[1] [2] Entre outras aplicações, pode ser usada no tratamento de artrite reumatoide, lúpus eritematoso, porfiria cutânea tarda, febre Q e doenças fotossensíveis. “Internet sleuths … got to work on the very heavy doses of the drug that were given – 2400 mg in the first 24 hours, a ‘dose fit for a gorilla’ as one critic had it,” wrote Fordham. • The U.K. Recovery Trial 23, 24, 25 — Funded in part by the Bill & Melinda Gates Foundation, Wellcome Trust and the U.K. government through Oxford University, 26 this study randomly assigned patients to usual care or to one of five primary drug treatments: lopinavir-ritonavir; a corticosteroid (low-dose dexamethasone); hydroxychloroquine; tociizumab; or azithromycin. As pointed out by Edmund Fordham, the RECOVERY trial used insanely high doses of a different form chloroquine to “prove” that the drug is dangerous and does not work. Some hydroxychloroquine trials are continuing, such as the very large RECOVERY trial in the UK. The trial was approved by Medical Research and Ethics Committee (MREC), MOH on 25 May 2021. The UK has had the ignominious triumph of having one of the world’s highest death rates. We were surprised by the hydroxychloroquine dose chosen in the Randomized Evaluation of Covid-19 Therapy (RECOVERY) trial conducted by Horby et al. Hydroxychloroquine (this arm of the trial has ceased recruitment, as no benefit demonstrated) ... Dexamethasone at a dose of 6mg/day given for 10 days reduces 28-day mortality in patients with COVID-19. The investigators hypothesize that a 400mg per day dose of hydroxychloroquine for 10 days will reduce all-cause hospital mortality in patients with severe respiratory COVID-19 disease. Thirty-nine percent of the subjects in Brazil who were given high doses of chloroquine died, average age 50. Why Did We Consider Chloroquine as A Potentially Useful Drug? Yet the Solidarity and Recovery hydroxychloroquine trials continued into June, stopping only after their extreme doses were exposed. The decision was motivated by the following statement " although it is not showing toxicity or causing more deaths, this drug does not work”. The trial has tested ten interventions on adults: eight repurposed drugs, one newly developed drug and convalescent plasma. The evidence from the RECOVERY trial has shown hydroxychloroquine, once considered a promising therapeutic candidate for COVID-19, has no clinical benefit for hospitalised patients. The study drugs were remdesivir, hydroxychloroquine, lopinavir (fixed-dose combination with ritonavir) and interferon-β1a (with and without lopinavir). RECOVERY is a randomised trial investigating whether treatment with Lopinavir-Ritonavir, Hydroxychloroquine, Corticosteroids, Azithromycin, Colchicine, IV Immunoglobulin (children only), Convalescent plasma, Synthetic neutralizing antibodies (REGN-COV2), Tocilizumab, Aspirin, Baricitinib, Infliximab or Anakinra (children only) prevents death in patients with COVID-19. [3] [1] É administrada por via oral. He additionally was central in setting up the UK Recovery trial, where 1,600 subjects were overdosed with hydroxychloroquine. The RECOVERY trial is a randomized trial among hospitalized patients in the United Kingdom [75]. But it is even worse for the following reasons: You have to be close to death, either on a ventilator or in shock, on pressor medications, to be included in the trial, according to the trial … Admitted to hospital 3. The Recovery trial used 1.86 grams hydroxychloroquine base (equal to 2400 mg of hydroxychloroquine) in the first 24 hours for treatment of already very ill, hospitalized Covid-19 patients, a potentially lethal dose. [5] The Recovery trial then became the principal study on which the WHO based its final decision to confirm for all drug agencies suspension of use of hydroxychloroquine for the treatment of COVID-19. The total dosage given to a patient over 11 days is about 9600 mg which is four times higher than the dose we are giving to our patients," informed the official. It goes without saying that when you give the wrong dose of a drug, bad things happen. 