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--- covid-19:treatments:drug_therapies:hydroxychloroquine [2022/01/02 09:43]
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+++ covid-19:treatments:drug_therapies:hydroxychloroquine [2022/10/05 01:02] (current)
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 ===== Rationale =====
-There are numerous rationale for using HCQ as prophylaxis to prevent SARS-CoV-2 infection and as treatment for COVID-19 patients including immuno-modulatory, immuno-suppression, anti-thrombotic, and in particular [[:antiviral]] properties.((Mar 2, 2021 | [[:Rounding The Earth]] | [[https://roundingtheearth.substack.com/p/the-chloroquine-wars-part-i|Drugs of the Cinchona Tree]])) Since HCQ is relatively inexpensive, and with a good safety history, it need only demonstrate modest efficacy to have a positive [[:risk-benefit]] as a prophylactic or treatment.((Mar 31, 2021| [[:Rounding The Earth]] | [[https://roundingtheearth.substack.com/p/the-chloroquine-wars-part-viii|Hydroxychloroquine's Safety Profile and a Cost-Benefit Analysis]]))
+There are numerous rationale for using HCQ as prophylaxis to prevent SARS-CoV-2 infection and as treatment for COVID-19 patients including immuno-modulatory, immuno-suppression, anti-thrombotic, and in particular [[:antiviral]] properties.((Mar 2, 2021 | [[:Rounding The Earth]] | [[https://roundingtheearth.substack.com/p/the-chloroquine-wars-part-i|Drugs of the Cinchona Tree]])) In particular, antivirals are effective only when used early during infection, so the best uses of HCQ would likely be as prophylaxis or as early ambulatory (outpatient) treatment. Since HCQ is relatively inexpensive, and with a good safety history, it need only demonstrate modest efficacy to have a positive [[:risk-benefit]] as a prophylactic or treatment.((Mar 31, 2021| [[:Rounding The Earth]] | [[https://roundingtheearth.substack.com/p/the-chloroquine-wars-part-viii|Hydroxychloroquine's Safety Profile and a Cost-Benefit Analysis]]))
+Additional Research:
+  * [[https://www.amjmed.com/article/S0002-9343(20)30673-2/fulltext| Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection]] by Dr. [[:Peter McCullough]] et al, Aug 6, 2020 in [[:The American Journal of Medicine]].
 See also [[covid-19:treatments:drug_therapies:zinc ionophores]]
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 ==== Prior Research ====
 Since shortly after the first [[:SARS-CoV]] outbreak, researchers compiled evidence that chloroquine and hydroxychloroquine would likely help fight another deadly [[:coronavirus]] outbreak.((Mar 25, 2021 | [[:Rounding The Earth]] | [[https://roundingtheearth.substack.com/p/the-chloroquine-wars-part-vii|Why Did Dr. Anthony Fauci Leave Hydroxychloroquine Off the Early Pandemic Research Priority List?]]))
+  * In 2005, researcher Martin Vincent and colleagues noted that chloroquine is a potent inhibitor of SARS coronavirus infection and spread.((August 22, 2005 | Vincent et al | [[:Virology Journal]] | [[https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-2-69|doi: 10.1186/1743-422X-2-69]]))
-==== Antiviral Properties ====
+==== Antiviral Properties Research (Mechanisms) ====
+  * Hydroxychloroquine blocks SARS-CoV-2 entry into the endocytic pathway in mammalian cell culture((September 14, 2022 | Zixuan Yuan et al | Nature (journal) | Hydroxychloroquine blocks SARS-CoV-2 entry into the endocytic pathway in mammalian cell culture | [[https://www.nature.com/articles/s42003-022-03841-8|doi.org/10.1038/s42003-022-03841-8]]))
 ===== Evidence for Prophylaxis =====
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 ===== Evidence Supporting HCQ Use in Treatment =====
+Evidence supporting HCQ's substantial evidence as an early therapeutic is quite strong, both in published literature, and in statements made by physicians successfully caring for large numbers of COVID-19 patients.
+==== Meta-Analysis of HCQ Studies ====
+A substantial majority of published [[:randomized control trials]] (RCTs) examining HCQ efficacy showed patients in the treatment arm performing better by numerous metrics than those who did not receive HCQ.((Mar 13, 2021 | [[:Rounding The Earth]] | [[https://roundingtheearth.substack.com/p/the-chloroquine-wars-part-v|A Closer Look at RCTs Studying Hydroxychloroquine Efficacy]]))
   * [[https://www.aestheticsadvisor.com/2021/02/hydroxychloroquine-Zinc-Yale-Study-Harvey-Risch.html|Yale Study]]
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 ==== Media Blitz ====
-Throughout the pandemic, the media parroted incorrect statements suggesting the both [[:chloroquine]] (CQ) and HCQ were dangerous drugs, which is not generally true.
+Throughout the pandemic, the media parroted incorrect statements suggesting the both [[:chloroquine]] (CQ) and HCQ were dangerous drugs, which is not generally true. More damaging was the logically incorrect interpretation of research at multiple levels. Dr. [[:Anthony Fauci]] and numerous other physicians were often interviewed sharing the plainly illogical((Mar 17, 2021 | [[:Rounding The Earth]] | [[https://roundingtheearth.substack.com/p/the-chloroquine-wars-part-vi|The Simple Logic of the Hydroxychloroquine Hypothesis]])) interpretation that one or a small number of studies could demonstrate the inefficacy of HCQ.
 ==== Tainted Research ====
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 "The hypothesis that the 4-aminoquinolines chloroquine and hydroxychloroquine may be beneficial in the treatment of COVID-19 is a weak one, based on poor mechanistic reasoning and inconsistent results of studies in vitro, in laboratory animals, and in humans."
+  * [[https://www.cureus.com/articles/76496-therapies-to-prevent-progression-of-covid-19-including-hydroxychloroquine-azithromycin-zinc-and-vitamin-d3-with-or-without-intravenous-vitamin-c-an-international-multicenter-randomized-trial|Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial]]