Jacques Reynes, head of the infectious diseases department at the Montpellier University Hospital Comments on the Lancet Study On Hydroxychloroquine for Covid-19

MIDI LIBRE ^ | 05/28/2020

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NOTE: THIS ARTICLE HAS BEEN TRANSLATED USING GOOGLE TRANSLATE FROM FRENCH

Jacques Reynes, head of the infectious diseases department at the Montpellier University Hospital, participated in studies on hydroxychloroquine: via the European Discovery and Covidoc trials, specific to Occitania. Treatment stop, Raoult controversy ... he regrets a "runaway" which will undoubtedly not allow to have indisputable data on the effectiveness of the treatment.

Q: What do you think of this very critical Lancet study on the interest of hydroxychloroquine, and the cascading effects of the publication of this prestigious scientific journal published last Friday, until the ban on the use of hydroxychloroquine, this Wednesday in France?

A: The problem is that the famous Lancet article has a lot of bias and inaccuracies. When Didier Raoult says that it is an electronic register disconnected from patients, he is not far from being right. But it is signed by one of the most eminent cardiologists in the world.

Q: What particularly bothers you about this study?

A: There are very astonishing figures, which one does not find in all the other studies already carried out on hydroxychloroquine, on the level of cardiovascular mortality for example. So far, the numbers have all been similar. What is problematic is the combination of hydroxychloroquine with another macrolide (Editor's note: antibiotic), without distinction between them. We cannot put azythromicin, which is one of these macrolides, on the same level, and other antibiotics.

Another major bias: in the population of deceased people, 30% of people who had heart disease before taking treatment. They should never have taken it! And 40% were also receiving another treatment that blocked metabolism, which led to an overdose of hydroxychloroquine.

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CONTINUATION OF THE TRANSLATED INTERVIEW....

Q: Which leads today to the banning of hydroxychloroquine in France ...

A: We know the harmful effects of hydroxychloroquine, but in very small proportions. And we know that use is problematic in people at risk. I am terrified by the publicity given to an article which should never have been published in a magazine as prestigious as the Lancet.

Suddenly, you suspended the trials started at the CHU of Montpellier on hydroxychloroquine ...

Monday evening, I received an email from the national drug safety agency (ANSM), and I immediately suspended the trials.

Q: So, Are the hydroxychloroquine against Covid-19 infection definitely over?

A: The Americans were preparing to launch a therapeutic trial. Will they do it? The World Health Organization (WHO) has also suspended the trials, but we know Donald Trump's relations with the WHO (not good) ... If we leave it there, we will not have an answer on the interest of the treatment.

Q: Do you still think that hydroxychloroquine is of interest?

A: As much as I am skeptical about hydroxychloroquine alone, I think that the association with azythromicine may have an interest, which Professor Raoult could not show because there is a bias in his studies, which included patients who are doing well, and who would never have had any complications.

In its first series of a thousand patients, 30% had a normal lung scan, no signs of pneumonia. The question is, what do we really gain in people with moderately severe conditions? Do we recover earlier? It is a pity that we have not been able to conclude.

Q: What do you think will be the future of Professor Raoult?

A: It will be difficult. The Lancet study is a "murder" in order ... It can recover if the Americans do a serious study, which provides tangible elements. They were to include 2,000 patients in their study. If they do, we will have answers ...

Look, I am neither for nor against Raoult. But his idea was not a rant, the interest presented by hydroxychloroquine is probable, and even if it is not gigantic, it had to be evaluated. Afterwards, there was such a runaway that nothing became controllable.

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Jacques Reynes, head of the infectious diseases department at the Montpellier University Hospital, participated in studies on Hydroxychloroquine for Covid-19, He eventually had to suspend the studies.

[Bob434]

just watched a commercial tonight put out by “Coronavirus.gov” who used a D.J Khaled as their spokesperson who said essentially

“Stay at home, spend time with your family, that’s the key. If you go outside you are being selfish, and are putting everybody at risk. If you care about your life, Stay Home”

https://www.youtube.com/watch?v=DTqP5vbU3lY

Seriously? So if we open up our front door to go out- we’re ‘being selfish’ and we are putting ‘everyone at risk’ and ‘we will die’?

