fidaxomycin.
pharmacokinetic problem... Fidaxomicin is poorly absorbed from the gut..its OK for Clostridium difficile..
inside the gut ..but not for systemic.. lots of side effects , worse than vancomycin...also as it is a new drug ...it is expensive.
Per above HCQ comments -
First, interesting that ivermectin works by interfering with viral cellular entry - not just via the
anti-importin route, i.e,, by blocking transport into the nucleus.
I also perplexed at the virulent anti-HCQ stance of the media and bureaucrats.
The U.S. hospitals don't seemed perturbed - they are hoarding HCQ.
As I understand, at least in India, Costa Rica, ..., it's being used prophylactically.
I also perplexed at the virulent anti-HCQ stance of the media and bureaucrats.
In the USA media... supporting HCQ is voting for Trump.. Fox versus CNN and the rest..
There is little balanced discussion since Trump said something positive about it..
What Asian nations know about squashing Covid
QUOTES:
. . . The United States has had more than 66,000 deaths, or about 20 deaths per 100,000 people. The number of deaths per 100,000 people reported in Western European countries is also very high: Belgium, 67; France, 37; Italy, 47; Germany, 8; Spain, 53; and Sweden, 26.
Meanwhile, the reported rates in Asia and Oceania are considerably lower: Australia, 0.4; China, 0.3; New Zealand, 0.4; South Korea, 0.5; Taiwan, 0.03.
Despite the stark disparities, America seems blind to the strategies other countries have used to control the virus. How is it that one part of the world is succeeding, while the other part refuses to learn the lessons of success?
On Tuesday, the The Wall Street Journal extolled the virtues of Germany's efforts in comparison with the United States, France, Italy, and Spain, without even a mention that Germany's mortality rate per million is itself more than 100 times higher than Taiwan and Hong Kong, and more than 10 times higher than in Australia, Japan, New Zealand and South Korea. . . .
I have another dumb question for you med types.
If HCQ or similar is used as a prophylactic to prevent things would it then prevent antibodies and immunity?
also.... these people that are "cured" by blood transfusions. Isn't that a passive immunity that will pass away and leave them without immunity in a second wave?
Good question I asked google.
. for HIV
probably exposure to prophylactic drugs does not affect immune response
https://www.fredhutch.org/en/n…fect-immune-response.html
If HCQ or similar is used as a prophylactic
Isn't that a passive immunity that will pass away
Yes
What Asian nations know about squashing Covid
In the Americas ..Costa Rica has no dysfunctional learning..
Hawaii isn't too bad.. but it is part of Oceania...
In the USA media... supporting HCQ is voting for Trump.. Fox versus CNN and the rest..
There is little balanced discussion since Trump said something positive about it..
It is insane how politically divided this goofy country is now.
“You’re having cheese on your Big Mac, you must be flat earthed, you idiot”.
“You buy your gas from Costco, you must be a liberal lunatic, you’re an idiot”.
Meanwhile, the reported rates in Asia and Oceania are considerably lower: Australia, 0.4; China, 0.3; New Zealand, 0.4; South Korea, 0.5; Taiwan, 0.03.
Despite the stark disparities, America seems blind to the strategies other countries have used to control the virus. How is it that one part of the world is succeeding, while the other part refuses to learn the lessons of success?
This is far from over, so still a few years too soon to start picking winners, and losers. I like the Swedes attitude that this is only the beginning of the soccer match, with a long ways left to go. When the match is over, the less severe policies may turn out to have been the best...or not.
In the USA media... supporting HCQ is voting for Trump.. Fox versus CNN and the rest..
There is little balanced discussion since Trump said something positive about it..
That is true: difficult therefore to trust info from USA. But other countries are looking at HCQ, like the UK.
Here: they are testing it, so far it does not seem better or worse than any of the other things they are testing (maybe worse than convalescent plasma, which seems to work).
Anyway - look to serious medical judgements away from the US if you want balance.
Even psychologists are getting in on the HCQ act..to advertise their Bayesian analyses
They must have time on their hands..reanalysing Chinese data
psycharxiv paper.
'"The data are 6 times more likely under the hypothesis that HCQ is beneficial than under the hypothesis that it is ineffective."
file:///home/chronos/u-f576f103d6dca9d26707073683d789482f80dd73/MyFiles/Downloads/WagenmakersGronauHydroxychloroquineReanalysisChenWuhan.pdf
There are even a few papers on EarthArxiv
The two direct biochemical papers (Wang at al and Gordon at al) showing the very similar dose response relations for chloroquine or hydroxychloroquine vs Corona virus are the only real evidence that this therapy can be considered effective. The question now should be if it is found t the ineffective in vivo we must now find out why this is. One good reason is from pharmacokinetics studies that it takes 2-3 days to build up to therapeutic concentrations in plasma due to intracellular compartmentation, so a low prophylactic dose would saturate this component and facilitate efficacy. Obvious removal by degradation to desethylchloroquine in the liver and excretion in the kidneys might also lower efficacy in vivo. There may be says of increasing its potency but in the current political ridiculous climate clinical scientists are giving it a wide berth rather than answering these questions which could in a sane world produce the magic bullet needed to sort this pandemic. All we can do so far is crude but if it works use Anti Bat.
