In reply to Infection_Ag11 Another question, is your facility also using Kevzara (sarilumab) for the same purpose? If so, any reports back there?

Seems that Toci has the upper hand on the storm fight over the last 3 months.

https://www.doctoroz.com/article/protocol-followed-french-covid-19-drug-combo-study

Interesting read.

In reply to DadHammer The authors of the study say that use of ARBs (high blood pressure meds) was associated with poor outcomes.

I wonder if no one in the study was using ACE inhibitors.

Does this study make us rethink the issue raised early on that ACE inhibitors and ARBs may allow the virus access to healthy cells?

In reply to OldArmy71 American cardiology and nephrology societies not recommending stopping these. In fact - there is a trial of HCQ + losartan as a treatment for COVID-19 ongoing.

In reply to Marcus Aurelius Yes, I have been following the recommendations. I take lisinopril and of course am worried about that.

I was hoping you would comment. Thanks!

Edited to add that the study also found that beta blockers had the same negative effect.

Listened to Dr Angus and this is the way you get a treatment expedited
https://inside.upmc.com/upmc-launches-clinical-trial-to-fast-track-covid-19-therapies/

https://www.mediterranee-infection.com/wp-content/uploads/2020/04/Table_final_website_IHU_09_04_2020.pdf

Great results again in France.

In reply to DadHammer

DadHammer said:

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https://www.mediterranee-infection.com/wp-content/uploads/2020/04/Table_final_website_IHU_09_04_2020.pdf

Great results again in France.

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Summary please? I am in no state to study this kind of data at the moment.

In reply to DadHammer Do you have a link to the paper, please? I'd like to understand the table better

In reply to Zobel https://www.mediterranee-infection.com/wp-content/uploads/2020/04/Abstract_Raoult_EarlyTrtCovid19_09042020_vD1v.pdf?fbclid=IwAR2Bx-Fldm2fFsLg7L06BYUz-8QvwuJ-hAW9uWmwx1KdKzCU0YGHtSwXXWw

In reply to DadHammer https://www.doctoroz.com/article/protocol-followed-french-covid-19-drug-combo-study

This might be easier to understand.

In reply to Zobel What issues are you referring too? This is there third study. Dr. Says unethical to give anyone a placebo when the treatment has such a high success rate so they wont do it.

In reply to Zobel Age definitely does have a major impact.

In reply to DadHammer Lots, unfortunately.

https://scienceintegritydigest.com/2020/03/24/thoughts-on-the-gautret-et-al-paper-about-hydroxychloroquine-and-azithromycin-treatment-of-covid-19-infections/

In reply to Zobel The study they just released has way more patients. The results are well documented so you either believe the guy or you don't. I will use this if I get sick for sure.

In reply to DadHammer Way more patients but no control. I really hope we get a clearer picture on this soon.

Interesting part is possible poor outcomes of ARB use. I know it is recommend currently to keep patients on these medications but we definitely need more data on this as soon as possible!

Most diabetics are on these or an ACE and we already know this disease preys on diabetics. So the sooner we can get some more data on this better.

Some postulating it could help and even studies ongoing as a treatment. While others postulating it could lead to a worse outcome!

Hopefully, we can some more intimation soon so we can better protect the diabetics! Because honestly on this one I am a primary care physician and I am not sure what to tell them. Currently I am simply saying American College of Cardiology and American Heart Association (ACC/AHA) notes that "there are no experimental or clinical data demonstrating beneficial or adverse outcomes with background use of ACE inhibitors [or] ARBs."

But I certainly would not to be harming any of my patients! I can't even decide if I or my family was on them would I stop it based on what we currently know!

In reply to Zobel

k2aggie07 said:

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I'd really like to see a study by someone else given all the issues with the first one from this group.

Also age seems to correlate strongly with good outcome and bad. Good outcome lower than mean age, bad outcome much much higher.

It's very hard to understand the efficacy without a control.

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Here you go.
Listen to the video
https://inside.upmc.com/upmc-launches-clinical-trial-to-fast-track-covid-19-therapies/

In reply to 74Ag1 Yeah there are about 60 ongoing. Need results. I'm impatient haha.

I will admit I haven't read any data on ARB or ACEI in COVID but have read about the concerns. I do know that diabetic hypertensives do not do well with this disease. Are not most of these patients on one or the other? If so, how and why are these drugs being scrutinized?

