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HCQ Plus Azithromycin Did Not Save COVID-19 Lives

Please do not shoot the messenger. Another study (JAMA, May 11, 2020) just reported that HCQ alone or HCQ plus azithromycin did not reduce COVID-19 deaths.
HCQ Plus Azithromycin Did Not Save COVID-19 Lives
Hydroxychloroquine sulphate tablets, in evaluation for treatment of COVID-19.Denmark, Mars 22, 2020

We were among the very first people to ask if there were compounds that might help control coronavirus (March 16, 2020).  We reported on the mechanism by which hydroxychloroquine (HCQ) and quercetin act as zinc transporters inside cells. We wanted hydroxychloroquine (HCQ) to work. We still want HCQ to work. Sadly, though, the latest research is not encouraging (JAMA, May 11, 2020).

Readers Reject New England Journal of Medicine Data:

We were severely criticized for reporting on data published in the New England Journal of Medicine (May 7, 2020). Here is last week’s article from The People’s Pharmacy:

Disappointing News on Hydroxychloroquine vs. COVID-19
We’ve been told that HCQ is either a miracle cure or a very dangerous drug. A study published in the NEJM presents disappointing news on hydroxychloroquine.

We noted that prompt hospital treatment with hydroxychloroquine neither helped nor hurt patients with COVID-19. It did not reduce the likelihood of intubation or speed healing.

We were disappointed. We stated:

“We have been anxiously awaiting data from New York City about HCQ. We need additional observational trial results. Several studies are ongoing, and data should be available soon.”

Additional data has just been published in JAMA (May 11, 2020). More about the results in a minute.

What Readers Had to Say:

We were unprepared for the outpouring of emotion around the data from the New England Journal of Medicine. We all desperately want effective treatments against the coronavirus. But we also must see where the science leads us. Here are just a few of the many comments that took us to task for reporting negative results:

Here is Don’s comment:

“There’s no profit to be made from wide distribution of this low cost and not patentable drug. This is why testing is rigged to show that it is ineffective:

1. Test primarily on people who are already very ill.

2. When testing on those who are not yet seriously ill, do not combine with zinc and azithromycin, which is the clinical treatment found to be most effective.

3. Use the media to discredit it, and censor dissenting voices. The testimony of dozens, if not hundreds of doctors and thousands of patients who have been helped with this drug count for nothing.

Sickening, no pun intended. Just because you’re paranoid, doesn’t mean they’re NOT out to get you.”

Connie writes:

“I don’t trust any study on Covid that was done in New York. I don’t care what medical journal is posting it. Cuomo banned the use of the drug so how were they even able to do this? Further study is needed and if a patient wants to try the drug it should be given.”

S.J. offers this commentary:

“Another study skewed by the people administrating the trial. It has been told that hydroxychloroquine helps get ZINC into the cells, which then stops the replication of the virus. Wow, none of these participants were given zinc along with the hydroxychloroquine. This is just another bogus report, because this is old and cheap. Everything has to be new and expensive these days. What a sham.”

Terry adds this about HCQ plus azithromycin:

“I agree with most of what other respondents said. From what I have read about this drug is that it should be administered as soon as it is determined a person has CoVid 19. NOT when they are so sick that they must be hospitalized, and only then given the drug. And then it should include a Z-Pak [azithromycin].

“Suggest that in your “Bottom Line”, you should have addressed that, as I am sure you also know this information, as well. And, I agree, it is a Political tactic to downplay HCQ, because it is a cheap drug that the Pharmaceutical Co.’s cannot profit from like the drug that they are pushing, Remdesivir, that costs tens of thousands of dollars.”

The People’s Pharmacy Response:

Anyone who has followed our work for the last 40 years knows that we have been tough on the pharmaceutical industry. We do our best to look at the data without bias.

Lots of people complained that azithromycin was not part of the protocol of the NEJM study.

Here is Kim’s comment:

“We are being scammed. The effective cocktail first reported was Hydroxychloroquine, Azithromycin and ZINC. The problem with this therapy is Big Pharma can’t make bank. The people reporting it works have no reason to lie. It’s in Big Pharma’s financial interest to say that it doesn’t work.”

Dr. Roger Seheult, who first alerted us to the potential of HCQ, does not suggest that people need extra zinc UNLESS they are zinc deficient. As far as I can tell, Dr. Didier Raoult, the French physician who really started the HCQ plus azithromycin protocol did not administer zinc either. The study published in the New England Journal of Medicine did look at both HCQ and azithromycin in some patients.

They found that:

“There was also no significant association between treatment with azithromycin and the composite end point…”

The Latest Data from JAMA (May 11, 2020):

OK, we have dawdled long enough. Here is the latest information from JAMA.

The question the researchers set out to answer was this:

“Among patients with coronavirus disease 2019 (COVID-19), is there an association between use of hydroxychloroquine, with or without azithromycin, and in-hospital mortality?”

The Conclusions:

“Among patients hospitalized in metropolitan New York with COVID-19, treatment with hydroxychloroquine, azithromycin, or both, compared with neither treatment, was not significantly associated with differences in in-hospital mortality.”

We take no pleasure in reporting this finding. We would have loved to see results that found HCQ plus azithromycin saved lives.

Is this the final answer? Definitely not! This was an observational study, not a prospective, randomized controlled trial. That kind of study will ultimately provide definitive data.

What They Did:

What the researchers did was analyze a random sample of New York hospital inpatients with laboratory-confirmed COVID-19 disease. They looked for patients who received: HCQ plus azithromycin; HCQ without azithromycin; azithromycin alone; neither drug. There were 1,438 patients in the study.

The authors acknowledge that an observational study can never be as strong as a randomized controlled trial (RCT). We concur. This is not the final word on HCQ plus azithromycin. An RCT may demonstrate effectiveness. That would be wonderful.

Until we have more and better observational data or an RCT, we cannot say that HCQ plus azithromycin is a miracle against COVID-19 nor can we say it is modestly effective. The results in both JAMA and the NEJM are disappointing. We wish it were otherwise.

We welcome your thoughts in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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