由于严重的副作用,世界卫生组织暂时中止羟氯喹试验

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World Health Organization temporarily halts hydroxychloroquine trials

WHO cites concerns about serious side-effects when the drug is used to treat COVID-19

The Associated Press · Posted: May 25, 2020 3:19 PM ET | Last Updated: 3 hours ago

The World Health Organization says it is temporarily dropping hydroxychloroquine — the malaria drug U.S. President Donald Trump said he was taking — from its global study into experimental COVID-19 treatments.

In a press briefing on Monday, WHO Director General Tedros Adhanom Ghebreyesus said in light of a paper published last week in the Lancet that suggested people taking hydroxychloroquine were at higher risk of death and heart problems, there would be "a temporary pause" on the hydroxychloroquine arm of its global clinical trial.

"This concern relates to the use of hydroxychloroquine and chloroquine in COVID-19," said Tedros, who pointed out the drugs are approved treatments for malaria and some autoimmune diseases.

Other treatments in the trial, including the experimental drug remdesivir and an HIV combination therapy, are still being tested.

Tedros said the executive group behind the WHO's global SOLIDARITY trial met on Saturday and decided to conduct a comprehensive review of all available data on hydroxychloroquine and suspend its use in the trial.

Canada is part of the Solidarity trials, known in this country as CATCO (Canadian Treatments for COVID-19). Patients requiring hospitalization for COVID-19 at one of 20 participating Canadian hospitals are eligible to take part.
 

lfe634

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只好觀察川普了。
 

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世界卫生组织主要是根据3位美国和一位瑞士医生教授发表在国际权威医学杂志《柳叶刀》上的论文做出上述决定。下面是论文链接:


Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis

Published:May 22, 2020DOI:Redirecting

Summary
Background
Hydroxychloroquine or chloroquine, often in combination with a second-generation macrolide, are being widely used for treatment of COVID-19, despite no conclusive evidence of their benefit. Although generally safe when used for approved indications such as autoimmune disease or malaria, the safety and benefit of these treatment regimens are poorly evaluated in COVID-19.
Methods
We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents. We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2. Patients who received one of the treatments of interest within 48 h of diagnosis were included in one of four treatment groups (chloroquine alone, chloroquine with a macrolide, hydroxychloroquine alone, or hydroxychloroquine with a macrolide), and patients who received none of these treatments formed the control group. Patients for whom one of the treatments of interest was initiated more than 48 h after diagnosis or while they were on mechanical ventilation, as well as patients who received remdesivir, were excluded. The main outcomes of interest were in-hospital mortality and the occurrence of de-novo ventricular arrhythmias (non-sustained or sustained ventricular tachycardia or ventricular fibrillation).
Findings
96 032 patients (mean age 53·8 years, 46·3% women) with COVID-19 were hospitalised during the study period and met the inclusion criteria. Of these, 14 888 patients were in the treatment groups (1868 received chloroquine, 3783 received chloroquine with a macrolide, 3016 received hydroxychloroquine, and 6221 received hydroxychloroquine with a macrolide) and 81 144 patients were in the control group. 10 698 (11·1%) patients died in hospital. After controlling for multiple confounding factors (age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity), when compared with mortality in the control group (9·3%), hydroxychloroquine (18·0%; hazard ratio 1·335, 95% CI 1·223–1·457), hydroxychloroquine with a macrolide (23·8%; 1·447, 1·368–1·531), chloroquine (16·4%; 1·365, 1·218–1·531), and chloroquine with a macrolide (22·2%; 1·368, 1·273–1·469) were each independently associated with an increased risk of in-hospital mortality. Compared with the control group (0·3%), hydroxychloroquine (6·1%; 2·369, 1·935–2·900), hydroxychloroquine with a macrolide (8·1%; 5·106, 4·106–5·983), chloroquine (4·3%; 3·561, 2·760–4·596), and chloroquine with a macrolide (6·5%; 4·011, 3·344–4·812) were independently associated with an increased risk of de-novo ventricular arrhythmia during hospitalisation.
Interpretation
We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.
Funding

William Harvey Distinguished Chair in Advanced Cardiovascular Medicine at Brigham and Women's Hospital.
 

向问天

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这个垃圾药折腾了世界3个月。
 

谷歌大侠

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只好觀察川普了。

Trump已经不吃hydroxychloroquine了。

Trump says he's done taking hydroxychloroquine, unproven treatment for COVID-19

TORONTO -- U.S. President Donald Trump is no longer taking the malaria drug hydroxychloroquine, he said in an interview Sunday, after weeks of promoting it as a treatment for the novel coronavirus.

In an interview with Sinclair Broadcast's program "Full Measure With Sharyl Attkisson,” Trump said he had completed a two-week course of the drug, which has not been proven to prevent or treat COVID-19.

“Finished, just finished, yeah,” he said. “And by the way, I’m still here. To the best of my knowledge, here I am.”
 