114 allocated to hydroxychloroquine (200mg tablet containing 155mg base equivalentsulfate ) 115 received a loading dose of 4tablets (800 mg) at zero and 6 hours, followed by 2 tablets (400 116 mg) starting at 12 hours after the initial dose and … said ‘In March this year, RECOVERY was established as a randomised clinical trial to test a range of potential drugs for COVID-19, including hydroxycholoroquine. We note that there is mounting evidence that hydroxychloroquine is active and tolerable against Covid-19. President Trump has received a dose of an experimental antibody cocktail being developed by the drug maker Regeneron, in addition to several other drugs, including zinc, vitamin D … Blood samples taken from a group of 500 volunteers in the UK who were given a dose of the vaccine showed BOTH antibodies and T cells responses to the virus. She also criticized the now-halted WHO’s Solidarity trial which proposed to use 1,600 mg in the first 24 hours and then 400 mg twice a day for nine more days, according to the Canadian and Norwegian arms of the trial. 3 For the record, the dose we proposed to evaluate in the C-20-15 DisCoVeRy trial (beginning 22 March 2020) was 400 mg twice … But hydroxychloroquine was ruled out as a potential treatment for covid19 quite early on. Every COVID-19 patient in the UK may be invited to participate in the RECOVERY Trial. The RECOVERY trial's biggest flaw was that it used toxic levels of the drug... the maximum recommended dose for hydroxychloroquine is 800 mg per day and the RECOVERY trial used a daily dose of 2400 mg, a dose that is three times higher! Double blinded randomized clinical trial designed to evaluate the security and efficacy of hydroxychloroquine as treatment for COVID-19 severe respiratory disease. RECOVERY TRIAL This trial began on March 13, 2020 in the United Kingdom. We have therefore decided to stop enrolling participants to the hydroxychloroquine arm of the RECOVERY Trial with immediate effect,” a June 5 press release says. The Recovery trial used 1.860 grams hydroxychloroquine base (equal to 2400 mg of hydroxychloroquine) in the first 24 hours for treatment of already very ill, hospitalized Covid-19 patients, a potentially lethal dose. Age ≥18 years 2. While the implications for using hydroxychloroquine to treat COVID-19 in the community or for prevention of COVID-19 remain unclear, if nothing else this study highlights the need to carefully monitor people receiving the drug. ‘The trial has proceeded at unprecedented speed, enrolling over 11,000 patients from 175 NHS For group B, Hydroxychloroquine 400mg first day then 200mg BID + Azithromycin 500mg BID for 5 days were given. The Recovery trial is a … ... Dexamethasone at a dose of 6mg/day given for 10 days reduces 28-day mortality in … A recent prospective randomized clinical trial confirmed that oral treatment with hydroxychloroquine 200 mg BID significantly decreased the time to reach viral RNA negativity and the time to clinical recovery. The Recovery trial used 2.4g of HCQ in the first 24 hours and the Solidarity trial used similar doses . The RECOVERY trial also put some of the final nails in the coffin of hydroxychloroquine, with early termination of the hydroxychloroquine arm. RECOVERY Collaborative Group* 10 . The recovery rate was slower for those given hydroxychloroquine only, and was worse for the control group. According to the release, “Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction [or] disappearance in COVID-19 patients and its effect is reinforced by azithromycin,” the paper concluded. 'IT DOESN'T WORK' Researchers from the Recovery trial said they would share their data with the World Health Organization (WHO), which on Wednesday restarted its own trials of hydroxychloroquine. J. Med. Methods The Randomised Evaluation of COVID-19 therapy (RECOVERY) trial is a randomized, controlled, open-label, platform trial comparing a range of possible treatments with usual … As noted by Zelenko above, the hydroxychloroquine is really only used to drive the zinc in to the cells. Following these findings, on the 15th of January 2021, the RECOVERY trial announced that they had halted recruitment to the convalescent plasma arm of that trial. The revelation was made in an article published in the JAMA in mid-April 2020. 3. Treatments used in the trial include lopinavir-ritonavir, low-dose dexamethasone ... they should carry on with getting a reliable answer on hydroxychloroquine through the Recovery trial. Randomisation includes the following arms: usual care alone; high-dose vs standard corticosteroids; baricitinib and dimethyl fumarate.The trial is designed to have the least possible impact on NHS staff. RECOVERY is a randomized clinical trial from the UK that looked at hydroxychloroquine use in hospitalized patients with COVID-19. 