Talk:Hydroxychloroquine

Semi-protected edit request on 30 April 2020

Would like to add citation on mechanism of action after this line. lysosomal pH in antigen-presenting cells. In inflammatory conditions, it blocks toll-like receptors on plasmacytoid dendritic cells (PDCs). Article https://www.nature.com/articles/s41584-020-0372-x Citation : Schrezenmeier, E., Dörner, T. Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nat Rev Rheumatol 16, 155–166 (2020). https://doi.org/10.1038/s41584-020-0372-x Clearly states that it does block toll-like receptors on plasmacytoid dendritic cells. DariusMD (talk) 18:22, 30 April 2020 (UTC)

 Done Interstellarity (talk) 20:31, 30 April 2020 (UTC)

Semi-protected edit request on 9 May 2020

In connection with the Covid19 pandemic, various medical publications explicitly indicated complications in patients with glucose-6-phosphate dehydrogenase deficiency. Treatment with hydroxychloroquine can lead to hemolysis and microembolism, and thus death. 2A01:C22:BC2F:F600:7DCB:453C:420B:23E1 (talk) 03:29, 9 May 2020 (UTC)

References

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. I also doubt this change would be necessary. This article is about the drug; its side effects have been known for a long time. The article already mentions the status of efficacy and risk/benefit research for its use in COVID-19. If you’re suggesting that side effects are different for this drug because a person has COVID-19 and glucose-6-phosphate dehydrogenase deficiency, then you should be more specific in your request and your references. It sounds to me, though, that you’re just pointing out existing adverse reactions to the drug in people with glucose-6-phosphate dehydrogenase deficiency, which would have nothing to do with COVID-19 and wouldn’t warrant additional mention in that section of the article. — Tartan357  ^(Talk) 09:44, 9 May 2020 (UTC)

Testing hydroxychloroquine in combination

As regards "Revision as of 07:20, 20 May 2020 (edit) (undo) (thank) Doc James (talk | contribs) (we already say it is being studied? no need for the primary source)" However I had introduced not that just it is being studied but now as part of a package which is topical. "Hydroxychloroquine and Zinc With Either Azithromycin or Doxycycline for Treatment of COVID-19 in Outpatient Setting" https://clinicaltrials.gov/ct2/show/NCT04370782Soundhill (talk) 08:57, 20 May 2020 (UTC)

Hydroxychloroquine is an ionophore which transports zinc into cells and it is the zinc which attacks the virus. I have tried several times to link studies which explain that and they have been removed and I am beginning to feel there may be an agenda to keep Trump's zinc aspect from consideration and pretend only the hydroxycholoroquine by itself happens to be valid to consider in building a picture of Trump's action. That doesn't seem scientific. Soundhill (talk) 10:23, 20 May 2020 (UTC)>

When applied in a combination with other drugs, it may actually "work" simply because other drugs work. This is known as axe porridge. I changed wording of first phrase in the paragraph to summarize better what the whole paragraph and the cited source [1] tell. And no, do not take hydroxychloroquine with zinc. Just zinc? Yes, if you have zinc defficiency. My very best wishes (talk) 15:29, 20 May 2020 (UTC)

Orange Man Bad. Hydroxychoroquine is one drug in a family of drugs that transport Zinc and other metals into the cell to suppress RNA replication of the coronavirus. In that sense, HCQ possesses an action potential that alters the concentration of Zn in the cell. So it works. Yes, HCQ works. Raoult has more than proven this treatment regime. The only times it doesn't work is after the virus has done it damage, and when Orange Man Bad. — Preceding unsigned comment added by 24.89.228.162 (talk) 04:07, 26 May 2020 (UTC)

quoting: "When applied in a combination with other drugs, it may actually "work" simply because other drugs work." That's why the combination study is needed, to see if there may be a difference when in combination.

And hydroxychloroquine being an ionophore I feel it to be wrong to have removed my reference to that and to another Wikipedia page on that.

quoting: "do not take hydroxychloroquine with zinc." Do you put yourself above the people who have approved the clinical trial doing exactly that?

quoting: "Just zinc? Yes, if you have zinc defficiency"

Your source refers to a study of zinc and vitamin C in combination.

Now presumably the clinical trial I cite may find if other hydroxychloroquine trials may have shown no result because of an underlying zinc deficiency when the drug was administered.

As we move towards the US presidential election we need to be very careful about ideological bias not affecting Wikipedia topics relating to what the current president may be doing. Soundhill (talk) 21:22, 20 May 2020 (UTC) Trump said he is taking hydroxy/zinc combo, some doctors recommend this combo for their patients claiming the 2 work very well together. See below from ABC

Dr. Cardillo with Mend Urgent Care in Sherman Oaks says using hydroxychloroquine with zinc appears to be working in the handful of patients he has prescribed it to.

"It was actually the hydroxychloroquine opening up a channel in the cellular membranes allowing zinc to come into the cells," he said, "And we do know high levels of zinc inside of the cell that's infected with the virus shuts down that viral replication machinery." https://abc7.com/health/doctors-say-caution-needed-in-drug-treatment-for-covid-19/6082485/ Berkshires (talk) 02:40, 21 May 2020 (UTC)

I have added mention of NYU study showing more favorable results when combining hydroxy with zinc. While the NYU study was retrospective, so was the study linking to higher death rates.. so to be fair, either both of them should be mentioned or neither of them. Berkshires (talk) 03:17, 21 May 2020 (UTC)

It tells: "Dr. Anthony Cardillo said he has seen ... but ...". Even if we had no WP:MEDRS, that would be an extremely weak source and undue claim. Further, "It was actually the hydroxychloroquine opening up a channel in the cellular membranes allowing zinc to come into the cells," he [Dr. Cardillo] said. What? Yes, there were publications that hydroxychloroquine can work as an ionophore. But ionophore is NOT an ion channel, but a carrier. My very best wishes (talk) 03:48, 21 May 2020 (UTC)

Why was this removed: "As of 8 May 2020, hydroxychloroquine and azithromycin plus zinc have been found to have effect against SARS-CoV-2 for patients in hospital but not yet in intensive care. "Zinc inhibits RNA dependent RNA polymerase, and has been shown to do this in vitro against SARS-CoV[13]. However, it is difficult to generate substantial intracellular concentrations of zinc, therefore prophylactic administration of zinc alone may not play a role against SarCoV-2[14]. When combined with a zinc ionophore, such as chloroquine (hydroxychloroquine), cellular uptake is increased making it more likely to achieve suitably elevated intracellular concentrations[15]. This combination is already being tested as a prophylactic regimen in a randomized clinical trial." Soundhill (talk) 05:38, 21 May 2020 (UTC)

The current paragraph is a shambles:

"On 18 May 2020, Trump publicly stated that he was taking hydroxychloroquine combined with Mineral Zinc during the COVID-19 pandemic, despite evidence indicating that it is "linked to higher rates of death in hospitalized COVID-19 patients with pre-existing conditions", and other studies that show it to be ineffective. [57] There is some counter evidence though, that when combining hydroxychloroquine with zinc the results would be more favorable than when taking hydroxychloroquine by itself. [58]"

The bolded passages are new. Now it reads as if the "despite evidence" part includes zinc. This is not how it is done. Also, the source is a primary one. I think the zinc part should be removed until we have a secondary source. --Hob Gadling (talk) 07:42, 21 May 2020 (UTC)

Hob Gabling is this what you mean by primary and secondary sources? Waiting for someone to interpret would seem to delay vital new information. As regards the passage you quote it might be useful to consider this change: "On 18 May 2020, Trump publicly stated that he was taking hydroxychloroquine combined with Mineral Zinc. Many secondary sources have sidelined Trump's reference to mineral zinc and talked of evidence indicating that hydroxychloroquine is "linked to higher rates of death in hospitalized COVID-19 patients with pre-existing conditions", and other studies that show it to be ineffective. An example: [57] To relate to what Trump actually said, the newer research including zinc supplementation should be noted and that that regime has started to be found helpful if started before any intensive care may be needed.[58]"Soundhill (talk) 09:45, 21 May 2020 (UTC)

Your main error is the assumption that it is Wikipedia's job to sideline science and gather primary sources. Read WP:SCHOLARSHIP to find out why secondary sources are what an encyclopedia should be based on.

Your second error is the assumption that anything coming from Trump can be "vital information". His doctor is not a doctor, and he himself is as far away from a reliable source as logically possible. If he jumps off a cliff, Wikipedia will not write that jumping off cliffs is healthy because he did it, and if somebody publishes preliminary findings saying that it may well be, we will wait until others confirm it. --Hob Gadling (talk) 11:41, 21 May 2020 (UTC)

I corrected language and i think its much better. Trump taking it combined with Zinc is not primary research, neither is the NYU large observational study. Both are simple facts reported by quite a few credible sources. — Preceding unsigned comment added by Berkshires (talk • contribs) 21:49, 21 May 2020 (UTC)

The fact that some prominent layman takes a medicine because he thinks it helps against some malady may be a fact, a well-reported fact even, but that does not make it WP:DUE for the article about the medicine. --Hob Gadling (talk) 06:08, 22 May 2020 (UTC)

To Hob Gadling I have suggested an edit to WP:SCHOLARSHIP that reliable secondary sources in medicine, nutrition and toxicology should include formulation dose. — Preceding unsigned comment added by Soundhill (talk • contribs) 00:27, 22 May 2020 (UTC)

There are quite a few reliable sources reporting that zinc/hydroxy/ziro combo is working differently and is alot more effective than hydroxy itself, and there seems to be some evidence backing it. (one ex. https://en.wikipedia.org/wiki/Chloroquine#Antiviral Chloroquine also seems to act as a zinc ionophore that allows extracellular zinc to enter the cell and inhibit viral RNA-dependent RNA polymerase.[4][5] )

While the NYU study is retrospective and not clinical trial so is the vetarns study. Leaving one and omitting other would be against Wiki bias policy.

The fact is that trump is taking the whole combo not just hydroxy, which make it relevant here (at least as much as the VA study which was a)on hydroxy itself b)people in late stages of corona c) people in critical conditions or ventilators). Before revereting again please explain your position here os talk page to avoid edit war. see link https://www.cnbc.com/2020/05/18/trump-says-he-takes-hydroxychloroquine-to-prevent-coronavirus-infection.html — Preceding unsigned comment added by Berkshires (talk • contribs) 20:28, 22 May 2020 (UTC)

I have also changed the language despite some evidence indicating that it is "linked to higher rates of death in hospitalized COVID-19 patients with pre-existing conditions""since there is only retrospective studies, so further research is required. Berkshires (talk) 20:48, 22 May 2020 (UTC)

Yeah right. And when scientists find out that adding zinc changes nothing, you will claim that it has to be taken at full moon, and when scientists find out that does have no consequence, you will claim that the mixture has to be stirred exactly three times. The usual response when people refuse to accept what the science tells them.

Enough of that. Wikipedia does not cluck before the egg has been laid.

I also removed the "some" because of WP:WEASEL. --Hob Gadling (talk) 06:46, 25 May 2020 (UTC)

References

Randomized trial? Where?

