Although asymptomatic QT prolongation is a well-recognized and infrequent (<1%) complication of HCQ, it is possible that in the setting of acute illness symptomatic arrhythmias could develop. Data safety and monitoring boards have not declared safety concerns in any clinical trial published to date. Rare patients with a personal or family history of prolonged QT syndrome and those on additional QT prolonging, contraindicated drugs (eg, dofetilide, sotalol) should be treated with caution and a plan to monitor the QTc in the ambulatory setting. A typical HCQ regimen is 200 mg bid for 5 days and extended to 30 days for continued symptoms. A minimal sufficient dose of HCQ should be used, because in excessive doses the drug can interfere with early immune response to the virus.
The AJM hasn't recommended anything. AJM has published a paper titled "Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection".
It hasn't published it "now". It has published it back in August of 2020.
According to the abstract, "This article outlines key pathophysiological principles that relate to the patient with early infection treated at home. Therapeutic approaches based on these principles include 1) reduction of reinoculation, 2) combination antiviral therapy, 3) immunomodulation, 4) antiplatelet/antithrombotic therapy, and 5) administration of oxygen, monitoring, and telemedicine".
Discussion of the HQC treatment in the article:
Hydroxychloroquine (HCQ) is an antimalarial/anti-inflammatory drug that impairs endosomal transfer of virions within human cells. HCQ is also a zinc ionophore that conveys zinc intracellularly to block the SARS-CoV-2 RNA-dependent RNA polymerase, which is the core enzyme of the virus replication. The currently completed retrospective studies and randomized trials have generally shown these findings: 1) when started late in the hospital course and for short durations of time, antimalarials appear to be ineffective, 2) when started earlier in the hospital course, for progressively longer durations and in outpatients, antimalarials may reduce the progression of disease, prevent hospitalization, and are associated with reduced mortality.
In a retrospective inpatient study of 2541 patients hospitalized with COVID-19, therapy associated with an adjusted reduction in mortality was HCQ alone (hazard ratio [HR] = 0.34, 95% confidence interval [CI] 0.25-0.46, P <0.001) and HCQ with azithromycin (HR = 0.29, 95% CI 0.22-0.40, P <0.001).23 HCQ was approved by the US Food and Drug Administration in 1955, has been used by hundreds of millions of people worldwide since then, is sold over the counter in many countries, and has a well-characterized safety profile that should not raise undue alarm. Although asymptomatic QT prolongation is a well-recognized and infrequent (<1%) complication of HCQ, it is possible that in the setting of acute illness symptomatic arrhythmias could develop. Data safety and monitoring boards have not declared safety concerns in any clinical trial published to date. Rare patients with a personal or family history of prolonged QT syndrome and those on additional QT prolonging, contraindicated drugs (eg, dofetilide, sotalol) should be treated with caution and a plan to monitor the QTc in the ambulatory setting. A typical HCQ regimen is 200 mg bid for 5 days and extended to 30 days for continued symptoms. A minimal sufficient dose of HCQ should be used, because in excessive doses the drug can interfere with early immune response to the virus.
>The AJM hasn't recommended anything. AJM has published a paper titled "Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection".
>It hasn't published it "now". It has published it back in August of 2020.
"The American Journal of Medicine, Vol 134, No 1, January 2021", Page 18, shows a treatment algorithm for Covid-19-like and confirmed Covid-19 illness, specifying 200mg of Hydroxochloroquine for patients over the age of 50 or with a single comorbidity.
I'm not talking about the primary study on HCQ, but the treatment algorithm is recent.
"The American Journal of Medicine, Vol 134, No 1, January 2021", Page 18, shows a treatment algorithm for Covid-19-like and confirmed Covid-19 illness, specifying 200mg of Hydroxochloroquine for patients over the age of 50 or with a single comorbidity.
I'm not talking about the primary study on HCQ, but the treatment algorithm is recent.
I thought this was quite interesting; after considerable negative coverage in the news-media, now an article in the American Journal of Medicine has recommended treatment of 200mgof Hydroxochloroquine per day for Covid-19 patients.
Negative media coverage has continued until quite recently:
https://www.nytimes.com/2020/11/24/opinion/hydroxychloroquin...