8 Notwithstanding, clearing the ability to detect the virus does not mean that morbidity and mortality from virus are decreased. “Internet sleuths … got to work on the very heavy doses of the drug that were given – 2400 mg in the first 24 hours, a ‘dose fit for a gorilla’ as one critic had it,” wrote Fordham. Double blinded randomized clinical trial designed to evaluate the security and efficacy of hydroxychloroquine as treatment for COVID-19 severe respiratory disease. The investigators hypothesize that a 400mg per day dose of hydroxychloroquine for 10 days will reduce all-cause hospital mortality in patients with severe respiratory COVID-19 disease. Chinese Centre for Disease Control and Prevention includes chloroquine in the treatment guideline for COVID‐19 patients which gave a high recovery rate (94.5%). Although it is disappointing that this treatment has been shown to be ineffective, it does allow us to focus care and research on more promising drugs.’ In the high-dose arm, 2 patients experienced ventricular tachycardia before death. A few weeks ago a press statement was released that claimed a benefit to dexamethasone in patients requiring oxygen and/or ventilatory support. Hydroxychloroquine is reportedly not effective to treat COVID. Nass observes: 44 “The conclusions to be drawn are frightening: The ultrasound substudy will address whether baseline synovitis is a predictor of therapeutic response. (Nov. 19 issue). Professor Peter Horby and Professor Martin Landray, chief investigators of the RECOVERY Trial, said ‘In March this year, RECOVERY was established as a randomised clinical trial to test a range of potential drugs for COVID-19, including … Nass specifically took issue with the United Kingdom’s Recovery trial, which used a 2,000 mg HCQ dose in the first 24 hours and 400 mg every 12 hours for nine more days (pdf). 2020. Much has been written about the roles of these drugs in the treatment of COVID-19 and the scientific debate and political support that hydroxychloroquine, in particular, received. The Recovery trial used 1.860 grams hydroxychloroquine base (equal to 2400 mg of hydroxychloroquine) in the first 24 hours for treatment of already very ill, hospitalized Covid-19 patients, a potentially lethal dose. Hydroxychloroquine, a 4-aminoquinoline with antimalarial and antiautophagic properties, has been identified as a possible prophylactic medication for SARS-CoV-2. In that study, 2,104 participants were randomized to receive dexamethasone (6 mg daily for up to 10 days) and 4,321 were randomized to usual care. Proven or suspected SARS-CoV-2 infection R No additional treatment Lopinavir-ritonavir 400/100 mg bd PO for 10 days Azithromycin 500 mg od PO/IV for 10 days Dexamethasone 6 mg od PO/IV for 10 days Hydroxychloroquine See protocol for dosing The role of hydroxychloroquine (HCQ) in early outpatient management of mild coronavirus disease 2019 (COVID-19) needs further investigation. For group B, Hydroxychloroquine 200mg BID for 10 days and Azithromycin 500mg single daily dose for 5days was given. You stop the trial before the data safety monitoring board has looked at your data, a Professor Peter Horby and Professor Martin Landray, chief investigators of the RECOVERY Trial, said: “There was no significant difference in the primary endpoint of 28-day mortality. ↑ Cao B et al. In particular, we have revealed problems of medical ethics (1)and notorious incompetence (2), and even potentially criminal a… It then came to light that the drug did not have the desired beneficial effects. A major blow for hydroxychloroquine came on 5 June 2020 when British scientists stopped the hydroxychloroquine arm of the Recovery trial. Recovery used highly toxic doses of hydroxychloroquine in over 1500 patients, of whom 396 died. The Recovery trial used 1.86 grams hydroxychloroquine base (equal to 2400 mg of hydroxychloroquine) in the first 24 hours for treatment of already very ill, hospitalized Covid-19 patients. Landray also claimed in an interview with Paris Soir that the maximum allowed HCQ dose was "6 or 10 