Where is this randomized controlled trial on 36 patients? I don't see it in the referenced source. 172.118.183.33 (talk) 01:31, 21 May 2020 (UTC)

It's on the cited John Hopkins page if you hover over where there is a citation for COVID-19 under the adult dosing section. It describes the small trial (it's actually non-randomized and I corrected this in our article) of 36 patients. I hope that helps. TylerDurden8823 (talk) 01:35, 21 May 2020 (UTC)

References

High-quality

My very best wishes, in your edit summary [2], you said "no, please read whole source. It tells:"Given the lack of evidence that HCQ is beneficial for the treatment of COVID‐19"". Please be clear-which cited source are you referring to specifically? I ask because the cited Meyerowitz source specifically says "Early anecdotal reports and limited in vitro data led to the significant uptake of hydroxychloroquine (HCQ), and to lesser extent chloroquine (CQ), for many patients with this disease. As an increasing number of patients with COVID‐19 are treated with these agents and more evidence accumulates, there continues to be no high‐quality clinical data showing a clear benefit of these agents for this disease (my bold)." Please explain why you are objecting to saying there is no high-quality evidence when the cited source says exactly that. It's not technically correct to say there is no evidence, but it is very low-quality evidence. It is certainly accurate to say there is no high-quality evidence to support chloroquine or hydroxychloroquine's use for COVID-19. Please elaborate on your objection, thanks. TylerDurden8823 (talk) 05:07, 21 May 2020 (UTC)

I refer to first ref used for in-line sourcing the phrase, that one, and it tells in conclusion of chapter 4: This finding highlights the concern that the combination of these two medications may place patients at increased health risk. Given the lack of evidence that HCQ is beneficial for the treatment of COVID‐19, these two agents should likely not be combined for COVID‐19 outside of a clinical trial.... Regardless, this and other sources tell there is simply no evidence. Also, speaking about "high-quality", what exactly does it mean? Can you explain it please? Without explanation, a reader can imagine whatever. My very best wishes (talk) 02:30, 22 May 2020 (UTC)

It means the same thing as it always has, that there is a lack of high-quality evidence (e.g., adequately powered well-done placbeo-controlled double-blind randomized controlled trials) supporting its use. The cited article uses that precise language. To be clear, I'm not in favor of HCQ use so I hope you realize that. But it's simply an inaccurate statement to say that there is no evidence. There is, it's just very low-quality in vitro and uncontrolled case series evidence. That's what stimulated more interest and study in the first place. The whole reason this received so much attention was because the aforementioned very preliminary data came out suggesting a possible role and tons of people jumped on the bandwagon, which wasn't really warranted. Nevertheless, the most accurate statement that is consistent with that cited article is that there is no high-quality supporting evidence. Please address the aforementioned bolded sentence directly from that source. We can certainly elaborate on what high-quality means though the cited article and we very commonly use this language in medical articles throughout Wikipedia without explaining in-depth what is meant by "high-quality" (we don't say, this means a lack of well-designed double-blinded RCTs every single time we say that). We reflect what high-quality sources (like the FASEB review) say, and that's what they say. TylerDurden8823 (talk) 17:37, 22 May 2020 (UTC)

Although this is true statement, the cited source under discussion [3] actually does not say "there is no strong evidence from double-blind placebo-controlled randomized controlled trials to support". Your explanation what "high-quality" means is actually a WP:OR. Besides, we must keep it simple. double-blind placebo-controlled randomized controlled trials. A typical reader does not know what that is. And once again, there is no scientific evidence (that is what we are talking about). There are only highly controversial data. This is not scientific evidence. My very best wishes (talk) 00:54, 23 May 2020 (UTC)

That's ridiculous. It's well-established. It's not OR or Synth, it's widely known. It's very clear in the paper that is what's needed "Given these facts and the growing un- certainty about these agents for the treatment of COVID-19, it is clear that at the very least thoughtful planning and data collection from randomized clinical trials are needed to understand what if any role these agents may have in this disease." And you're wrong that highly controversial data is "not evidence". It's poor-quality evidence. TylerDurden8823 (talk) 04:47, 26 May 2020 (UTC)

I think this is very simple. One questionable study tells there are might be some benefits. Another, more rigorous study tells the probability of death due to use of the drug increases, i.e. the drug is harmful (and the toxicity of this drug is generally well known). Even WHO stopped their trial. Do we have a scientific evidence this drug works for this specific disease? Of course not. My very best wishes (talk) 17:12, 26 May 2020 (UTC)

It's a semantics argument and you're mistaken. Even if it's questionable evidence, it's still evidence. To simply say "it doesn't exist", is factually untrue. I have already made my thoughts on whether it actually works abundantly clear (I certainly don't think so and the best available evidence suggests it doesn't but generally calls for more rigorous evidence). I added another high-quality source that also supports the language more explicitly. This conversation is really going nowhere. Stay well, MVBW. TylerDurden8823 (talk) 18:32, 26 May 2020 (UTC)

I see what are you talking about. According to our page, "Evidence, broadly construed, is anything presented in support of an assertion". If so, then there is definitely an "evidence" that Earth is flat. But you are right. I will stay out of it. Thanks, My very best wishes (talk) 19:07, 26 May 2020 (UTC)

Semi-protected edit request on 21 May 2020

Hello, I created an account to correct an error I found. I am new to this so please let me know if my submission is not in the proper format.

Under the article's section:

"Society and culture", "2020 COVID-19 use", "In the state of Arizona, a man died..."

Multiple news outlets have incorrectly reported Chloroquine Phosphate as a "fish-tank cleaner". It is a medicine designed to treat fish parasites and infections. Here is a source from NBC that is correct:

https://www.nbcnews.com/health/health-news/man-dies-after-ingesting-chloroquine-attempt-prevent-coronavirus-n1167166

Here is a source explaining what Chloroquine Phosphate is in the context of fish:

https://www.vin.com/apputil/content/defaultadv1.aspx?pId=20778&meta=Generic&catId=113378&id=8505022&ind=33&objTypeID=17

I would like the portion of the paragraph to be changed from:

In the state of Arizona, a man died, leaving his wife in critical condition, as a result of ingesting fish bowl cleaner, which contained chloroquine phosphate. The couple believed the chemical cleaner could prevent them from contracting COVID-19, although the chloroquine phosphate in fish bowl cleaners is not the same formulation found in the medicines chloroquine or hydroxychloroquine.

to:

In the state of Arizona, a man died, leaving his wife in critical condition, as a result of ingesting a product containing Chloroquine Phosphate designed for treating sick fish. The couple believed the fish treatment could prevent them from contracting COVID-19. Chloroquine Phosphate, used for the treatment of fish parasites and infections, has a different chemical structure than the medicines Chloroquine and Hydroxychloroquine.

 Done Eumat114 formerly TLOM (Message) 04:17, 22 May 2020 (UTC)

Diction

Hello. This suggestion has nothing whatsoever to do with the content; it's only a matter of phrasing and diction. Currently, the lead paragraph includes: "HCQ is being studied to prevent and treat coronavirus disease 2019 (COVID‑19)." The verb "studied" does not usually take an indirect object-phrase beginning with "to". This construct "[Noun] is being studied to [verb]" is poor English grammar (or, at least, awkward diction), and, its meaning is not entirely obvious. A better, clearer, less ambiguous English sentence might be: "Scientists are currently investigating the possibility that HCQ may be useful for prevention and/or treatment of coronavirus disease 2019 (COVID‑19)." This is longer, but it's grammatically impeccable (unless I'm missing something) and its meaning is quite clear.

If you like my suggestion, feel free to put it into the article, Masters of the Wikiverse! I tried to make the modification, but I am shut out by the protection.

HandsomeMrToad (talk) 05:57, 24 May 2020 (UTC)

Semi-protected edit request on 25 May 2020

Request the sentence High quality evidence of benefit for such use is lacking, with concerns of potential harms from side effects.[3][4][5]

be changed to: While reports exist to support the administration of low dose HCQ to COVID-19 patients [added reference], concerns of potential harms from side effects also exist.[3][4][5]

Basis: A study has shown that low doses of hydroxychloroquine used for COVID-19 patients with serious illness significantly reduced the mortality rate from 47.4%(258/502) to 18.8%(9/48) with p<0.001. The reference is below.

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 Zhuhui (talk) 09:08, 25 May 2020 (UTC)

 Already done - Thanks for this suggestion, but I think the COVID-19 section in the article already makes this point pretty clearly. — Tartan357  ^(Talk) 13:43, 25 May 2020 (UTC)

I would like to second this change: it cites reliable sources, impartially assesses both the risks and benefits of using the medicine and provides specific results/rates. All these combined will improve the quality of this article. Please also add the cited rates (47% vs 19%) and the source link for the cited ref it is available here: https://pubmed.ncbi.nlm.nih.gov/32418114/ Aenchevich (talk) 21:31, 25 May 2020 (UTC)

Semi-protected edit request on 30 May 2020

Hi. I would like to edit the following paragraph on this page:

"In anticipation of product shortages, the FDA issued product-specific guidance for chloroquine phosphate and for hydroxychloroquine sulfate for generic drug manufacturers.[49] The combination of hydroxychloroquine and azithromycin is not recommended outside the context of a clinical trial due to safety concerns with this combination and no proven benefit to combining these medications.[3]"

There are some issues I noticed:

1. The second sentence implies that the FDA does not recommend using hydroxychloroquine except in clinical trials. This is false. The FDA cautioned use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial. See [77].

2. The second sentence should state who made this recommendation, given the first sentence it implies that this is a recommendation by the FDA. That is incorrect as per the source [3] provided in the current page; this is the recommendation by the authors of the study in the FASEB journal, not the FDA.

3. The second sentence says "hydroxychloroquine and azithromycin is not recommended outside the context of a clinical trial". This is incorrect because the referenced source [3] also says it can be used on a case-by-case basis:

"they should only be used with caution and in the context of carefully thought out clinical trials, or on a case‐by‐case basis after rigorous consideration of the risks and benefits

4. The [3] source provided only refers to the outcome in the FASEB journal. This journal lists a study on the medrxiv.org website as the reason for its recommendation. Below quoted from the referenced FASAB journal:

"Given the increase in the use of HCQ for COVID‐19, a group recently published their analysis of the risk for adverse events associated with this medication.[33] They included more than 950 000 HCQ users of whom more than "320 000 had combination therapy with azithromycin"

"[33] https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v1"

The study referenced by the FASEB journal has not yet been certified by peer review. The top of the [33] Medrxiv article specifically states that the study should not be used to guide clinical practice.

Also it was was a retrospective study, not a randomized controlled study so cannot conclusively prove its theories. The study itself makes note of these inherent limitations.

5. The second sentence ends with "and no clinically demonstrable benefit to combine these medications", however at least three peer reviewed French studies have shown the combination appears to show benefit. [75] [76] [79] Two of these studies were published after the [3] source was published. Referencing a source of a study that has not been peer reviewed [3] to say there is no evidence of benefit, and then not referencing studies that have been peer reviewed that show evidence of benefit is misleading.

However it is only when large randomized clinical trials have concluded that there will sufficient evidence to say whether hydroxychloroquine, or hydroxychloroquine combined with azithromycin are definitely beneficial or not. That should be mentioned.

