Read on Twitter
Great summary of hydroxychloroquine clinical data so far.
My thoughts:
1/
There is a LOT more data (clinical, in vitro, long term safety profile, etc.) than ANY other drug being tried for COVID19.
MUCH more than Remdesivir! So don& #39;t bash it either. https://twitter.com/Dereklowe/status/1247190231503310848">https://twitter.com/Dereklowe...
My thoughts:
1/
There is a LOT more data (clinical, in vitro, long term safety profile, etc.) than ANY other drug being tried for COVID19.
MUCH more than Remdesivir! So don& #39;t bash it either. https://twitter.com/Dereklowe/status/1247190231503310848">https://twitter.com/Dereklowe...
2/
Kaletra, based on data we have seen so far, isn& #39;t promising at all, at least by itself (which is already a combo drug!)
Kaletra, based on data we have seen so far, isn& #39;t promising at all, at least by itself (which is already a combo drug!)
3/
And don& #39;t get your hopes up for Remdesivir if you are pessimistic about hydroxychloroquine/Chloroquine
- IC50 from CoV2 infection assay is about the same
- 1st Remdesivir read out will be in mod/severe patients, who are probably too late for antivirals to do anything
And don& #39;t get your hopes up for Remdesivir if you are pessimistic about hydroxychloroquine/Chloroquine
- IC50 from CoV2 infection assay is about the same
- 1st Remdesivir read out will be in mod/severe patients, who are probably too late for antivirals to do anything
4/
As some others point out, hydroxychloroquine gets partitioned in red blood cells. Works great for Malaria, but may not translate to CoV2.
I hope praying that remdesivir will work better because of this difference
As some others point out, hydroxychloroquine gets partitioned in red blood cells. Works great for Malaria, but may not translate to CoV2.
I hope praying that remdesivir will work better because of this difference
5/
Frankly, it& #39;s much easier to bash these potential treatments from the comfort of your home than it is in the ICU.
If remdesivir fails and hcq fails. Doctors really have a blank sheet of paper.
Sure anti-IL-6 sees promising, but I just don& #39;t see that being widely available
Frankly, it& #39;s much easier to bash these potential treatments from the comfort of your home than it is in the ICU.
If remdesivir fails and hcq fails. Doctors really have a blank sheet of paper.
Sure anti-IL-6 sees promising, but I just don& #39;t see that being widely available
6/
@Dereklowe mentioned effect size in his post. I agree that is probably the most important question here.
For anti-virals, single agents have a poor track record. HIV and HCV both required 3-drug combos until recently (now 2)
Q should be how do shoot for effect size?
@Dereklowe mentioned effect size in his post. I agree that is probably the most important question here.
For anti-virals, single agents have a poor track record. HIV and HCV both required 3-drug combos until recently (now 2)
Q should be how do shoot for effect size?
7/
I think the mAbs and plasma will have great effect size. And hopefully vaccines. But realistically, we have to wait 12-18 months to have them widely available (in the best case scenario)
I think the mAbs and plasma will have great effect size. And hopefully vaccines. But realistically, we have to wait 12-18 months to have them widely available (in the best case scenario)
8/
In the mean time, we need to test combination approaches. That is the only sensible route in my opinion.
In the mean time, we need to test combination approaches. That is the only sensible route in my opinion.
9/ Actually have 1 more thought.
Running a trial in ACUTE viral infection is EXTREMELY hard.
You need huge effect size, and you have a very narrow window to administer the drug.
Even if a drug WORKS, designing and running a trial that shows stat. sig is EXTREMELY challenging
Running a trial in ACUTE viral infection is EXTREMELY hard.
You need huge effect size, and you have a very narrow window to administer the drug.
Even if a drug WORKS, designing and running a trial that shows stat. sig is EXTREMELY challenging