times" the dose used in Recovery, and that he was using the hydroxychloroquine dose that is used for … There was a study done in 1979 that showed a dose of 1.5-2g of Chloroquine was potentially fatal . N. Engl. A randomized parallel-group trial of 62 patients (non-peer-reviewed) showed shorter time to clinical recovery (without a … 382:1787-1799. ized, controlled trial involving patients who were hospitalized with mild-to-moderate Covid-19 showed that hydroxychloroquine (at a dose of 400 mg twice daily, with or without azithromy- This study was a multicenter, population-based national retrospective-cohort investigation of 28,759 adults with mild COVID-19 seen at the network of Comprehensive Healthcare Centers (CHC) between March and September 2020 throughout Iran. The REMAP-Covid study is using the same HCQ dose as the Recovery trial for 6 days. We have previously covered the RECOVERY trial on St Emlyn’s noting that the first results out of this large pragmatic, adaptive design platform RCT showed no benefit to Hydroxychloroquine. Hydroxychloroquine was just one of a range of potential treatments for Covid-19 being tested in the Recovery trial, run across 176 NHS hospitals and led by scientists at Oxford University. Internet sleuths also got to work on the very heavy doses of the drug that were given – 2400 mg in the first 24 hours, a ‘dose fit for a gorilla’ as one critic had it. Recovery used highly toxic doses of hydroxychloroquine in over 1500 patients, of whom 396 died. The Recovery trial used 1.86 grams hydroxychloroquine base (equal to 2400 mg of hydroxychloroquine) in the first 24 hours for treatment of already very ill, hospitalized Covid-19 patients. Letters from the Chief Medical Officers The Chief Medical Officers of England, Wales, Scotland and Northern Ireland, and the NHS Medical Director, have written to all doctors strongly encouraging participation in the national randomised trials in COVID-19 of which RECOVERY is one. April 24: A trial comparing doses of hydroxychloroquine, stopped at 81 people because too many people taking the higher dose of the drug were dying (not cited by Arshad). The high doses of hydroxychloroquine used in RECOVERY—800 mg at 0 and 6 hours followed by 400 mg at 12 hours and then every 12 hours for up to nine additional days—have raised concern among experts. The link provided below is for convenience only, and is not an endorsement of either the linked-to entity or any product or service. hydroxychloroquine in the Solidarity trial. The trial’s hydroxychloroquine dosage. The Canadian and Norwegian Solidarity trials used 2,000 mg of HCQ, or 1.55 grams of HCQ base in the first 24 hours. Background Hydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease 2019 (COVID-19) on the basis of in vitro activity, uncontrolled data, and small randomized studies. Professor Peter Horby, the chief investigator of the trial, doubled up: ‘The RECOVERY trial has shown that hydroxychloroquine is not an effective treatment in patients hospitalised with COVID-19. April 10: Trial 2, with 62 people (cited by Arshad). The RECOVERY Trial team will constantly review information on new drugs and include promising ones in the trial. N. Engl. 26 A recent study relying on a multinational registry analysis which was published on May 22, 2020, found no evidence of hydroxychloroquine effectiveness to treat COVID‐19. The Recovery trial used 1.86 grams hydroxychloroquine base (equal to 2400 mg of hydroxychloroquine) in the first 24 hours for treatment of already very ill, hospitalized Covid-19 patients, a potentially lethal dose. The Canadian and Norwegian trials used 2,000 mg of HCQ, or 1.55 grams of HCQ base in the first 24 hours. Hydroxychloroquine has been in use for years but it has a number of potentially serious side effects, including heart arrhythmia. Overall, QTcF >500 ms occurred more frequently in high-dose arm (18.9% of patients) than in low-dose arm (11.1%). We did a randomised, double-blind, placebo-controlled, multicentre trial at ten hospitals in Hubei, China. The Protocol provides the doses of hydroxychloroquine used, on page 22. The article by Ceplowicz Rajter et al1 published in CHEST (January 2021), which presents a significant effect of ivermectin at standard dose on COVID-19 mortality rates, raises once again important questions on the