For the above reasons I believe the current paragraph should change as per below:

From:

"In anticipation of product shortages, the FDA issued product-specific guidance for chloroquine phosphate and for hydroxychloroquine sulfate for generic drug manufacturers.[49] The combination of hydroxychloroquine and azithromycin is not recommended outside the context of a clinical trial due to safety concerns with this combination and no clinically demonstrable benefit to combining these medications.[3]"

To:

On 20 March 2020 the results of a small (24 patients), non-randomized clinical trial conducted in France were published in the "International Journal of Antimicrobial Agents" showing evidence that the combination of hydroxychloroquine and azithromycin benefited patients with COVID-19. [75] On 11 April a further observational study in France of 80 patients was published in "Travel Medicine and Infectious Disease" showing further evidence that the combination of hydroxychloroquine and azithromycin benefited patients with COVID-19.[76]

On April 14 2020 in anticipation of product shortages, the FDA issued product-specific guidance for chloroquine phosphate and for hydroxychloroquine sulfate for generic drug manufacturers.[49] Ten days later they cautioned use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial. [77].

On 29 April an article in the "Federation of American Societies for Experimental Biology" journal said that the combination of hydroxychloroquine and azithromycin is only recommended in the context of a clinical trial, or on a case‐by‐case basis after rigorous consideration of the risks and benefits. This is due to safety concerns with this combination and a lack of evidence showing benefit when combining these medications.[3] The conclusion was based on retrospective study posted 10 April 2020 involving 323,122 users of hydroxychloroquine and azithromycin from Germany, Japan, Netherlands, Spain, UK, and USA. That study has not been certified by peer review and was based on hydroxychloroquine users with Rheumatoid arthritis, not COVID-19 [78].

On 5 May 2020 a retrospective analysis of 1061 patients with COVID-19 in France was published in "Travel Medicine and Infectious Disease". The patients were given hydroxychloroquine and azithromycin early in their treatment and their analysis provided further evidence that this treatment was beneficial to patients with COVID-19. [79]

On 8 May 2020 a not yet peer reviewed, retrospective study of hospitalized patients in USA showed evidence that adding Zinc to treatments using hydroxychloroquine and azithromycin provided further benefits to COVID-19 patients. [80] A study published in the PLOS journal on 4 November 2010 showed evidence that when Zinc is inside cells it blocks Coronavirus from replicating. [81] Another study in the same journal published 1 October 2014 showed evidence that chloroquine helps Zinc enter cells. [82] Enabling Zinc to more easily enter cells could be one of the ways hydroxychloroquine stops coronavirus from replicating and becoming worse in COVID-19 patients [80].

To find out with more certainty whether hydroxychloroquine, or hydroxychloroquine combined with azithromycin are beneficial or not, large Randomized Controlled Trials are needed. For this reason a number of these trials are currently running. [83]

[75] 20 March 2020 24 patients non-randomized clinical trial https://doi.org/10.1016%2Fj.ijantimicag.2020.105949

[76] 11 April 2020 80 patients observational study https://doi.org/10.1016/j.tmaid.2020.101663

[77] https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or

[78] https://doi.org/10.1096/fj.202000919 , which references the not yet peer reviewed https://doi.org/10.1101/2020.04.08.20054551

[79] 05 May 2020 1061 patients retrospective anaylsis https://dx.doi.org/10.1016%2Fj.tmaid.2020.101738

[80] 08 May 2020 retrospective USA study with Zinc https://doi.org/10.1101/2020.05.02.20080036

[81] 04 November 2010 Zinc Ionophores blocks the replication of Coronavirus https://dx.doi.org/10.1371%2Fjournal.ppat.1001176

[82] 01 October 2014 Chloroquine Is a Zinc Ionophore https://dx.doi.org/10.1371%2Fjournal.pone.0109180

[83] Running RCTs https://doi.org/10.1136/bmj.m1626 , https://doi.org/10.1101/2020.05.19.20106997, https://clinicaltrials.gov/ct2/show/NCT04358068?term=A5395&draw=2&rank=1

— Preceding unsigned comment added by Robbymcd (talk • contribs) 16:54, 30 May 2020 (UTC)

The words “prove” and “proven” are inappropriate here, both before and after the proposed changes. Clinical research is a complex, continuous process of weighing observed risks versus observed benefits, and if new risks are subsequently found in postmarketing surveillance, medicines get pulled from sale (and sometimes from further trials) by regulatory authorities. Capewearer (talk) 19:20, 30 May 2020 (UTC)

Yes I agree. Can you suggest a better word? Robbymcd (talk) 03:15, 31 May 2020 (UTC)

I've tentatively replaced "proven benefit" with "clinically demonstrable benefit" in the article, but am open to suggestions for better wording. Capewearer (talk) 09:57, 31 May 2020 (UTC)

How about "a lack of evidence showing benefit", that is simpler and probably more accurate. I've updated the original request with this change and some other corrections/improvements. Robbymcd (talk) 16:34, 31 May 2020 (UTC)

Due to lack of any response I started with main change to the section I identified as incorrect. The studies referenced should probably go under the research section rather. — Preceding unsigned comment added by Robbymcd (talk • contribs) 18:53, 3 June 2020 (UTC)

New development -- Major study retracted

I am not sure how notable this is, but according to this Vox article (https://www.vox.com/future-perfect/2020/6/4/21280855/coronavirus-treatment-hydroxychloroquine-lancet-retraction), The Lancet has just retrated a study that suggested hydroxychloroquine increased mortality in patients. Worth adding to the article? Elvis2500 (talk) 22:58, 4 June 2020 (UTC)Elvis2500

This was also covered at BBC Coronavirus: Influential study on hydroxychloroquine withdrawn. My preference is there should be a 48-hour holding period, to allow further info and due WEIGHT to appear. Cheers Markbassett (talk) 01:04, 5 June 2020 (UTC)

The study was not influential - it was ve fraud.— Preceding unsigned comment added by Brett Alexander Hunter (talk • contribs)

Actually, the Lancet itself has published a retraction [4]

’Statement from The Lancet’

Today, three of the authors of the paper, "Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis", have retracted their study. They were unable to complete an independent audit of the data underpinning their analysis. As a result, they have concluded that they "can no longer vouch for the veracity of the primary data sources." The Lancet takes issues of scientific integrity extremely seriously, and there are many outstanding questions about Surgisphere and the data that were allegedly included in this study. Following guidelines from the Committee on Publication Ethics (COPE) and International Committee of Medical Journal Editors (ICMJE), institutional reviews of Surgisphere’s research collaborations are urgently needed.

The retraction notice is published today, June 4, 2020. The article will be updated to reflect this retraction shortly.” BoonDock (talk) 01:11, 5 June 2020 (UTC)

There has also been some further showing of the WEIGHT and responses... seems low-to-medium coverage, noting flaws of fast science and the politicisation of it.

• Vox on the retraction, WSJ, The Guardian on how could this happen, The Verge on speedy science.
• Fox commentary from Dr. Marc Siegel. (Given Minor prominence there, way down in list of stories below numerous Floyd items, then Marine flag item and SpaceX item,) mostly noting prior coverage was political not medical. “Does hydroxychloroquine actually work early in the game to help decrease the symptoms of COVID-19? It's been studied in the lab as an antiviral," Siegel said. "Medical, we don't know yet. Political, we know this is a political hit job." Fox media about that, noting The Guardian and NewsBusters and NEJM reports. (And whinging that ABC CBS NBC were silent about Lancet story). Fox science on the limit of observational data.
• NPR, Marketwatch, Discover, NY Mag, Miami Herald,
• Politico on the retraction politics and mistrust; National Review also, Bloomberg on French questions,

... side notes

• Time notes resumption of studies about using it; CNN notes U.K. stopping theirs.
• Stat preliminary study results, with FDA note ... basically no significant benefit and no major risk.
• CBS, NBC, NYT, The Guardian, Washington Post, ... top google hydroxychloroquine results this week are of the ‘does not prevent’ story and ‘retraction’ thread needs to expressly search for ‘Lancet retraction’

Cheers Markbassett (talk) 17:12, 6 June 2020 (UTC)

Split

The following discussion is an archived record of a request for comment. Please do not modify it. No further edits should be made to this discussion. A summary of the conclusions reached follows.

The hydroxychloroquine arm of the WHO Solidarity trial has been dropped as of 17 June. There is no consensus to split the article into its focus related to COVID-19, and no longer a reason to specify COVID-19. Vote count 9:3, oppose:support. (non-admin closure). Zefr (talk) 20:55, 17 June 2020 (UTC)

---

The section Hydroxychloroquine#COVID-19 is growing fast and overlaps widely with many similar sections in other articles (linked as see-alsos). Any opposition to splitting it into Use of chloroquine and hydrochloroquine for treatment of COVID-19? Thanks. fgnievinski (talk) 00:06, 5 June 2020 (UTC)

I disagree. The only reason that this article (Surgisphere) exists at all is because it has gained notability for the fact that they provided data for the Lancet study and further that the data’s legitimacy has been called into question. Remove that section and I would not be surprised to see a nomination for speedy deletion of the article for non notability BoonDock (talk) 00:59, 5 June 2020 (UTC)

That wasn't a Lancet study.— Preceding unsigned comment added by Brett Alexander Hunter (talk • contribs)

@BoonDock: you only mentioned the article about Surgisphere; we can leave it out if you prefer. But we're in the talk page of Hydroxychloroquine#COVID-19. There's still plenty of duplication in all the other see-alsos: Chloroquine#COVID-19, COVID-19 drug development#Hydroxychloroquine, COVID-19 drug repurposing research#Hydroxychloroquine, Trump administration communication during the COVID-19 pandemic#Hydroxychloroquine. fgnievinski (talk) 06:11, 5 June 2020 (UTC)

• Oppose: The recent controversy regarding the study has pretty much come to an end as the study has been retracted. Additionally, the sections on the drugs' main articles + Surgisphere's article have sufficient information. A splitting article would overlap most of the information already stated in these asrticles, making it a redundant fork. •Shawnqual• 📚 • 💭 03:52, 5 June 2020 (UTC)

The intention is quite the opposite: to centralize in a single article the information currently dispersed and duplicated in multiple articles, which would then just contain a summary, basically the lead of the proposed article (Use of chloroquine and hydrochloroquine for treatment of COVID-19). fgnievinski (talk) 04:11, 5 June 2020 (UTC)

Still disagree I understand your intention and disagree that it will achieve that. BoonDock (talk) 04:22, 5 June 2020 (UTC)

