Since Trump started hawking hydroxychloroquine at every press conference, intrepid young bloggers and tweeters have been hell bent on showing a connection between the evil pharma company, Novartis, and the kickback grubbing Trump.
I’d like to bring back some sanity to this conversation. I’ll make it short:
Hydroxychloroquine was approved back in 1955. Back then, the FDA had a lot fewer safety standards. Today, I’m going to guess that the safety issues for this drug are so significant that it wouldn’t get past the drug approval process. The reason why it’s still in the market probably has to do with it being an older off patent drug for diseases that are resistant to everything else.
Just because Trump keeps hawking it at a news conference doesn’t mean he and Novartis have some kind of scam going on. I can’t think of any reason why Novartis would want to promote an older drug with this safety profile on the basis of incomplete and inconclusive tests of efficacy. That’s the kind of thing that results in billions of dollars in class action lawsuits.
Best guess, Trump wants very badly to be a heroic savior messiah so that everyone is saved and we can all get back to work pushing the Dow over 30,000. (Yeah, that’s never going to happen) So he’s pushing this as a quick and easy fix. He’s so confident in his abilities to assess the outcome of this therapy that he’s willing to risk thousands of lives to do it.
It’s very dangerous and if I were Novartis, I’d feel super uncomfortable about what he’s doing. The only thing worse would be the backlash that would follow if Novartis publicly distanced itself from the idea, like the way Fauci was overruled and the press scolded yesterday when the subject came up.
I know it’s cliche by now to say he needs to be stopped and forced to resign. I know it looks really bad for Republicans in the middle of a global crisis. But he’s making things worse and he’s going to cause a lot of unnecessary deaths.
Somebody do something.
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Speak of the Devil, Derek Lowe of the In the Pipeline blog has a post evaluating the latest results on treatment of Covid-19 patients with hydroxychloroquine. It’s not promising and there is at least one significant side effect that should probably kill this idea. That is an elongated QT interval, the bane of every drug hunter. So, if I were Trump, I’d move on to actually doing something useful.
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A couple of other things to watch out for:
Occasionally, you’re going to hear experts talk about “in vitro” studies. In vitro roughly means in a Petrie dish or test tube or tissue culture. In vitro studies are the first steps in proving that a compound might be a lead drug. But if the studies are not done in vivo, in other words in a live animal, the in vitro results remain just a hypothesis. That’s because once a compound gets into the system and metabolized, unpredictable things can happen. So it’s very important to test the drug, vaccine, antibody in a mouse model or rhesus monkey or dog or something before it gets to humans. I know this isn’t going to make the “anti-cruelty” people very happy but it’s very important that this step not be missed.
I’m sure there will be no shortage of human test subjects. There will still be a lot of mice sacrificed to the cause first.
So, caveat emptor. If there is no in vivo study cited, then it’s not really a cure. Or at least not yet.
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