Interested in everyone’s opinion/perspective on Hydroxychloroquine as either prophalactic or treatment for Covid-19.
The data is preliminary and mixed. This article out of France talks about the shortcomings in our understanding due to the inability to do proper research at this moment in time when speed is more important than fully vetting the answers.
Another small trial out of China:
My answer to you is that it looks like it may help patients that come down with Covid-19, but much more data is needed. To answer your second question i.e. prophylactic treatment; it looks like that is starting to be studied. The nice part about the drug is that it is an older treatment so the safety profile is understood.
I am skeptical about any such treatment with the limited amount of data available.
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@Chris
I’m a scientist, so naturally I want to see peer-reviewed data before making a conclusion. But, times are extraordinary, and there are a number of Drs taking it as a prophalactic based on the scant data available. Quite a few anecdotes of successful treatment, but they are anecdotes. I don’t know what to think. I took hydroxychloroquine for rheumatoid arthritis for 20 years, so the short-term safety is not an issue. Long-term use (20 years) resulted in retinal toxicity. Just an interesting possibility.
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While it would be nice in that it is known and understood drug, I still think taking it on a prophylactic basis is a bit unnecessary if you are practicing social distancing. Physicians who are treating patients with Covid-19 are being exposed to the virus on a daily basis are in a different category in my mind. i.e. they are at a very high risk of infection, so the risk from the drug is proportionately lower whereas someone who is properly isolating is at much lower risk and therefore the drug risk becomes much less acceptable.
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I’m not thinking of taking it myself, just trying to educate myself as only I am in charge of my health. Wouldn’t you say that you are more educated in treating T1 than any of your health care providers? I just want to be prepared for anything necessary.
I certainly am not trying to criticize, I think being informed is a great thing. I went looking and was hoping for more trust than these small ancedotal studies are providing. Unfortunately, I suspect this is why there is so much fear even in the medical community, i.e. no one knows what to do which is rare in the medical world. I just wish the Chinese were a bit more free flowing with information so that there was more data available. yesterday I saw a Covid-19 machine learning story and just about laughed, because there is unlikely to be a dataset that is large enough for machine learning to work. Even worse it was indicating what factors physicians should be looking at, which is even more fantastical.
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As i understand it, none of the medicines is a “cure” for covid-19. They assist (some) and cure (some) of the bacterial infections that are caused by the pneumonia that covid causes. But there are as many negative stories as there are positive outcomes and there is a reason clinical trials typically take years or decades…
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@Chris
I’m in a high risk group, obviously T1, age over 60, plus several co-morbidities. It increases my anxiety and I just want to be able to say “Why don’t you try this?” if necessary. 
@ClaudnDaye
They are also investigating several anti-virals that were approved for HIV and SARS, and several other drugs that reduce the cytokine “storm” in the lungs that our immune system causes in reaction to the virus.
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Anyone on these forums (diabetics in the forums) is in the “high risk” group in having T1. You’re just in super high risk! Stay safe!!!
I fear this “fast-tracking” is going to have some pretty severe reprocussions - I hope not. But I’ll say it again, there is a reason clinical trials take years, sometimes decades and it’s not beurocracy (most of the time.) It takes years to ensure there are no contraindications.
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@Jan, I grew up in Africa, in French naval bases. We used to take chloroquine as a preventive all over the base.
I know you know about this @Jan, but, for others who read this, be aware there can be some significant liver damage (sometimes, although rarely, deadly) as a “side effect.” This is not a drug that should be used without at least some medical supervision.
I am not sure if anyone has looked at research specifically on chloroquine and T1D?
FYI, I read on the BBC two days ago that the British Government believes that infection rates in China are really 40x higher. Unfortunately, having personal experience with doing business in China, I am ready to believe this is true. In the 2000s, China is turning into the evil Big Brother of the story.
So true!
In this case, though, there is some longstanding use in other applications. So I expect that the secondary effects are well known.
As for whether it does anything for COVID-19–that is another issue 
I certainly hope so.
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And the following article shows there was “rare industrywide slump in (mobile) subscribers” in China. They say some of the cancelations could be related to work phones no longer being needed.
https://www.bloomberg.com/news/articles/2020-03-23/china-s-mobile-carriers-lose-15-million-users-as-virus-bites
Yes chloroquine has been used forever just as a preventative. Every time I sailed to Africa we’d take it as a preventative, under the guidance of a doctor. I am not concerned about it.
As for Zithromax, doctors have for years been handing it out like candy essentially as a placebo just to get patients out of their office for things that it’s not indicated for… this has been going on for years
I welcome the fast tracking of these things and hope they’re helpful…
Their safety has already been well documented… their efficacy for treating this is not proven but at this point it’s not like there’s anything to lose
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I’m really wary about people just jumping in and using it. The fact that they allow “compassionate use” for this drug will undercut trials that can evaluate whether it is effective. My guess is, like many antivirals, it will work better to prevent COVID-19 either early on after infection or to prevent someone testing positive in the first place.
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While I don’t doubt infection rates are higher in China than reported (as they are everywhere, because it is simply too hard right now to test everyone who is symptomatic, let alone everyone who is asymptomatic), and while China is a pretty terrible, authoritarian regime so I certainly wouldn’t put it past them to fabricate numbers to make themselves look better, the WHO was allowed on the scene and got a rough sense of the scale of the pandemic. If there were 40 times more cases (symptomatic ones, at least) there is no way on Earth that the WHO would have been able to miss that.
Seem to be losing sight of the fact that it’s already approved… just not specifically for this use, but doctors can prescribe it off label just like anything else
No different than a doctor prescribing metformin in addition to insulin for a type 1 diabetic… that’s not approved… but they certainly can do it and many do it “off label”
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Well, so some forms of chloroquine-derivates are approved, not all – the FDA just granted emergency authorization for a form that wasn’t yet approved. But even for forms that have been on the market for years here, I think doctors are looking at what the FDA says to decide whether to give this to patients, and I worry that fewer people will choose to enroll in a trial where they might get a placebo if it’s widely available as treatment… And the data so far is just not so stunning that you can clearly see the effect.
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I’m not sure about all the different derivatives, but I know chloroquine and hydroxy chloroquine have been around forever. Were they approved for treating this virus forever? No, but this virus just appeared.
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This mentions the one that was granted emergency authorization: https://www.biopharmadive.com/news/coronavirus-fda-chloroquine-emergency-use/575097/
Seems to be a lot of forms of the drug.
That’s a really poorly written article… makes it sound like the drug wasn’t approved but it was already in the national stockpile? Find that hard to believe… I suspect they’re just talking about a slightly different composition of chloroquine sulfate that’s used overseas that they’re now allowing for import, but I’m wild guessing.
But anyway, my point is that people have been eating chloroquine and Zithromax like candy for decades and It was never controversial until this moment… so I’d sure as heck be all over them if needed…
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Anyone ready to jump on the malaria drug bandwagon Is hopefully equally as prepared for the potential side effects that may come along with It. I wouldn’t personally use them, but I’m a believer in Science and bonifide clinical trials. To each their own though.
Chemo is approved for treating cancer but i wouldn’t use it for allergies…(just one of millions of examples)
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