• Support There have been campaigns including by Trump promoting Hydroxychloroquine as a measure to cure COVID-19. There is a much broader coverage and I agree to have a separate article on that. Abishe (talk) 14:32, 5 June 2020 (UTC)
• Oppose - that section fits here and just doesn’t seem large enough to be a separate article per WP:SPLIT. Plus in addition to the other articles already covering the politics..... It’s already enough places to make complexity for editing and reading, a split would be worse rather than helpful. Cheers Markbassett (talk) 18:27, 6 June 2020 (UTC)
• Oppose as this is basically the reason they are notable and it isn't large enough to fork. Dennis Brown - 2¢ 13:01, 7 June 2020 (UTC)
• Oppose under WP:MEDRS. A specialised article might be acceptable under WP:MEDRS with a title such as Irreproducible science and misinformation in relation to chloroquine and hydrochloroquine for the treatment of COVID-19, as long as it's not redundant with Misinformation related to the COVID-19 pandemic (which presently have just very brief subsections on this subtopic), but that's not the present proposal. Reproducibility in scientific research, irreproducibility in this context, and the way that misinformation has spread in this context are all interesting and valid topics. The fact that the two medicines have been used in this context is less interesting - we don't seem to have articles on the use of homeopathic pills. Boud (talk) 17:37, 7 June 2020 (UTC)
• I disagree with splitting the Surgisphere page up as the COVID19 scandal is most likely going to cause the company's demise.Mfernflower (talk) 18:48, 8 June 2020 (UTC)
• Support, as it's going to be more than Surgisphere, it has enveloped Amit Patel now. It seems like this whole topic (hydro/chloroquine and covid, this paper and retractions, other research) needs to be centralized. tedder (talk) 00:48, 9 June 2020 (UTC)
• Oppose for reasons mentioned so far: not large enough to fork, section fits here and even the fact that the company is likely going belly up.--Wuerzele (talk) 20:17, 9 June 2020 (UTC)
• Oppose too small for relevance just keep it in the section. --Cs california (talk) 07:58, 15 June 2020 (UTC)
• Oppose: With the closure today of the hydroxychloroquine arm of the WHO Solidarity trial - the world's largest trial involving hydroxychloroquine/chloroquine, this is no longer an issue concerning COVID-19. The vote count is 9-3 opposing the proposed split, indicating insufficient consensus and warrant to close the discussion. Zefr (talk) 20:55, 17 June 2020 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Adding Zinc to treatment with hydroxychloroquine

Hi I would like to add the following to the COVID-19 Timeline:

"On 12 May 2020 news outlets reported that NYU hospitals had treated 411 patients hospitalized with COVID-19 using an investigational therapy of hydroxychloroquine, azithromycin and zinc. Only low-level, in-vitro and preprint retrospective cohort study evidence suggests that the addition of zinc with hydroxychloroquine may be beneficial in the treatment of COVID-19 patients. . To obtain high-level evidence if the addition of zinc is beneficial in this combination a Randomized Controlled Trial is currently recruiting and estimated to complete 31 December 2020. "

The news articles refer to the preprint medrxiv observational study: https://doi.org/10.1101/2020.05.02.20080036

As per WP:MEDRS preprints should not be sourced as evidence. However it seems factual that NY hospitals used this treatment and at the very least the secondary news sources above as well as the the primary source preprint confirm this event happened.

This topic appears to have been discussed at length in the section https://en.wikipedia.org/wiki/Talk:Hydroxychloroquine#Testing_hydroxychloroquine_in_combination section. Hob Gadling said "I think the zinc part should be removed until we have a secondary source" . Below I think counts as a secondary source given it was published on the East Virginia Medical School website and the says:

"This is our recommended approach to COVID-19 based on the best (and most recent) literature"

https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf

It advocates the use of Zinc in addition to other treatments including Hydroxychloroquine saying:

"while there is no high-level evidence that this cocktail is effective; it is cheap, safe and widely available"

The link to the ongoing RCT for this combination is also relevant given all of the above. The fact is nothing is currently proven and very little has been disproven relating to COVID-19 treatments, so really everything to do with treatment is speculative in one way or another.

Robbymcd (talk) 16:46, 5 June 2020 (UTC)

 Not done: , this clearly fails WP:MEDRS, WP:OR, and WP:SYNTH. TylerDurden8823 (talk) 09:35, 6 June 2020 (UTC)

Ok so why the bias then to only this post when there are clearly other posts here that make the same violations. If cant provide a suitable reason will remove them too. Robbymcd (talk) 09:45, 6 June 2020 (UTC)

It's not a bias. It's simply following well-established Wikipedia procedure that is there for many good reasons. You'll have to be more specific about what other content you're suggesting is objectionable. TylerDurden8823 (talk) 10:12, 6 June 2020 (UTC)

Just looking in the last few days 961032578 (RECOVERY Trial) 960626395 ( add new study) clearly fail WP:MEDRS and WP:OR as well. So why the bias for my post? However I've managed to find an existing source in this article for my latest attempt to make mention of the possible benefit zinc might have for COVID-19 patients on this page. So if still not happy then seems we need to delete most of the covid-19 section because it follows the same methods as my most recent post. Robbymcd (talk) 12:54, 6 June 2020 (UTC)

Service: You probably mean these: [5][6]. (This way, only I had to do the work of deriving which edits you mean, everybody else can just click on the links. Next time, do that yourself please.) --Hob Gadling (talk) 17:07, 6 June 2020 (UTC)

Because I happened to be online right now and noticed you posted this and it overtly failed the aforementioned policies. Again, it's not a "bias". TylerDurden8823 (talk) 18:22, 6 June 2020 (UTC)

References

WHO resumed HCQ Testing on June 3 2020

https://time.com/5847664/who-hydroxychloroquine-covid-19/ The article says the opposite. — Preceding unsigned comment added by 24.89.228.162 (talk) 00:24, 11 June 2020 (UTC)

The timeline section already says the WHO resumed testing on 3 June. Where does it say the opposite? Capewearer (talk) 04:33, 11 June 2020 (UTC)

History of Hydroxychloroquine and Details of pharmacokinetics

Hello wiki community. I would like to add few very important missing evidences from the topic. That is history and pharmacokinetic detailing.

"When in 1638, a patient from Peru’s Viceroy’s family, countess cinchona, contracted Malaria. She was cured with a bark of a tree called Jesuit’s bark. It took 200 years to isolate its active ingredient ‘quinine’. In 1945, quinine was hydroxylated to form hydroxychloroquine, a safer derivative. The drug has continued its glorious march since then. Currently, the drug is the United States Food and Drug Administration (FDA) approved for Malaria, discoid lupus erythematosus, systemic lupus erythematosus (SLE), and rheumatoid arthritis."https://academic.oup.com/jpubhealth/advance-article/doi/10.1093/pubmed/fdaa074/5850534?searchresult=1

Pharmacokinetics: Hydroxychloroquine sulfate (blood half-life 537 hours or 22.4 days) attains peak blood levels 3.26 hours after administration of 200 mg salt (155-mg base) orally in healthy males. Absorption of the drug was found to be less in patients with rheumatoid arthritis with severe disease activity compared with the less severe groups. This observation may have significant importance while ascertaining the dosage recommendation in a healthy subset of the population. https://academic.oup.com/jpubhealth/advance-article/doi/10.1093/pubmed/fdaa074/5850534?searchresult=1 https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/009768s037s045s047lbl.pdf

Mendellwiki (talk) 10:05, 13 June 2020 (UTC)Mendellwiki, 15:34, 13.06.2020

References

Studies favoring HQC for Covid-19 keep getting deleted

Did anyone else notcied that? Berkshires (talk) 02:36, 3 July 2020 (UTC)

How much convincing of its ineffectiveness for treating COVID-19-infected people is needed? It has been withdrawn for providing no benefit in the WHO Solidarity trial, UK Recovery trial, and the FDA EUA. My edit summary explained why, and your use of this one observational study (not an interventional trial) is primary research. If warranted, it could be included under the Timeline section. WP:BRD means a contested edit is brought here to the talk page for dispute resolution and consensus building, rather than the edit warring that you prefer. Discuss the merits and seek consensus, WP:CON. Zefr (talk) 03:07, 3 July 2020 (UTC)

You are putting a different standard for studies that are not favoring HCQ versus those favoring. Did you used the same standard to delete "the Lancet study" from Wiki pages??? The Lancet study was from the outset NOT peer reviewed and the source of data was confidential??? you are clearly biased on this and should be ashamed of your behavior. Seeing you cant win with normal conversation you got the page to barred from editing... what a wonderfull way of having accurate info on wiki. Shame.Berkshires (talk) 03:15, 3 July 2020 (UTC)

Note the general sanctions and need for high-quality sources on COVID-19 topics at the top of this talk page. Zefr (talk) 03:25, 3 July 2020 (UTC)

Zefr As mentioned before, instead of deleting peoples edits when you see an issue with them, rather correct them. In this case there is an obvious high quality source as mentioned in the news references from Berkshires

Yes, i realized and i suddenly got 3 massages from different administrators (I am sure it has nothing to with you alerting them). Great way how to avoid legit debate is by deleting and barring. Sounds more like USSR. Good luck — Preceding unsigned comment added by Berkshires (talk • contribs) 03:31, 3 July 2020 (UTC)

Zefr So what you're saying is because the WHO Solidarity trial and UK Recovery trial were cancelled and FDA removed authorization for emergency use in hospitals, you now feel that any new studies that show benefit of its use cannot be shown on this page, no matter how much they meet Wikipedia's criteria for addition? I'm sorry but unless you can provide a better argument I will need to report your continued removal of people's edits, as I am not the only person that has found your edits extremely biased. Robbymcd (talk) 13:32, 3 July 2020 (UTC)

The WHO Solidarity trial and UK Recovery trial are not 'cancelled', but rather have specifically discontinued the study of HCQ because it proved to be ineffective at reducing COVID-19 deaths. Those are multi-investigator organizations relying on expert safety review boards making that conclusion, so qualify as high-quality sources for the encyclopedia per WP:MEDASSESS - see the left pyramid classifying the evidence to which can be added the withdrawn EUA by the FDA. Concerning the disputed July report in IJID (which is not a review, but rather a preliminary report), the authors of that article stated: "our results should be interpreted with some caution and should not be applied to patients treated outside of hospital settings. Our results also require further confirmation in prospective, randomized controlled trials that rigorously evaluate the safety, and efficacy of hydroxychloroquine therapy for COVID-19 in hospitalized patients." Their conclusion indicates the preliminary nature of that limited observational study which falls within "primary" research, shown in the left pyramid of MEDASSESS. There's really no place in the article at present for such preliminary findings, which should be excluded until expert assessment with other results about HCQ and COVID-19 are published in a review that meets the standards of MEDASSESS. Zefr (talk) 14:17, 3 July 2020 (UTC)

Zefr yes those two trials were discontinued but what about all the other Hydroxychloroquine trials that are ongoing? The discontinued trials were testing specific doses, combinations and timing, different to the ongoing trials. Regarding your claim that this source is preliminary and falls in the primary study section of MEDASSESS pyramid, the same could be said for most of the sources used on this page and used to say HCQ has no benefit. For example [3][4][48][49] in main article are based on much weaker sources than the one proposed here, one of the sources reference a study that has not even been peer reviewed yet, another only a single author. Also they are all older than current study so are essentially outdated by this newest study. Please explain your bias here to prevent this being reported. Robbymcd (talk) 14:34, 3 July 2020 (UTC)

Even the founder of wikipedia doesn't trust wikipedia.