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不明白美国,瑞士的试验怎么都无效,看到武汉的两个试验,分别对重症和轻症病人都有效。而且只要控制好计量,副作用也没那么大。

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COVID-19 Update 13: Randomized Controlled Trial of Hydroxychloroquine (Chen et al., Wuhan, China)
羟氯喹的随机对照试验(Chen等,中国武汉)
2月28日起,武汉人民?医院进行的一项随机临床试验,遵循了很好的科研原则。142名确诊病人,选样条件为,大于18岁,阳性,确诊患有肺炎,氧饱和度大于93%,都选取轻症患者,80名病人被排除,剩余62人分成两组,性别,年龄大体相当,一组每日400毫克羟氯喹,另外31为病人为对照组,进行其他方法治疗。病人和医生都不知道实情,每天测量3次体温,和检查咳嗽状况,第一天和第六天做CT检查。

使用羟氯喹组发烧,咳嗽的恢复时间短于对照组,分别为2天对3天,对照组有4人转为重症,羟氯喹组无人转重症,羟氯喹组有两人出现过敏反应:一人出疹子,一人头疼。CT检查发现,羟氯喹组81%有所改进,对照组为55%。

这是个好消息。我们期待听到有关最近启动的世界卫生组织大型试验的结果,该试验还评估了氯喹(以及其他药物)。

Finally, we have a randomized clinical trial assessing the efficacy of hydroxychloroquine for the treatment of mild cases of COVID-19. The trial was performed in Remnin Hospital in Wuhan and seems to have adhered to good scientific research principles. Also, their chosen outcomes (recovery times and CT findings) are much more relevant as compared to PCR of nasopharyngeal swabs. This is great news. We are looking forward to hearing about the results of the recently launched WHO mega-trial, which also assesses chloroquine (among other drugs).


中国武汉同济医院的科学家新发表的羟氯喹对比试验,结论:应为新冠病毒重症患者开处方HCQ,以挽救生命。

所有病人加同样的基础治疗羟氯喹组(48人)非羟氯喹组(502人)
死亡率18.8% (9/48人)47.4% (238/502)
死亡前存活时间15天8天
炎症细胞因子5.222.2


Sci China Life Sci

. 2020 May 15;1-7.
doi: 10.1007/s11427-020-1732-2. Online ahead of print.
Low Dose of Hydroxychloroquine Reduces Fatality of Critically Ill Patients With COVID-19
Bo Yu 1, Chenze Li 1, Peng Chen 1, Ning Zhou 1, Luyun Wang 1, Jia Li 2, Hualiang Jiang 2 3, Dao-Wen Wang 4

Abstract

Coronavirus disease 2019 (COVID-19) is a pandemic with no specific drugs and high fatality. The most urgent need is to find effective treatments. We sought to determine whether hydroxychloroquine (HCQ) application may reduce the death risk of critically ill COVID-19 patients. In this retrospective study, we included 550 critically ill COVID-19 patients who need mechanical ventilation in Tongji Hospital, Wuhan, from February 1, 2020 to April 4, 2020. All 550 patients received comparable basic treatments including antiviral drugs and antibiotics, and 48 of them were treated with oral HCQ treatment (200 mg twice a day for 7-10 days) in addition to the basic treatments. Primary endpoint is fatality of patients, and inflammatory cytokine levels were compared between HCQ and non-hydroxychloroquine (NHCQ) treatments. We found that fatalities are 18.8% (9/48) in HCQ group, which is significantly lower than 47.4% (238/502) in the NHCQ group (P<0.001). The time of hospital stay before patient death is 15 (10-21) days and 8 (4-14) days for the HCQ and NHCQ groups, respectively (P<0.05). The levels of inflammatory cytokine IL-6 were significantly reduced from 22.2 (8.3-118.9) pg mL-1 at the beginning of the treatment to 5.2 (3.0-23.4) pg mL-1 (P<0.05) at the end of the treatment in the HCQ group but there is no change in the NHCQ group. These data demonstrate that addition of HCQ on top of the basic treatments is highly effective in reducing the fatality of critically ill patients of COVID-19 through attenuation of inflammatory cytokine storm. Therefore, HCQ should be prescribed as a part of treatment for critically ill COVID-19 patients, with possible outcome of saving lives. hydroxychloroquine, IL-6, mortalities, COVID-19.

Low Dose of Hydroxychloroquine Reduces Fatality of Critically Ill Patients With COVID-19 - PubMed
Coronavirus disease 2019 (COVID-19) is a pandemic with no specific drugs and high fatality. The most urgent need is to find effective treatments. We sought to determine whether hydroxychloroquine (HCQ) application may reduce the death risk of critically ill COVID-19 patients. In this...
pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov

还是韩国人聪明,韩国人从一开始羟氯喹十锌死亡率低1%,法国的羟氯喹十阿奇酶素死亡率近10%
 

ottawa_tj

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全是政治化,药物,柳叶刀,WHO。。。全是针对Trump!
 

lindamy

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全是政治化,药物,柳叶刀,WHO。。。全是针对Trump!
他咋把整个世界,从里到外都得罪了?遍地五毛。
 

gcy1208

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这个药到底管用不管用,有没有副作用@贵圈
 

heureux

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他咋把整个世界,从里到外都得罪了?遍地五毛。
整个世界又没有选票。 只要能得到选票,得罪谁都行。
 

aottawa

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这个药到底管用不管用,有没有副作用@贵圈
可能对轻症有一定作用,重症基本没用(到了重症,什么药都不如祈祷)。每日200mg副作用不大,川普好像就是用的这个计量。等重症时,用量到每日1g毒副作用就全出来了。平时如果想预防又不想有副作用,可以买tonic饮料来喝,那里面有低剂量的氯喹,多有效不知道,但肯定不致死,本着喝点比没有好的心态,每日喝点,肯定有益无害。
 
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