Dr, Richard will not like this, but it is strong food for thought. Shortcut to review paper here.
Although anything coming from the US is potentially contaminated (and therefore worth investigating whether this guy is strongly political) he is doing what you would want anyone to do in a review and raising what is a real possible issue with HCQ (rather than what is not a real issue). I'd say it will be absolutely required reading for anyone thinking of using HCQ for COVID: but as with all medical research on new stuff, take it just as more straws in the wind.
Summary (of the review paper) here:
"We chose to dive into this important matter in an expedited manner to create a science-based awareness of this subject," said Poznansky. "Beyond the known cardiac side effects of this drug, we aimed to reveal those aspects of the anti-viral and immune modulatory activities of hydroxychloroquine that could potentially help or, as importantly, impair a patient's response to the virus. The goal was to help physicians make data-informed decisions about how to use this drug for patients with COVID-19 infection within carefully designed clinical trials," he said.
The authors reviewed earlier anecdotal reports and poorly controlled clinical trials that raised considerable optimism about the widespread adoption of this therapy. However, the authors present mechanistic reasons why these drugs may fail for COVID-19. They point to fast-moving data - accumulated through April 22 - that creates significant skepticism for therapy with either chloroquine or hydroxychloroquine for which there was early optimism; namely, that these drugs reduced viral uptake by cells cultured in the laboratory, rather than in patients.
This ray of optimism overlooked something far more worrisome: the powerful immunosuppressive action of these drugs, which is the basis of their potency in rheumatoid arthritis and lupus. But these drugs have failed in previous respiratory virus outbreaks, including influenza. The authors surmise that the drugs inhibit innate immune reactions critical to viral defense, as well as the generation of adaptive, cell-mediated immunity that is also necessary to control a virus like SARS-CoV-2.
Initial check for source: published in FASEB journal (not political, impact factor 5.3)
The FASEB Journal is published by the Federation of the American Societies for Experimental Biology (FASEB). The world's most cited biology journal according to the Institute for Scientific Information, it has been recognized by the Special Libraries Association as one of the top 100 most influential biomedical journals of the past century. FASEB is composed of 28 societies with more than 130,000 members, making it the largest coalition of biomedical research associations in the United States. FASEB's mission is to advance health and well-being by promoting research and education in biological and biomedical sciences through collaborative advocacy and service to member societies and their members.
Author: Mark Poznansky
He is published in Huffpost (does that make him political?) the following (non-political) article (EDIT - Huffpost: https://mediabiasfactcheck.com/huffington-post/ so definitely Left, but reasonably though not 100% fact-based. Does publishing a medical article there determine his political views? Likely. Does it make him a political person? No. Not in the way that Zelenko sending a letter to Trump does...
I choose to rate his contribution to the debate as a reviewer quite high based on his medical / science credentials and obvious current involvement, with the caveat that he will definitely give Trump pronouncements zero weighting.
It will be interesting to review this as containing some insights from people on front line using HCQ, together with an informed review. It will not however settle the matter - just give an "evidence so far" checkpoint.
EDIT: here is the paper!
https://faseb.onlinelibrary.wi…/doi/10.1096/fj.202000919
EDIT again:
Now I have read it: it seems a very balanced and careful review of data so far, and at least is well enough written. It will of course be increasingly less relevant as more data comes in from RCTs, but as a proper summary of what we now know it seems fair.
If it tastes bad - its good for you - with special reference to COVID-19 and TAS2R10 receptor.
(Traditional Chinese Medicine strikes back - e.g. with Artemisinin testing)
THHuxleynew Yeah sure but any idiot knows that the reduction in immunity is a much longer term effect than the acute 7 day treatment envisaged for CO VID 19 treatment. Remember how long it takes for a Lupus or RA patient to derive benefit from HCQ treatment? It can take weeks to months to be effective. The influenza study he's referring to was rather sketchy too, and was at a time when pharma didn't want a cheap drug like chloroquine competing with tamiflu etc. The biochemistry stands. If it does not work effectively in vivo their job is to stop prevaricating about side effects and find out why. Further there are many other analogues like mefloquine etc which they should be testing. The Russians have evidence that this works without serious side effects. I can post all the references to this but just Google it all of you have time. Things are often not what they seem, and I don't care about not liking the report. It is a review but the conclusions happen to be garbage and again unfortunately appear to be politically motivated. Why can't Trump keep his big mouth shut over issues he knows nothing about?