"As the originator of and the first person to elaborate Wikipedia’s neutrality policy, and as an agnostic who believes intelligent design to be completely wrong, I just have to say that this article is appallingly biased. It simply cannot be defended as neutral. If you want to understand why, read this. I’m not here to argue the point, as I completely despair of persuading Wikipedians of the error of their ways. I’m just officially registering my protest." —Larry Sanger (talk) 05:30, 8 December 2017 (UTC) So, do you actually think that any article in wikipedia escapes the fascist left? See https://c19study.com Poquelin1 (talk) 06:34, 4 July 2020 (UTC)

Sadly, that’s a great quote from Mr Sanger, Poquelin1. In answer to your question, I think the fascist left sees to all the current topics that have any degree of controversy to them. But there are many others that they don’t patrol. So this one, well <sarcasm> we can’t possibly have anything positive about covid19 anywhere in Wikipedia, now can we? After all, the over-riding priority is to prevent Trump’s re-election. <sarcasm /> And so it is that the general public must not be allowed to see any mention of a study which makes it clear that lives can and are saved by the use of Hydroxychloroquine. I call that assisting death. And there are such studies. Anyone deleting their mention from the article should be ashamed of themselves. Boscaswell talk 09:45, 30 July 2020 (UTC)

Extended-confirmed-protected edit request on 3 July 2020

Berkshires (talk) 03:08, 3 July 2020 (UTC)

Hi,

Would like to add the following 4 sources to the IJID study. Thanks

https://www.henryford.com/news/2020/07/hydro-treatment-study https://www.wsj.com/articles/hydroxychloroquine-given-early-helped-coronavirus-patients-study-finds-11593729664 https://www.cnn.com/2020/07/02/health/hydroxychloroquine-coronavirus-detroit-study/index.html https://www.modernhealthcare.com/safety-quality/hydroxychloroquine-may-lower-covid-19-death-rates-henry-ford-finds

 Not done - use strong review sources for medical content per WP:MEDRS, not news, WP:NOTNEWS. Zefr (talk) 03:14, 3 July 2020 (UTC)

A cursory look at the cardiac drugs on WP,90percent of which have been FDA approved without the Fauci standard set for HCQ shows exactly zero mention of this on their wikipedia pages? — Preceding unsigned comment added by 2601:46:C800:2260:DFD:C69B:4927:494B (talk) 18:09, 17 August 2020 (UTC)

Surely a mention of a peer reviewed study published in the International Journal of Infectious Diseases specifically about the use of Hydroxychloroquine should at least appear in the timeline section of this Wikipedia page? Zefr Please explain why the below review source does not count as a strong review source as per WP:MEDRS Robbymcd (talk) 13:22, 3 July 2020 (UTC)

https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

Surely a mention of a peer reviewed study published in the International Journal of Infectious Diseases specifically about the use of Hydroxychloroquine should at least appear in the timeline section of this Wikipedia page? Drsruli (talk) 22:39, 3 August 2020 (UTC)

List of publications on the efficiency of Hydroxychloroquine Azythromicine

List of publications Poquelin1 (talk) 06:07, 4 July 2020 (UTC)

In the summer of 2020, there are clear indications corroborating the effectiveness of hydroxychloroquine -Azithromycin taken in the first stage of infection with coronavirus disease 2019, see all the studies published on the subject . Poquelin1 (talk) 06:08, 4 July 2020 (UTC)

References

The WP:MEDRS guidelines applies to medical sourcing we use here. Unlike the media, Wikipedia does not buy into hype-based medicine. Alexbrn (talk) 06:17, 4 July 2020 (UTC)

@TylerDurden8823: Can you read? It is only links to publications Poquelin1 (talk) 06:19, 4 July 2020 (UTC)

On the contrary of what is said in the medias Poquelin1 (talk) 06:20, 4 July 2020 (UTC)

There is no comment added on these publications list Poquelin1 (talk) 06:21, 4 July 2020 (UTC)

It contains the list of 52 studies categorized in 4 groups Poquelin1 (talk) 06:23, 4 July 2020 (UTC)

This information should be added to the article Poquelin1 (talk) 06:23, 4 July 2020 (UTC)

---

Please make a proper edit request, with the format of change or add X to Y. El_C 06:27, 4 July 2020 (UTC)

To be added

In the summer of 2020, there are clear indications corroborating the effectiveness of hydroxychloroquine -Azithromycin taken in the first stage of infection with coronavirus disease 2019, see all the studies published on the subject [1]. References

https://c19study.com Poquelin1 (talk) 06:29, 4 July 2020 (UTC)

 Not done WP:MEDRS is required for any statement about effectiveness. The link is not a reliable source. Alexbrn (talk) 06:36, 4 July 2020 (UTC)

This website is garbage propaganda: Anonymous, counting all "studies" in the same way whether they are peer reviewed or not or whether they are clinical trials or retrospective, using cherry-picked data for their diagrams, mixing up correlation with causality, not controlling for other factors, etc. etc. etc. — Preceding unsigned comment added by 87.152.182.39 (talk) 09:55, 22 July 2020 (UTC)

Extended-confirmed-protected edit request on 4 July 2020

The study published by the Lancet and by the New England Medical Journal which led to WHO & FDA cancelling hydroxychloriquine treatments, was retracted by the Lancet, the New England Medical Journal, and the authors due to the authors refusing to provide methodology. https://www.nbcnews.com/health/health-news/lancet-retracts-large-study-hydroxychloroquine-n1225091 GreekLantern (talk) 15:06, 4 July 2020 (UTC)

 Not done The retraction is already covered. Alexbrn (talk) 15:11, 4 July 2020 (UTC)

The retraction should be directly in the header. Further, a peer-reviewed study by Ford Health System shows effectiveness in reducing covid19 death rate. [7]

https://www.henryford.com/news/2020/07/hydro-treatment-study

there was a new study on Hydroxychloroquine by the henry ford foundation i would hope there would be some kind of comment about it — Preceding unsigned comment added by Gatesdantesr (talk • contribs) 00:08, 8 July 2020 (UTC)

This study has an age bias. The median age of the no-drug group was 71. The median age of the HCQ Group was 53. This age difference alone accounts for the miraculous results.

This was not an actual clinical trial, and it does not control for confounding factors. For all we know, the patients receiving HCQ may have been lower-risk patients. Anywikiuser (talk) 15:32, 8 July 2020 (UTC)

Update(8/12): The median age for the HCQ group has been modified in this study from 53 to 64.— Preceding unsigned comment added by 73.57.110.91 (talk)

This study is biased and basically useless: https://www.ijidonline.com/article/S1201-9712(20)30530-0/fulltext# — Preceding unsigned comment added by 87.152.182.39 (talk) 10:06, 22 July 2020 (UTC)

It seems that the age- difference was reckoned in the analysis, however steroids were also used for many or most patients, which would also tend to confound the results. Drsruli (talk) 22:42, 2 August 2020 (UTC)

Chloroquine Study at Henry Ford

Dear Wikipedia,

After consultation with many medical professionals and Boards of Directors of major hospitals your coverage of this potential drug shows your left wing bias, as you cite many studies that were not "clinical studies" but utilized data from multiple hospitals. To not even mention this study is journalistic malpractice. Count on no further contributions from me, but I will continue to use you as I get to spend your money.

Dr. Dale S. Steichen — Preceding unsigned comment added by 2601:782:4080:1DA:CD3:FD17:A78E:1F26 (talk) 21:03, 11 July 2020 (UTC)

Hello, friend! I would like to ask if we may continue discussing on this topic in a more empirical manner, instead of dismissing the entirety of Wikipedia as one of "left wing bias"? Justin J. Liu (Dylan Smithson) (talk) 22:38, 11 July 2020 (UTC)

I think that it's official. Like TNYT. https://en.wikipedia.org/wiki/Ideological_bias_on_Wikipedia#Wikipedia_co-founder

https://larrysanger.org/2020/05/

Drsruli (talk) 06:40, 9 August 2020 (UTC)

If some crank who used to work here gets interviewed, yes, obviously, what he says is the official truth.

Please stop it. This does not help the article. --Hob Gadling (talk) 13:30, 9 August 2020 (UTC)

Brazil study

Alexbrn Please explain your concerns about the article and study. Thanks. Whywhenwhohow (talk) 20:33, 25 July 2020 (UTC)

It's a primary source, so not reliable per WP:MEDRS. Alexbrn (talk) 20:35, 25 July 2020 (UTC)

It looks like there are other non-reliable sources per WP:MEDRS in the COVID-19 section. I moved the section into a Research section. Whywhenwhohow (talk) 22:29, 25 July 2020 (UTC)

Yes, the article needs a haircut. Let's not make it worse. Alexbrn (talk) 04:43, 26 July 2020 (UTC)

A multicenter, randomized, open-label, three-group, controlled trial in Brazil found no benefit from using hydroxychloroquine, alone or with azithromycin, to treat mild-to-moderate COVID‑19.

--Whywhenwhohow (talk) 00:44, 26 July 2020 (UTC)

We really need to be improving source quality in the COVID articles, which are getting overstuffed with poor material. Primary sources and lay press for health information, no thanks. Alexbrn (talk) 04:47, 26 July 2020 (UTC)

It may be appropriate to include primary sources if they influenced treatment guidelines, which are the only secondary sources we really have at the moment. So for example, it makes sense to cite the RECOVERY trial primary source because it is cited in the US FDA's decision to revoke emergency use of HCQ. Anywikiuser (talk) 22:20, 26 July 2020 (UTC)

Just had a thought on the Brazil study: it does provide a result on the HCQ-azithromycin and so might be useful on that until a secondary source emerges. Anywikiuser (talk) 14:01, 28 July 2020 (UTC)

It's not reliable. Alexbrn (talk) 14:07, 28 July 2020 (UTC)

The hiatus

The fraudulent Lancet study noted above led to multinational prohibitions of hydroxychloroquine which were reversed soon after the study was retracted. This hiatus provided excellent opportunity to observe the drug's effectiveness. FranceSoir reports: "According to the critics of hydroxychloroquine, these 15 days of prohibition should have had no impact on patient survival, but this is not the case: it is enough to look at the evolution over time of the proportion of deaths among newly resolved cases, only to find that hydroxychloroquine, the only molecule banned within this time, works." http://www.francesoir.fr/societe-sante/covid-19-hydroxychloroquine-works-irrefutable-proof 76.23.29.23 (talk) 00:32, 26 July 2020 (UTC)AGF

This is not a usable source for medical information. It is an article in the popular press, not a scientific paper. Even if it was a scientific paper, it would be unacceptable for this article as it is not a randomised clinical trial, which is the only way that you can control for confounding factors. For all we know, the period with higher deaths could have been caused by something completely unrelated, such as a local outbreak. Anywikiuser (talk) 22:20, 26 July 2020 (UTC)

This is what you call shooting the messenger. What matters is the validity of the data reported in the graphs and the chance of coincidence granted the time lag assumed. Obviously the burden of proof falls on die hard opponents of hydroxychloroquine to identify alternative explanations for the hiatus in mortality in both France and Switzerland, and any other countries where the phenomenon may show up. The unseemly rush by Lancet and NEJM to accept Surgisphere's legitimacy is matched only by the denial of good statistical work buy these good doctors. 2601:681:5400:2BD:A802:F84A:982:A1BA (talk) 23:10, 26 July 2020 (UTC)AGF

