"Dr Jeff Colyer, the former governor of Kansas who is a practicing physician, reported Sunday in the Wall Street Journal that the combination of hydroxychloroquine and azithromycin is continuing to show "promising" results in coronavirus patients.
From The Wall Street Journal:
In the fight against Covid-19 though we might look forward in doom, one day we will look backward in awe. In an article last week, I discussed a promising drug combination to treat the disease. There is now new data supporting this treatment. Since then, Kansas City area physicians, including Joe Brewer, Dan Hinthorn and me, continue to treat many patients, and some have shown improvement. Major medical centers including the University of Washington and Mass General have added hydroxychloroquine to treatment options. [...]
Physicians are using two drugs in combination—hydroxychloroquine and azithromycin, which I’ll abbreviate HC and AZ—to treat patients with advanced Covid-19 symptoms. We use a regimen reported in a recent open-label trial in Marseille, France, which was updated March 26, and which doctors may modify in any given case.
[...] Clinical information has also emerged from Covid treatment. During the initial Chinese outbreak, Wuhan doctors observed that patients with lupus—a disease for which HC is a common treatment—did not seem to develop Covid-19. Of 178 hospital patients who tested positive, none had lupus and none were on HC. None of this Wuhan hospital’s dermatology department’s 80 lupus patients were infected with the novel coronavirus. The Wuhan doctors hypothesized that this may be due to long-term use of HC. They treated 20 Covid-19 patients with HC. Their result: “Clinical symptoms improve significantly in 1 to 2 days. After five days of chest CT examination, 19 cases showed significant absorption improvement.”
Second, consider AZ—the antibiotic marketed as Z-Pak—combined with HC. The French study showed that 57% of 14 Covid-19 patients receiving HC without AZ tested negative for the virus on a nasal swab on day six. But 100% of the six patients who received both HC and AZ tested negative on day six. Compare that with 16 infected patients at another hospital who didn’t receive either treatment: only 12% tested negative on day six. These are small samples, but significant.
The authors of the French study last week published the results of an additional 80 hospitalized patients receiving a combination of HC and AZ. By day eight of treatment, 93% showed a negative nasopharyngeal swab for the virus. “This allowed patients to rapidly be discharged from highly contagious wards with a mean length of stay of five days,” the authors write. “Other teams should urgently evaluate this cost-effective therapeutic strategy, to both avoid the spread of the disease and treat patients as soon as possible before severe respiratory irreversible complications take hold.” I agree." informationliberation
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Well, pilgrims? pl
Fred
Osteoarthritis while quite debilitating is quite different than Rheumatoid arthritis. I work as physical therapy assistant and was treating a gentleman whose wife with RA would get very quick onset pneumonia.
"RA is known to be associated with an increased risk of serious infection. Even more than 50 years ago, observational studies showed a greater than 2-fold increased risk of serious infection in RA. This was reinforced by various subsequent cohort studies. The elevated susceptibility of patients with RA can be explained by the pathobiology of the disease itself, the impact of chronic comorbid conditions, as well as sequelae of immunosuppressive treatment. It has been suggested that premature ageing of the immune system in RA contributes to weakened protection against infectious organisms. In addition, chronic comorbid conditions such as diabetes or chronic lung or kidney disease, disease-related functional disability, as well as lifestyle factors such as smoking, increase the risk in individual patients. For a long time glucocorticoids (GCs) have been used as potent immunosuppressive drugs in RA. There is evidence that they increase the risk of serious infections up to 4-fold in a dose-dependent manner. TNF-α inhibitors increase the serious infection risk up to 2-fold. They have, however, the potential to outweigh their risk when higher GC doses can be tapered down. If patients need higher dosages of GCs in addition to treatment with biologic agents, their risk of infection is substantial. This combination should be used carefully and, if possible, avoided in patients with additional risk factors such as older age or comorbid conditions."
https://www.ncbi.nlm.nih.gov/pubmed/23192911
Posted by: Terence Gore | 02 April 2020 at 06:52 PM
Fred
Sorry that was worked as in past tense. I also should have been more clear in my original post as regard to RA. Since we were discussing Plaquenil my background would suggest RA as a given
Posted by: Terence Gore | 02 April 2020 at 07:08 PM
JJackson,
It appears they are digging into exactly how this virus kills, and according to this it's the victim's own immune system that's the enemy in a lot of cases, particularly the younger ones. About 15% of the population carries traits that makes them suceptable to a cytokine storm reaction. This accounts for those who get sick, seem to get better, and suddenly fail.
https://www.nytimes.com/2020/04/01/health/coronavirus-cytokine-storm-immune-system.html
The good news is suppressing the immune system is fairly old-hat. The caveat: Not a simple matter for people to prescribe for themselves.
Sound plausible?
My confirmation bias is going ape with it. We may be close to effective therapeutics. Whole 'nother game if so.
Posted by: Mark K Logan | 02 April 2020 at 07:18 PM
Dang. All the world health agencies missed it and Z-pac too. Are we the smartest dudes on earth or what?
Posted by: zartogg2 | 04 April 2020 at 10:29 PM