significance of observational studies that report posttreatment outcome for COVID-19. A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19. Hydroxychloroquine (related to an anti-malarial drug) Azithromycin (a commonly used antibiotic) Tocilizumab (an anti-inflammatory treatment given by injection) Trial Design. Informal consultation on the dose of chloroquine and hydroxychloroquine for the SOLIDARITY Clinical Trial - 8 April 2020 - Select language - العربية 中文 … This is what their trial document says as well, on page 23. The outcome of the RECOVERY TRIAL can also bring to an end the ongoing debate on the use of Hydroxychloroquine (HCQ). All three trials above that used toxic hydroxychloroquine doses — Recovery, Solidarity and REMAP — also failed to include zinc, which appears to be a key factor. May 4: Trial 3, with 150 people (cited by Arshad). In this study 81 patients with suspected COVID-19 infection were randomised to either high dose chloroquine (600mg twice daily for 10 days) or low dose chloroquine (450mg twice daily on day 1, then 450mg once daily for 4 days). RECOVERY trial design ELIGIBLE PATIENTS 1. 13 manuscript and a complete list of collaborators in the Randomised Evaluation of 14 COVID-19 Therapy (RECOVERY) trial is provided in the Supplementary Appendix. Edmund Fordham wrote a piece on what is an emerging controversy, in which it appears the lead of the RECOVERY trial took hydroxychloroquine for another drug, resulting in a high death rate. 11 . The research on low-dose dexamethasone steroid treatment was a part of the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial that was testing the … Patients were randomly assigned to either get hydroxychloroquine (1,561 patients) or usual care (3,155 patients). HYDROXYCHLOROQUINE - Recovery trial results finally out - and hopefully puts nail in coffin. “The chloroquine or hydroxychloroquine schedule selected for the trial includes two oral loading doses (250 mg per tablet CQ or 200 mg per tablet HCQ), then oral twice-daily maintenance doses for ten days. This meeting convened to discuss the appropriateness of the selected doses for the trial.” The Canadian and Norwegian Solidarity trials used 2,000 mg of HCQ, or 1.55 grams of HCQ base in the first 24 hours. This is a UK based platform trial (more on this later) looking at patients admitted to hospital with Covid-19. 12 *The writing committee and trial steering committee are listed at the end of this . 27 However, this study was retracted after some … The trial was later expanded to Indonesia, Nepal and Vietnam. Statement from the Chief Investigators of the Randomised Evaluation of COVid-19 thERapY (RECOVERY) Trial on hydroxychloroquine, 5 June 2020. These results further strengthened data from the smaller phase 2 clinical trial published last October, which suggested the same nutritional protocol, also referred to as combined metabolic cofactor supplement (CMCS), delivered in conjunction with the Turkish standard of care therapy (hydroxychloroquine), significantly shortened recovery time of mild-to-moderate COVID-19 infected … Oxford professor Peter Horby, the lead investigator on the Recovery Trial, said there was probably a “very large number” of people around the world taking hydroxychloroquine … About the author : Meryl Nass, MD , is an internal medicine physician and activist with expertise in anthrax and bioterrorism; her interest is in prevention, investigation, amelioration, and safe and effective medical response. The Canadian and Norwegian trials used 2,000 mg of HCQ, or 1.55 grams of HCQ base in the first 24 hours. This decision was based on preliminary analysis of data from more than 10,00 patients which showed no significant difference in 28-day mortality (18% vs 18%, RR 1.04, 95%CI 0.95 to 1.14). Limitations: More older patients and more patients with a history of heart disease were randomized into the high-dose arm than into the low-dose arm. As noted by Zelenko above, the hydroxychloroquine is really only used to drive the zinc in to the cells. These doses are also more than four times the doses used in the studies showing successful outcomes. . “We have concluded that there is no beneficial effect of hydroxychloroquine in patients hospitalised with COVID-19. What could be worse than giving potentially lethal doses of hydroxychloroquine to Hospitalized Covid-19 patients? 