Nonsense. A popular press article is not a reliable source for medical information, full stop. And everybody who knows how science works can see why that is justified in this case: the reasoning is a classic example of post hoc ergo propter hoc. Stuff varies over time, and other stuff varies ofer time, therefore the first stuff was because of the other stuff - no. --Hob Gadling (talk) 07:01, 27 July 2020 (UTC)

On another note, in the period with an apparent increase in the likelihood of deaths (8-23 June), Switzerland officially records 5 deaths. This is not likely to produce statistically significant results. Anywikiuser (talk) 08:34, 27 July 2020 (UTC)

I counted 35 Swiss deaths from 8-23 June https://www.worldometers.info/coronavirus/country/switzerland/ France had about 500 deaths in the same period. https://www.worldometers.info/coronavirus/country/france/ As for peer review fast tracking did little for Lancet's and NEJM's credibility; medics in the trench are excused from formalities even when reputable publications are available. The upshot is Surgisphere killed people around the globe, and its financing and the motives of those who concocted it are wide open to serious scrutiny. 97.44.1.83 (talk) 15:15, 27 July 2020 (UTC)AGF

Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health analyzes this phenomenon and comes to similar conclusions in a few places (popular media). Unfortunately, he has not appended this observation to his earlier scientific paper on the topic, nor has he published a new paper yet. Drsruli (talk) 22:37, 5 August 2020 (UTC)

Political Medicine is not acceptable According to Yale Professor

Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535 154.5.24.90 (talk) 23:23, 29 July 2020 (UTC)

We do not permit articles in the popular press to be used as sources for medical information. And even if this was a scientific paper, in the context of medical research it would be a primary source and we do not generally permit those to be used as sources either. See WP:MEDRS for more info. Anywikiuser (talk) 10:27, 30 July 2020 (UTC)

But now that the information is being presented as a timeline, then the article could be mentioned, as a historical point. (His opinion is just as valid as Peter Horby's.) In that vein, suggest include https://www.whio.com/home/coronavirus-whats-next-ohio-ohio-bans-hydroxychloroquine-treatment-covid-19/CDOQOBAWWVF6PG2LGTHXHMPRXI/ (Ohio pharmacy board subsequently reverses rule banning off-label prescription of HCQ.). Drsruli (talk) 12:36, 31 July 2020 (UTC)

@154.5.24.90: They DO quote from Dr Risch earlier scientific paper, see note 87, drawn from Risch, Harvey A. (27 May 2020). "Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis". American Journal of Epidemiology. doi:10.1093/aje/kwaa093. PMID 32458969. S2CID 218909081. Drsruli (talk) 13:17, 31 July 2020 (UTC)

Opening needs reconsideration

Please correct a sentence in the first paragraph:

"HCQ is being studied to prevent and treat coronavirus disease 2019 (COVID‑19)".

No, the datasets for the *agents* is being "reviewed". As written, this sentence is misleading. From source 3 "Rethinking the role of hydroxychloroquine in the treatment of COVID‐19":

"In this article, we review the datasets that support or detract from the use of these agents for the treatment of COVID‐19".

It is still under active study for the disease (though study after study shows it doesn't work). TylerDurden8823 (talk) 19:04, 2 August 2020 (UTC)

But that would need a source. A review and a study are not the same thing in academic and professional nomenclature. That statement needs either a new source to support the claim that it's under active study, or that statement needs to be edited. — Preceding unsigned comment added by 67.247.199.33 (talk) 20:28, 3 August 2020 (UTC)

Extended-confirmed-protected edit request on 3 August 2020

Using this drug to combat COVID19 was studied and the science has show it to be ineffective. The page should be edited to reflect facts.

There are citations in the article, some of which refer to the drug as being under current testing. Those studies have concluded and the drug has no effect on the virus.

A google news search for "Hydroxychloroquine covid19" without quotes should back my claims.

Thank you. Alex M Santos (talk) 17:45, 3 August 2020 (UTC)

google uses an algorithm to weight the order of appearance of the articles. Using other search engines will yield somewhat different results. And performing your search using https://aapsonline.org/?s=Hydroxychloroquine or scholar.google.com may leave a different impression entirely. Drsruli (talk) 20:07, 3 August 2020 (UTC) 19:58, 3 August 2020 (UTC) — Preceding unsigned comment added by Drsruli (talk • contribs)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270792/ — Preceding unsigned comment added by Drsruli (talk • contribs) 21:10, 3 August 2020 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. ~ Amkgp 💬 18:24, 4 August 2020 (UTC)

He's highlighting that the article contains a timeline. And in the last 7 weeks, there's probably 20 items that could be added (equivalent in nature to what is already up there). Maybe due for an update... Drsruli (talk) 21:36, 5 August 2020 (UTC)

https://www.cnn.com/2020/05/27/americas/salvador-president-coronavirus-hydroxychloroquine-intl/index.html

https://nypost.com/2020/08/08/nyc-councilman-credits-hydroxychloroquine-for-covid-19-recovery/

https://www.ny1.com/nyc/all-boroughs/news/2020/05/12/nyu-study-looks-at-hydroxychloroquine-zinc-azithromycin-combo-on-decreasing-covid-19-deaths

https://www.whitehouse.gov/briefings-statements/joint-statement-united-states-america-federative-republic-brazil-regarding-health-cooperation/

https://7news.com.au/sunrise/on-the-show/coronavirus-australia-clive-palmers-foundation-buys-millions-of-doses-of-hydroxychloroquine-c-995714

https://aapsonline.org/hcqsuit/

https://icjournal.org/DOIx.php?id=10.3947/ic.2020.52.e43

https://www.dawn.com/news/1570211/study-claims-hydroxychloroquine-is-safe-effective-to-cure-covid-19

https://healthwise.punchng.com/nigerian-researchers-find-chloroquine-hydroxychloroquine-effective-for-covid-19-prevention/

https://www.tevapharm.com/news-and-media/latest-news/teva-to-donate-potential-covid-19-treatment-hydroxychloroquine-sulfate-tablets-to-hospitals-nationwide/

https://www.bbva.com/en/hydroxychloroquine-may-have-favorable-results-in-humans-infected-with-coronavirus/

https://www.businesswire.com/news/home/20200408005387/en/Sermo-Reports-Hydroxychloroquine-Usage-Expands-Globally-Plasma

https://dailynewsegypt.com/2020/06/06/health-ministry-keeps-hydroxychloroquine-in-covid-19-treatment-protocol-removes-tamiflu/

https://www.saudi24news.com/2020/06/an-egyptian-minister-reveals-the-results-of-the-drug-hydroxychloroquine-on-coronary-patients-the-main-health-statement.html

https://www.palmerfoundation.com.au/hydroxychloroquine-is-currently-being-used-with-great-success-qatar-has-a-case-fatality-rate-of-only-0-04-with-21-deaths-out-of-43714-cases/

https://www.youtube.com/watch?v=VbkGlfkrNB0&t=555s

https://www.cbsnews.com/news/hydroxychloroquine-coronavirus-covid-19-treatment-turkey/

https://www.belarus.by/en/press-center/press-release/belarus-to-receive-potential-effective-drug-for-covid-19-treatment_i_112034.html

https://timesofoman.com/article/3014038/oman/health/covid-19-oman-receives-hydroxychloroquine-tablets-from-india

https://www.arabnews.com/node/1662476/middle-east

https://webcache.googleusercontent.com/search?q=cache:MtDg65s2OmYJ:www.hifmradio.com/oman/muscat-daily-oman-news/complications-with-hydroxychloroquine-unseen-in-oman/&hl=en&gl=us&strip=1&vwsrc=0

https://omannews.gov.om/NewsDescription/ArtMID/392/ArticleID/11905/Health-Ministry-Gets-1-Million-Hydroxychloroquine-Tablets

https://economictimes.indiatimes.com/news/politics-and-nation/india-sending-hydroxychloroquine-to-55-coronavirus-hit-countries/articleshow/75186938.cms?from=mdr

https://www.wionews.com/india-news/india-to-send-second-consignment-of-hydroxychloroquine-to-uae-296310

https://twitter.com/niro60487270/status/1256642227230498816

https://www.thehindu.com/news/international/coronavirus-israel-pm-netanyahu-thanks-india-for-delivering-hydroxychloroquine/article31305220.ece

https://www.israel21c.org/israels-teva-donating-potential-covid-19-treatment-to-us-hospitals/

https://www.haaretz.com/israel-news/.premium-what-we-did-right-israeli-doctors-explain-how-they-beat-coronavirus-1.8849374

https://apnews.com/Business%20Wire/8075f513189d40c4bd2dd46b528202e0

https://www.prnewswire.com/news-releases/more-evidence-presented-for-why-hydroxychloroquine-should-be-made-available-in-a-new-court-filing-by-the-association-of-american-physicians--surgeons-aaps-301098030.html

https://jewishjournal.com/israel/314230/two-coronavirus-patients-improve-after-using-israeli-drug/

https://www.precisionvaccinations.com/teva-pharmaceutical-hydroxychloroquine-sulfate-tablets-will-be-distributed-through-hospitals

https://justthenews.com/politics-policy/coronavirus/bahrain-hydroxychloroquine-success-response-covid-19

https://english.alarabiya.net/en/News/gulf/2020/03/26/Bahrain-one-of-the-first-countries-to-use-Hydroxychloroquine-to-treat-coronavirus

https://www.trialsitenews.com/bahrain-health-authority-observes-some-success-with-use-of-hydroxychloroquine-against-covid-19/

https://twitter.com/niro60487270/status/1260588201179144193

https://www.arabnews.com/node/1664176/middle-east

https://www.bna.bh/en/BahrainreceivesshipmentofHydroxychloroquine.aspx?cms=q8FmFJgiscL2fwIzON1%2BDm7FLOC7Lsjd6bT6rb7fE4c%3D

https://www.thenational.ae/world/gcc/bahrain-says-anti-malarial-drug-proving-effective-in-battling-coronavirus-1.996968

https://www.thestar.com.my/news/world/2020/03/25/covid-19-bahrain-one-of-the-first-in-the-world-to-use-hydroxychloroquine-for-treatment

https://www.al-monitor.com/pulse/originals/2020/03/bahrain-claim-success-anti-malarial-drug-coronavirus.html

https://www.reddit.com/r/China_Flu/comments/fpaibx/belgium_joins_bahrain_in_affirming_coronavirus/

https://www.preprints.org/manuscript/202004.0381/v1/download

https://al-bab.com/blog/2020/05/covid-19-algeria-and-morocco-continue-using-chloroquine-despite-concerns

https://www.youtube.com/watch?v=6kkNntDc3c8

https://www.sdjewishworld.com/2020/06/29/coronavirus-and-political-medicine/

https://www.bna.bh/en/SCHPresidentBahrainstherapeuticprotocolprovedeffective.aspx?cms=q8FmFJgiscL2fwIzON1%2bDmX4XVZ8fQTmaJ3pfQVhjK0%3d

https://www.moh.gov.bh/COVID19/Details/4180

https://english.alaraby.co.uk/english/news/2020/5/8/syria-labs-churn-out-anti-malarial-drug-for-coronavirus-treatment

http://joannenova.com.au/2020/08/countries-that-use-hydroxychloroquine-may-have-80-lower-covid-death-rates/

https://hcqtrial.com/

https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwaa152/5873640

https://justthenews.com/politics-policy/coronavirus/yale-epidemiologist-accuses-fauci-running-disinformation-campaign

https://justthenews.com/politics-policy/coronavirus/hldbill-gates-says-hydroxychloroquine-has-severe-side-effects-little

https://www.thedesertreview.com/opinion/columnists/open-letter-to-dr-anthony-fauci-regarding-the-use-of-hydroxychloroquine-for-treating-covid-19/article_31d37842-dd8f-11ea-80b5-bf80983bc072.html