Hey Khaled- people are committing suicide because they’ve lost their jobs, lost their homes because they can’;tr par rent or pay the bills- they can’t feed their families properly- 99% pf the population is going to survive this virus just fine- your commercial makes it seem that if so much as open a window to the outdoor world, we’ll catch the virus and die- The flu kills 10’s of 1000’s every year- shall we all hide inside every time the flu season rolls around twice a year? Those ofr you who are rich might be able to weather long downtime without a job- but hte vast majority of Americans can’t- and shouldn’t have to since the virus will take less than 2% of the population- so stop scaremongering and shaming people for going outside and living their lives-

[MAGAthon]

25 May: Stat Modeling (Columbia Uni): This controversial hydroxychloroquine paper: What’s Lancet gonna do about it?
Posted by Andrew
Lancet
A recent paper published in the famous/notorious medical journal Lancet reports that hydroxychloroquine and chloroquine increased the risk of in-hospital death by 30% to 40% and increased arrhythmia by a factor of 2 to 5. The study hit the news with the headline, “Antimalarial drug touted by President Trump is linked to increased risk of death in coronavirus patients, study says.” (Meanwhile, Trump says that Columbia is “a liberal, disgraceful institution.” Good thing we still employ Dr. Oz!)…

All this politics . . . in the meantime, this Lancet study has been criticized; see here and here. I have not read the article in detail so I’m not quite sure what to make of the criticisms; I linked to them on Pubpeer in the hope that some experts can join in...

Almost all the press coverage of this study seemed to be taking the Lancet label as a sign of quality...READ ON

FIRST COMMENT:
25 May: ETH: One additional important development: The WHO announced today that they would be temporarily pausing their trial of hydroxychloroquine, citing the results of The Lancet paper.
SECOND COMMENT:
26 May: Zach: It looks like they’ve already restarted it
https://statmodeling.stat.columbia.edu/2020/05/25/this-controversial-hydroxychloroquine-paper-whats-lancet-gonna-do-about-it/

26 May: RecoveryTrial.net: Recruitment to the RECOVERY trial continues as planned
Prof Peter Horby and Prof Martin Landray, Chief Investigators of the RECOVERY trial, said ‘We have been working over the weekend to understand the implications of the Mehra paper for the safety and welfare of patients randomised to hydroxychloroquine.
‘On Saturday 23 May, the independent Data Monitoring Committee conducted an urgent review of the data that we have collected so far on the effects of hydroxychloroquine on mortality among patients admitted to hospital with COVID-19. The Committee concluded that there is “no cogent reason to suspend recruitment for safety reasons.”

‘The Committee found that the effects of hydroxychloroquine on mortality reported in the analysis by Mehra were not consistent with those observed in the RECOVERY trial. The Committee therefore recommended that the trial continue recruitment without interruption, a recommendation that was endorsed on Sunday by the MHRA.

‘The conclusion of the Mehra paper is that “Randomised clinical trials will be required before any conclusion can be reached regarding benefit or harm of these agents in COVID-19 patients.” The RECOVERY trial is currently the largest randomised controlled trial of hydroxychloroquine and other potential treatments for COVID-19. Enrolment in this trial is the best way to provide definitive evidence on these drugs.’
https://www.recoverytrial.net/news/recruitment-to-the-recovery-trial-continues-as-planned

25 May: StatModeling: Hydroxychloroquine update
Posted by Andrew
The study only has 4 authors which is weird for a global study in 96,000 patients (and no acknowledgements at the end of the paper). Studies like this in medicine usually would have 50-100 authors (often in some kind of collaborative group). The data come from the “Surgical Outcomes Collaborative”, which is in fact a company. The CEO (Sapan Desai) is the second author. One of the comments on the blog post is “I was surprised to see that the data have not been analyzed using a hierarchical model”. But not only do they not use hierarchical modelling and they do not appear to be adjusting by hospital/country, they also give almost no information about the different hospitals: which countries (just continent level), how the treated vs not treated are distributed across hospitals etc. A previous paper by the same group in NEJM says that they use data from UK hospitals (no private hospitals are treating COVID so must be from the NHS). Who is allowing some random company to use NHS data and publish with no acknowledgments. Another interesting sentence is about patient consent and ethical approval:

We emailed them to ask for the data, in particular to look at the dose effect which I think is key in understanding the results. They got back to us very quickly and said:
“Thanks for your email inquiry. Our data sharing agreements with the various governments, countries and hospitals do not allow us to share data unfortunately. I do wish you all the very best as you continue to perform trials since that is the stance we advocate. All we have said is to cease and desist the off label and unmonitored and uncontrolled use of such therapy in hospitalized patients.”

So unavailable data from unknown origins . . .

Another rather remarkable aspect is how beautifully uniform the aggregated data are across continents: ...
https://statmodeling.stat.columbia.edu/2020/05/25/hydroxychloroquine-update/

22 May: PubPeer: Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis
The Lancet(2020) - 11 Comments

[Dogbert41]

The World Order made sure a cheap effective drug would be villified.

[ScaniaBoy]

Please, read this. Is the Lancet study a complete hoax?

https://defyccc.com/anti-hcq-paper-in-the-lancet-uses-fabricated-data/

[FreedomForce]

Martenson tears the Lancet study to shreds. Rips the Lancet, the WHO, Fauci. I bet this video gets taken down by youtube very quickly.

https://youtu.be/IUD_wvkNhnk

[originalbuckeye]

I have been indirectly accused, ‘anybody who believes “Yada, yada, yada, etc” is a selfish Nazi’. The Left has no shame. (And I have also been accused of being shameless for not wearing a mask at all times)