15 . The Canadian and Norwegian trials used 2,000 mg of HCQ, or 1.55 grams of HCQ base in the first 24 hours. In this trial, we will administer 24 g vitamin C per day for 7 days intravenously. “These first results from the RECOVERY trial are very helpful. 66% improvement for early treatment, p < 0.0001. Uncontrolled, observational studies have already created confusion in the medical … Compared with the first randomised trial to investigate lopinavir–ritonavir in patients with COVID-19 by Cao and colleagues (including the authors of this Comment), 2 the size of the lopinavir–ritonavir group in the RECOVERY trial was much larger and hence provides a more solid evidence base regarding possible lopinavir–ritonavir treatment effects. HIVC has advantages in terms of stability, availability, safety and cost compared with other treatments. 255 HCQ COVID-19 controlled studies. The Recovery trial dosed at 1.86 grams HCQ base (equal to 2,400 mg HCQ) in the first 24 hours, over the potentially fatal dose. A new tack after the withdrawal of The Lancet’s study that had qualified hydroxychloroquine as dangerous … It’s an open label RCT that was developed out of the ASAP trial 1 .ASAP was (still is) a hibernating trial 2 that was designed to test the use of steroids in a future flu pandemic. This review looks at the dexamethasone arm of the RECOVERY trial; Design. The second time, June 17, WHO claimed the stop was in response to the Recovery trial results. 1 In this trial… Some see the solution in continuing lockdowns, more testing and ultimately the vaccine. Co-Principal Investigators of the Recovery trial, Drs. The third scandal, is when asked to justify the 2400mg dose in the first 24 hours, the only conclusion from statements from one of designers of the trial, is that they likely confused Hydroxychloroquine for a drug used for treating amoebic dysentery; hydroxyquinoline. hydroxychloroquine (at a dose of 400 mg twice daily, with or without azithromycin) did not im-prove clinical status at day 15, as compared with usual care.25-29 Here, as part of the controlled, open-label Randomized Evaluation of Covid-19 Therapy (RECOVERY) trial, we report the results of a comparison between hydroxychloroquine and Rationale On the back of these results a number of trials investigating hydroxychloroquine in COVID-19, including a WHO trial, were suspended, after a reassessment of the possible harms from hydroxychloroquine. 16 At the start of the COVID-19 pandemic in France, the doses of hydroxychloroquine sulphate used were mostly derived from those used for the indication of chronic autoimmune disease treatment, with no loading dose and even three administrations per day. In a randomized trial of 1033 hospitalized adults with COVID-19, baricitinib plus remdesivir reduced time to recovery (defined as hospital discharge or continued hospitalization without need for oxygen or medical care) compared with placebo plus remdesivir (7 versus 8 days, RR for recovery 1.16, 95% CI 1.01-1.32) . The second time, June 17, WHO claimed the stop was in response to the Recovery trial results. A prospective controlled clinical trial of hydroxychloroquine with 30 enrolled patients demonstrated no clinical benefit over usual supportive care. “The Canadian and Norwegian trials used 2,000 mg of HCQ, or 1.55 grams of HCQ base in the first 24 hours. Today, the preliminary analysis of just the hydroxychloroquine (HCQ) … The Recovery trial used 1.86 grams hydroxychloroquine base (equal to 2400 mg of hydroxychloroquine) in the first 24 hours for treatment of already very ill, hospitalized Covid-19 patients. The aim of this study was to describe the outcomes of patients with coronavirus disease 2019 (COVID-19) in the outpatient setting after early treatment with zinc, low-dose hydroxychloroquine and azithromycin (triple therapy) dependent on risk stratification. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. Data Safety Committee has put a hold on HCQ trials because it wasn't effective in treating the virus but it could still be used to stop the spread of infection. Methods The Randomised Evaluation of COVID-19 therapy (RECOVERY) trial is a randomized, controlled, open-label, platform trial comparing a range of possible treatments with usual … As pointed out by Edmund Fordham, the RECOVERY trial used insanely high doses of a different form chloroquine to “prove” that the drug is dangerous and does not work. All three trials above that used toxic hydroxychloroquine doses — Recovery, Solidarity and REMAP — also failed to include zinc, which appears to be a key factor. In nonhospitalized patients, the Panel recommends against the use of chloroquine or hydroxychloroquine with or without azithromycin for the treatment of COVID-19, except in a clinical trial (AIIa). The trial has recruited over 11 000 patients to several different arms (treatments, or placebo). RECOVERY is a randomised trial investigating whether treatment with Lopinavir-Ritonavir, Hydroxychloroquine, Corticosteroids, Azithromycin, Colchicine, IV Immunoglobulin (children only), Convalescent plasma, Synthetic neutralizing antibodies (REGN-COV2), Tocilizumab, Aspirin, Baricitinib, Infliximab or Anakinra (children only) prevents death in patients with COVID-19. About the author : Meryl Nass, MD , is an internal medicine physician and activist with expertise in anthrax and bioterrorism; her interest is in prevention, investigation, amelioration, and safe and effective medical response. The RECOVERY trial reported on the outcomes of mortality and hospital discharge. The Panel recommends against the use of high-dose chloroquine (600 mg twice daily for 10 days) for the treatment of COVID-19 (AI). 2020. You mention the “stellar” Recovery trial in the August 5NY Times, but avoid any hint that its hydroxychloroquine arm gave patients a toxic dose. One such cocktail – hydroxychloroquine combined with a high dose of zinc (as a sulfate, 220 mg (50 mg elemental Zn) per day for five days, a zinc dose ~4 times higher than the reference daily intake level) and an approved antibiotic, either azithromycin or doxycycline – began in May as a Phase IV trial … Investigators at the RECOVERY trial analysed their interim results rapidly. Among 1542 patients randomised to hydroxychloroquine 25.7% had died within 28 days; among 3132 patients randomised to usual care 23.5% had died. 26 During the conduct of our trial, data emerged on the role of both hydroxychloroquine or lopinavir-ritonavir among hospitalized patients via the RECOVERY trial. Too small for a meaningful result on mortality. (the initial dose was 1, 200 mg daily for three days followed by a maintained dose of 800 mg daily for two or three weeks, and only 150 patients were studied). Patients were not allocated study drugs equally, presumably due to local availability of the treatment options, with those treated with remdesivir having the highest number of included patients at 2750 compared to 954 receiving hydroxychloroquine. The adult dosage regimen in the RECOVERY trial is 2400 mg in the first 24 hours followed by 400 mg 12-hourly for 10 days or until discharge from hospital, which could be longer. The RECOVERY Trial is currently testing some of these suggested treatments: baricitinib (an immunomodulatory drug used in rheumatoid arthritis) dimethyl fumarate (an immunomodulatory drug used in psoriasis and multiple sclerosis) high-dose vs standard corticosteroids. You stop the trial before the data safety monitoring board has looked at your data, a The Recovery trial used 1.86 grams hydroxychloroquine base (equal to 2400 mg of hydroxychloroquine) in the first 24 hours for treatment of already very ill, hospitalized Covid-19 patients, a potentially lethal dose. and Korean use of hydroxychloroquine (HCQ), an antimalarial agent, against coronavirus, within an hour I found more than 20 scientific papers, written in the last 40 years on the use of lysosomotropic agents—specifically chloroquine—to treat viruses. This was a retrospective case series study in the general practice setting. The dose used in the Recovery trial is not recommended for therapy of any medical condition, which I confirmed with Goodman and Gilman’s Pharmacology textbook, the drug’s … A previous meta-analysis considered high doses as equal to or greater than 10 g/day. Although it shows no benefit from treatment with hydroxychloroquine, it will prevent many people being treated with a drug that is potentially harmful, particularly in high doses. Twitter users began to notice a dosing problem, with hashtag #Recoverygate.

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