Blatant incorrect information

In the second paragraph, blatant incorrect information is used. Hydroxychloroquine sulphate is not hydroxychloroquine. Hydroxychloroquine sulphate uses hydroxychloroquine as its base. I've read many articles about hydroxychloroquine and all of them state that hydroxychloroquine is safe and of course I mean safe when prescribe by a doctor. I won't be editing anything here as this is so politically charged, and what I mean is, many Wikipedia editors are so anti-Trump that they allow incorrect information into Wikipedia articles. Leveni (talk) 20:45, 4 August 2020 (UTC)

Nonsense. TylerDurden8823 (talk) 04:32, 4 August 2020 (UTC)

The fact that these side-effects exist and are mentioned does not represent an attempt to discredit the drug, which is an accepted treatment for malaria. Virtually all medicines have unwanted side-effects, especially if the dose is too big. The OP would have been better discussing the issue from an empirical and scientific perspective instead of digressing into baseless accusations of political bias. Anywikiuser (talk) 13:55, 4 August 2020 (UTC)

At least all reference to Hydroxychloroquine sulphate and anything else that is not Hydroxychloroquine needs to be deleted.Leveni (talk) 16:45, 5 August 2020 (UTC)

Hydroxychloroquine sulphate really is hydroxychloroquine, for almost all practical purposes and the side-effect profile should be nearly identical when adjusted for dosage, excepting any sensitivities related to sulphate. Suggest that OP is perhaps confusing with VETERINARY chloroquine phosphate, which has been reported to have significant toxicity (presumably through ease of overdose). Drsruli (talk) 21:45, 5 August 2020 (UTC)

Thanks Drsruli, I want to do an edit for this article but only have 405 edits, but I require 500 to edit this article. So, I'd like somebody else to edit it for me as follows, or similar, in the first sentence:

Hydroxychloroquine, also known as hydroxychloroquine sulfate,... ref: https://www.cdc.gov/malaria/resources/pdf/fsp/drugs/hydroxychloroquine.pdf,

The compounds are theoretically different but for their use in studies the terminology is interchangable. Leveni (talk) 06:45, August 2020 (UTC)

The article already says "It is frequently sold as a sulfate salt known as hydroxychloroquine sulfate" and, not quite correctly, "Other names" - "Hydroxychloroquine sulfate, HCQ". Actually, it is not a different name, but a different, but closely related compound with the same medical effects.

BTW, you got your first contribution wrong:

many Wikipedia editors are so anti-Trump that they allow incorrect information into Wikipedia articles

should be

"many Wikipedia editors are so anti-incorrect-information that they do not allow using Trump as a source for Wikipedia articles"

The problem is that trumpkins will interpret every bit of information that contradicts their lying idol as politically motivated fake news. --Hob Gadling (talk) 13:06, 7 August 2020 (UTC)

I agree. Another example is Obama never being called out for his administrations making of cages for people crossing the Mexican boarder and he never will be called out for it. Hydroxychloroquine has been safe for many years, but all of a sudden it is no longer safe and the reason for this is the anti-Trump attitude that exists. Anyway, I think my edit is reasonable. Leveni (talk) 21:22, 7 August 2020 (UTC)

It's clear from the very nature of your comments that the editor with the POV editing issue is you. Your claim of "anti-Trump" bias here betrays your own pro-Trump bias. And your "but what about Obama" non sequitur makes that bias even more transparent. Since it's quite clear that you are likely incapable of editing without allowing your personal politics to taint your contributions, it's probably best that you recuse yourself, not only from this article - but others of current political hot button interest. Because otherwise, while I wouldn't do it, you certainly invite, and leave yourself vulnerable to, others reviewing all your prior edits for, dare I say, any additional, possible POV pushing vios and subsequent actions. X4n6 (talk) 08:07, 11 August 2020 (UTC)

Feel free to add the cages thing to the Obama page, with reliable sources. But - if he has not been "called out for it", as you say, then those sources do not exist and there you have your reason for it not being in the article.

HCQ has been safe enough for treating malaria, lupus, and some other maladies because it actually works against those, so the benefits outweigh the risks. It does not seem to work against COVID-19, so the risks outweigh the benefits. --Hob Gadling (talk) 04:39, 8 August 2020 (UTC)

The 65year old drug, dosed 5million times annually was regarded safer than Tylenol magically until Trump mentioned it. — Preceding unsigned comment added by 2601:46:C800:2260:DFD:C69B:4927:494B (talk) 18:30, 17 August 2020 (UTC)

I disagree with this reversion

https://en.wikipedia.org/w/index.php?title=Hydroxychloroquine&diff=971056225&oldid=970733714

Trim it, perhaps, but I would argue that the bulk of the traffic to this article is driven by people seeking to determine the veracity of claims, and that should be right up top. Maybe later it can come out. soibangla (talk) 23:05, 3 August 2020 (UTC)

No, this is an article about a drug, not about news or opinions driven by politics and unscientific promotion; WP:NOTNEWS, WP:RECENTISM, WP:NOTSOCIAL. Zefr (talk) 23:09, 3 August 2020 (UTC)

I think it should it stay: https://pageviews.toolforge.org/?project=en.wikipedia.org&platform=all-access&agent=user&redirects=0&start=2019-08&end=2020-07&pages=Hydroxychloroquine soibangla (talk) 23:15, 3 August 2020 (UTC)

There is also the misinformation related to the Covid-19 pandemic article. Anywikiuser (talk) 09:42, 4 August 2020 (UTC)

Agree with Zefr here; and besides, this article ALSO has an entire section dedicated to this issue which would be found listed immediately below the introduction, anyway. Drsruli (talk) 22:07, 5 August 2020 (UTC)

‘Ineffective’ should be changed to ‘unclear’

According to the article’s abstract, the use of HCQ has been proven ‘innefective’, whole every single one of the cited articles says that evidence is ‘unclear’ (side-effects aside).

I recommend modifying the term so that the article corresponds better to the cited evidence. — Preceding unsigned comment added by 200.104.142.101 (talk) 12:59, 5 August 2020 (UTC)

"Ineffective" means its effect is zero, plus or minus some measuring uncertainty (lets call it epsilon). "Unclear" means it is either zero or it has another value that is smaller than a certain boundary that depends on the accuracy of the measurements that have already been done and failed to find an effect (let's call that boundary epsilon). As you can see, mathematically, the meaning of both is the same.

But the second way of putting it is used by people who either want to hide the fact that the effect is so close to zero that people have not been able to measure it, or did not notice that fact. --Hob Gadling (talk) 19:26, 5 August 2020 (UTC)

Wikipedia is more precise, than the evidence that it cites, in some cases. Drsruli (talk) 22:28, 5 August 2020 (UTC)

Is this supposed to be reason for or against anything? --Hob Gadling (talk) 05:59, 6 August 2020 (UTC)

It has been found by statistical analysis to be ineffective, which does not necessarily mean there is zero chance it is effective. It remains possible it is effective. Similarly, by statistical analysis it has been determined that the sun will rise tomorrow, but there is a non-zero chance it won't. It's possible. soibangla (talk) 22:44, 5 August 2020 (UTC)

Technically, the sun never rises; the earth turns. Right? Drsruli (talk) 00:39, 6 August 2020 (UTC)

Could you people please learn how to indent? I do not know what Soibangla is answering to. Possibly me. If yes: Wikipedia does not mention every possibility. It follows the reliable sources.

I changed some of your indentation. --Hob Gadling (talk) 05:59, 6 August 2020 (UTC)

How about "...all clinical trials conducted during 2020 failed to show that it is effective..." or "...all clinical trials conducted during 2020 failed to prove efficacy ..." That makes the meaning unambiguous, I think. HandsomeMrToad (talk) 06:42, 14 August 2020 (UTC)

• In such cases Wikipedia (in common with much RS) often has the formulation "there is no good evidence that ... " Alexbrn (talk) 07:07, 14 August 2020 (UTC)

Editors of The Lancet and the New England Journal of Medicine pressured to publish papers

The following information was removed from COVID-19 section of the article as the source was found weak. Sharing it for information below. If any strong source is found, this information can be added in the article.

"Later it was accepted by the editors of journals like The Lancet and The New England Journal of Medicine that they published the papers showing HCQ in negative light for the treatment of COVID-19 under pressure of financially powerful pharma companies."

References

Thank you. -- Dr. Abhijeet Safai (talk) 05:29, 7 August 2020 (UTC)

Health Impact News is a source of misinformation. Alexbrn (talk) 06:04, 7 August 2020 (UTC)

I should point out that pharmaceutical companies do not gain anything if an effective treatment is mistaken as ineffective, but do gain a lot if an ineffective treatment is mistaken as effective. Not every single unfavourable result in a clinical trial is trustworthy, of course, but it's why "X is suppressing a cure for Y" theories should be greeted with scepticism. Anywikiuser (talk) 22:32, 7 August 2020 (UTC)

HCQ is a generic drug for many years and cheap. The billions to be made go to the vaccines and the Israeli antiviral newer antivirals. There is nothing sexy about HCQ; it's like chicken soup and Vitamin C. The profit motive is much greater, to suppress HCQ. Drsruli (talk) 00:44, 8 August 2020 (UTC)

As Anywikiuser said, pretending that something you manufacture does not work makes no sense.

It does not suddenly become a good idea if that thing is "not sexy" or if something else is sexier.

Independent of your bad logic, this page is for improving the article, not for spreading conspiracy theories. --Hob Gadling (talk) 04:48, 8 August 2020 (UTC)

Pretending [something that anybody could manufacture] doesn't work, makes plenty of sense, if you want them to buy something more expensive. There are conspiracy theories on both sides of this issue. But if the conspiracy is to have a financial motive, then it really only makes sense from one side. (Political basis for conspiracy would work both ways.) (And of course, just because a theoretical profit motive exists, in no way establishes any reality to any proposed conspiracy.) The article that OP mentioned has been reproduced on over 40 sites verbatim, none of them credible sources, and most of them even sketchier than 'Health Impact News'. I couldn't find any recognized outlet that touched that particular story yet, and it's been circulating for two months. (Also, the content of the article, does not seem to support the allegation of the headline.) Drsruli (talk) 09:09, 8 August 2020 (UTC)

Besides, theoretical profit motive notwithstanding, it would have been stupid for Pharmaceuticals to lean on the journal editors, and if they had, then the paper would have been recognized as fraudulent immediately and never been published. For the same reason that it was immediately retracted once the error had been identified. The editors just made a dumb mistake (presumably in the heat of all the virus hubbub). Drsruli (talk) 09:38, 8 August 2020 (UTC)

It was a bad idea of Anywikiuser to start this, and it was a bad idea of me to continue it. Conspiracy theorists will not be discouraged by logic.