In reply to Reveille Please let us know if you decide that ACE and ARBs are probably harmful!

In reply to Zobel

k2aggie07 said:

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Way more patients but no control. I really hope we get a clearer picture on this soon.

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The fact that it is actually helping a lot of people is a good thing.

I would use it right now. Most people don't take those drugs. Yes, some do and need to be more careful. But, most of the public don't and the side effects are dang near zero. I am going to request this if I get sick.

For the tiny amount of people you are concerned about, that is easily managed. This is a pandemic crazy time. We don't have time to wait for 6 month controlled studies.

In reply to Zobel Lots of studies and first hand accounts say it is. I chose to believe them.

In reply to OldArmy71

OldArmy71 said:

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Please let us know if you decide that ACE and ARBs are probably harmful!

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As soon as I have enough good information to make a decision I will let you know. There is just too much conflicting data right now to decide either way. Hopefully somebody smarter then me can figure this out soon.

In reply to Reveille

Reveille said:

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OldArmy71 said:

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Please let us know if you decide that ACE and ARBs are probably harmful!

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As soon as I have enough good information to make a decision I will let you know. There is just too much conflicting data right now to decide either way. Hopefully somebody smarter then me can figure this out soon.

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Seeing how these are some of the most widely used meds in the world, any official data to go against using them will likely have to go through the formal vetting process before anyone sticks their neck out going against them, eh?

(also posted on politics board HCL thread, sorry if you see this twice)

big, big study looking at history in RA patients, comparing HCL with sulfasalazine, and compares HCL with azithromycin vs HCL and amoxicillin.

Overall 956,374 sample checked
310,350 HCL vs sulfasalazine
323,112 HCL + azithromycin
351,956 HCL + amoxicillin

Good news is in one month dosage, HCL looks to be safe. No excess risk of severe adverse events in 30 day usage.

Bad news is HCL + azithromycin has an increased risk of 30 day cardiovascular mortality, chest pain, and heart failure.

From the paper:

Quote:

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Despite a lack of evidence on efficacy, HCQ and HCQ+AZM have become the most popular treatment/s for COVID-19. This is the largest ever analysis of the safety of such treatments worldwide, examining over 900,000 HCQ and more than 300,000 HCQ+AZM users respectively.

The results on the risk of SAEs associated with short-term (1 month) HCQ treatment as proposed for COVID-19 therapy are reassuring, with no excess risk of any of the considered safety outcomes compared to an equivalent therapy (SSZ). However, long-term treatment with HCQ as used for RA is associated with a 65% increase in cardiovascular mortality.

Worryingly, significant risks are identified for combination users of HCQ+AZM even in the short-term as proposed for COVID19 management, with a 15-20% increased risk of angina/chest pain and heart failure, and a two-fold risk of cardiovascular mortality in the first month of treatment.

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I didn't know HCL reduced viral load vs placebo in HIV patients or improved resopnse vs Hepatitis C, in addition to being an IL6 inhibitor. Very versatile drug.

In reply to Zobel Maybe the way to go then is to substitute doxycycline for Z pak, as previously mentioned.

In reply to OldArmy71 Could be, I have read of Dr.'s doing that already.

In reply to Zobel

Quote:

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I didn't know HCL reduced viral load vs placebo in HIV patients

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source?

Mixed results at best, because I read this paper the other day stating the opposite: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821003/

More good news.

https://www.houstonchronicle.com/news/houston-texas/houston/article/texas-city-nursing-home-doctor-unproven-drug-trump-15192584.php

In reply to NawlinsAg01 It was in the same paper, did not read the cites.

10. Helal GK, Gad MA, Abd-Ellah MF, Eid MS. Hydroxychloroquine augments early virological response to pegylated interferon plus ribavirin in genotype-4 chronic hepatitis C patients. Journal of medical virology 2016;88:2170-8.
11. Sperber K, Louie M, Kraus T, et al. Hydroxychloroquine treatment of patients with human immunodeficiency virus type 1. Clin Ther 1995;17:622-36.
12. Sperber K, Chiang G, Chen H, et al. Comparison of hydroxychloroquine with zidovudine in asymptomatic patients infected with human immunodeficiency virus type 1. Clin Ther 1997;19:913-23.

https://nypost.com/2020/04/11/doctors-pols-urge-use-of-miracle-coronavirus-drug-cocktail/

Another good report from NY.