Again:

This. Page. Is. For. Improving. The. Article.

Got it now? --Hob Gadling (talk) 13:30, 9 August 2020 (UTC)

Yeah, I was confused by both of you. Drsruli (talk) 19:21, 9 August 2020 (UTC)

I realise it may be unwise to continue this thread, but there is something I want to single out as being particularly contemptible: the idea that a conspiracy to hide a treatment involves an 'Israeli antiviral'. If viewed in isolation, it would be nothing more than a baseless, nutty conspiracy theory that would deserve no further comment. But it's also worth noting that this fits with a centuries-old tradition: every time misfortune strikes, some people will invent a reason to blame the Jews. Except nowadays, to avoid being too politically incorrect, 'Israel' or some similar dog whistle is used instead of 'the Jews'. It may be a centuries-old tradition but it deserves no respect or accommodation in public life, and especially not on a website devoted to knowledge. Anywikiuser (talk) 11:03, 11 August 2020 (UTC)

Perhaps I wasn't clear, above, in my initial comments. I was saying that even though Pharmaceutical companies would benefit disproportionately and decidedly from the failure of a solid treatment from a generic medication, the idea that they would have done what was suggested by the headline of the offerred article doesn't make much sense, the article itself doesn't seem to say that such ever happenned, and no mainstream newssource has touched the story in the two months since it was released. I don't think that the Lancet editors were ever contacted by Pharmaceutical companies regarding the study, and they retracted the article very quickly, besides.

I don't think that the story in Health Impact News is reliable (even to the extent that the content fails to live up to the headline).

Drsruli (talk) 22:33, 14 August 2020 (UTC)

I accept that it was not your intention. Please be careful next time. Anywikiuser (talk) 22:50, 14 August 2020 (UTC)

Extended-confirmed-protected edit request on 17 August 2020

Negative side effects not verified by science. Do not spread dis-information here. 188.149.149.125 (talk) 08:31, 17 August 2020 (UTC)

 Not done The side effects are supported by secondary sources. Next time, please be more precise in saying what you want changing and use the "Change X to Y" format. Anywikiuser (talk) 10:45, 17 August 2020 (UTC)

Author of retracted study

The other day I added the fact that the study in the The Lancet in May that was quickly retracted was by the head of the Heart and Vascular Center at Brigham and Women's Hospital, Mandeep Mehra. This was quickly reverted (by a guy who seems to track what I do!) with the comment "Unnecessary. Study was retracted, the gossipy bit about which authors retracted isn't relevant to this article". The point of my edit is not "which authors retracted it"! It was about the fact that the article's main author is a well-known cardiologist. What I added may be "unnecessary", but I think it's worth adding. Of course it's not relevant to the chemistry of this compound or to how it works pharmacologically. But the story of hydroxychloroquine is a bigger story than that. It's about claims and counterclaims, hastily done research, and in this case even apparently fraud (not on the part of Mehra). I think it's instructive that a respected cardiologist (who even has an article on him in Wikipedia) was apparently duped by one of his co-authors. I know that some people say we shouldn't put interesting things into Wikipedia (I may be slightly misquoting them), but does anyone agree with me? Eric Kvaalen (talk) 15:36, 17 August 2020 (UTC)

The authors are listed in the paper, cited by the reference (and visible on mouse-over, not even any need to click on the citation). The relevant facts for this article is that a study was published in the Lancet (where the paper was published is the distinguishing characteristic), and that it was retracted within a matter of days. I'd earlier reverted your edit specifying that an author was a respected cardiologist, as WP:PEACOCK, because it's not relevant how respected any of the authors is. The paper was accepted by a major journal, and retracted. That's a massive error which will damage everyone's career, but it's not relevant to Hydroxychloroquine. Tarl N. (discuss) 15:45, 17 August 2020 (UTC)

For what it's worth, if you want to write an article about the fiasco, that might not be a bad idea. One of the authors (I think it was Mehra Desai corrected) manufactured data and got a bunch of other scientists to analyze what he'd manufactured. As soon as the article hit the public, where people working at the establishments specified as supplying the data could see it, it was immediately obvious the data wasn't real. That resulted in the retraction. One could argue that there should have been a way to catch this earlier, and discussions on medical ethics vs. reliability of data could get quite interesting. But either way, it's not relevant to an article about a particular drug - if it belongs anywhere, it belongs in articles about the fiasco or the authors. Tarl N. (discuss) 15:54, 17 August 2020 (UTC)

Detailed coverage of the scandal is probably better suited to the Surgisphere article. Anywikiuser (talk) 16:27, 17 August 2020 (UTC)

Ah, thank you for that reference. I had misremembered the protagonist. Struck out and corrected above. Tarl N. (discuss) 17:47, 17 August 2020 (UTC)

25 Nations have approved Hydroxychloroquine for covid use and prophylaxis

Why is this article so US and FDA centric? — Preceding unsigned comment added by 2601:46:C800:2260:DFD:C69B:4927:494B (talk) 17:50, 17 August 2020 (UTC)

Either: 1) because they are not following the best available evidence or 2) they only gave HCQ an emergency approval, just as the US FDA did (before later revoking it). Anywikiuser (talk) 18:05, 17 August 2020 (UTC)

So it is not mentioned on the page despite being an encyclopedic fact because you don't like. Maybe you should tell the Israelis about this best available evidence. whom are responsible for more medical advancement and technology than France. Maybe relay it along to the Swiss who followed the FDA, immediately saw a spike in deaths, resumed HCQ use and saw deaths once again drop.  Preceding unsigned comment added by 2601:46:C800:2260:DFD:C69B:4927:494B (Anywikiuser (talk) 18:46, 17 August 2020 (UTC))

We rely on reliable secondary medical sources for medical information, see WP:MEDRS. Anywikiuser (talk) 18:48, 17 August 2020 (UTC)

89percent of all FDA approved cardiac drugs were not double blind peer reviewed and yet FDA approved

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439920/

Oddly I looked at five wikipedia pages for some of these drugs referenced in the NIH study above- Not a single mention on any of the drug's pages lacking the best practices approval and obviously there was never a pandemic of heart attacks. Unlike others, I am ambivalent on correcting the obvious hit piece nature of this page. WP serves as a chronicle of leftist fail, this page will be no different. — Preceding unsigned comment added by 2601:46:C800:2260:DFD:C69B:4927:494B (talk) 18:24, 17 August 2020 (UTC)

The article cited is about the level of evidence for cardiac treatment guidelines, and not the level of evidence required to approve drugs. These guidelines are made by Cadiology associations and have little to do with the FDA.Jancarcu (talk) 16:34, 24 August 2020 (UTC)

nice propaganda

"speculative use of hydroxychloroquine for COVID‑19 threatens its availability for people"

That's false. Hydroxychloroquine has always been widely available, but was restricted because a bunch of anti-Trump governors, medical personnel, and pharmacists didn't want to even consider this drug as being helpful. Some did late study trials intentionally to discredit it and big pharma executives felt threatened and wrote pieces and fake studies to discredit it. Next thing you know people are parroting the fake information on Wikipedia. Seems people have a problem finding out the truth. The studies are all public- read them yourself. https://c19study.com/ When used early it prevents the virus from replicating and saves lives. Countless thousands have died unnecessarily because of such false information. What a tragedy. — Preceding unsigned comment added by Cheap-stock-photos (talk • contribs) 19:01, 25 August 2020 (UTC)

Find good WP:MEDRS sources for your claims, and they will end up in the article. Some random website collecting studies does not cut it. --Hob Gadling (talk) 06:04, 7 September 2020 (UTC)

Yes good sources like those used to discredit HCQ in this article. /s It seems to be a handful of politically/financially motivated people with high Wikipedia edit counts making sure anything with dodgy sources but against HCQ is allowed, anything pro HCQ is rejected. I've sent examples before and they were ignored. The most I've ever gotten from this corrupt rotten bunch (you know who you are) is that yes I suppose the site is due a trimming. Robbymcd (talk) 16:06, 14 September 2020 (UTC)

Article is too USA centric, clear WP:NPOV violatons in medical (!) article

12 hours ago Russia updated the list of drugs for COVID-19, HCQ is still there (for light and middle level COVID). There may be other countries (France prohibited HCQ, Israel did not). There should be a list of countries that use HCQ for COVID. Also there should be a probability of heart conditions HCQ causes and so clarification why it is still authorised for other uses. 91.78.221.238 (talk) 01:30, 7 September 2020 (UTC)

New Systematic Review - September 2020

According to WP:MEDASSESS, Systematic Review is the highest level of evidence for this topic. The most recent Systematic Review is titled: Hydroxychloroquine is Effective and Safe for the Treatment of COVID-19, and May be Universally Effective When Used Early Before Hospitalization: A Systematic Review The link is here: https://www.researchgate.net/publication/344103059_Hydroxychloroquine_is_Effective_and_Safe_for_the_Treatment_of_COVID-19_and_May_be_Universally_Effective_When_Used_Early_Before_Hospitalization_A_Systematic_Review

" RESULTS HCQ was found consistently effective against COVID-19 when used early, in the outpatient setting. It was found overall effective. No credible study found worse outcomes with HCQ use. No mortality or other serious safety issue was found CONCLUSIONS HCQ is consistently effective against COVID-19 when used early in the outpatient setting, it is overall effective against COVID-19, it has not produced worsening, it is safe."

Please update this article to remove all of the debunked pseudoscience stating that Hydroxchloroquine is ineffective for covid-19 and/or unsafe in light of this evidence.180.150.68.232 (talk) 12:09, 10 September 2020 (UTC)

This just looks like somebody's Word document. Has it actually been published anywhere reputable? Alexbrn (talk) 12:53, 10 September 2020 (UTC)

Here's another systematic review, published the same day, in Naunyn-Schmiedeberg's Archives of Pharmacology:

https://link.springer.com/article/10.1007/s00210-020-01964-5

"Our meta-analysis demonstrated that there was no robust evidence to support prescribing HCQ as a treatment for COVID-19." Capewearer (talk) 13:38, 10 September 2020 (UTC)

A reputable publisher would probably have caught the INTROUCTION typo.

At least there are no sharpie traces in the paper, crossing out the "no" in "no evidence". --Hob Gadling (talk) 16:29, 10 September 2020 (UTC)

"Sharpie" is Trump's reference? Such behaviour is really not acceptable in Wikipedia, wow. Again, when you will add "a probability of heart conditions HCQ causes and so clarification why it is still authorised for other uses"?91.78.221.238 (talk) 06:32, 13 September 2020 (UTC)

Ooh, a quick one.

If it is not acceptable, go report me. Or send an unmarked car to disappear me.

I corrected your wrong indentation, and I have no idea where I could get that information you demand. Why do you think it exists? Do you think this is some sort of restaurant where you can order what you want and get it served promptly? --Hob Gadling (talk) 06:57, 13 September 2020 (UTC)