World Hydroxychloroquine: was the Lancet study biased?

23:15  29 may  2020
23:15  29 may  2020 Source:   pressfrom.com

Trump defends hydroxychloroquine use after meeting with GOP senators

  Trump defends hydroxychloroquine use after meeting with GOP senators President Trump on Tuesday defended his decision to take hydroxychloroquine as a preventative measure against the coronavirus."I think it gives you an additional level of safety," Trump told reporters after attending a Senate GOP lunch. "But you can ask many doctors who are in favor of it. Many front-line workers won't go there unless they have the hydroxy.

Hydroxychloroquine : l’étude du Lancet était-elle biaisée ? © SOPA Images / Getty Images Hydroxychloroquine: was the Lancet study biased? In an open letter, scientists ask for clarification on the methodology and the data used.

This is a new chapter to say the least unexpected in the debate on chloroquine. On May 22, a study published in the scientific journal The Lancet questioned the effectiveness of chloroquine against the coronavirus and even concluded that it could be harmful. A publication that was followed by the WHO suspension of the hydroxychloroquine trials. But today, the study, which is based on approximately 96,000 patients hospitalized between December and April in 671 hospitals, is under attack from all sides.

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Dr. Mandeep Mehra and his colleagues, authors of the study, maintain their results: "we are proud to contribute to the work on the Covid-19" in this period of "uncertainty", told Agence France- Press one of the authors, Sapan Desai. These results, which go in the same direction as many other smaller studies, had a considerable impact and dramatic consequences. Three days later, the World Health Organization (WHO) announced the precautionary suspension of clinical trials she was conducting on this molecule with her partners in several countries. Several other clinical trials have been suspended and some countries, including France, have banned the use of hydroxychloroquine for the treatment of Covid-19, much to the chagrin of its sponsors.

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Concerns about the methodology and integrity of the data

The first of them, the now famous Professor Didier Raoult, immediately judged the Lancet study "messy". His own work, which concludes that hydroxychloroquine is combined with an antibiotic, azithromycin, has been criticized, with other scientists pointing to numerous methodological biases. But even skeptical researchers on the interest of the molecule against Covid-19 have expressed their doubts about the Lancet study.

In an open letter published Thursday evening, dozens of scientists from around the world, from Harvard to Imperial College London, stress that the scrutiny of the Lancet study raises "both concerns related to the methodology and data integrity ". They draw up a long list of problematic points, from inconsistencies in the doses administered in certain countries to ethical questions about the collection of information on patients, including the refusal of the authors to give access to raw data. This data comes from Surgisphere, which presents itself as a health data analysis company, based in the United States. The company led by Sapan Desai has assured that the agreements with partner hospitals prohibit it from sharing data, the integrity of which it has defended.

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A patch from The Lancet

But on Friday, The Lancet released a patch on deaths attributed to an Australian hospital that should have been counted in Asia. This "underscores the need for error checking throughout the database," insist the scientists who signed the open letter, calling for the establishment, for example, by WHO of a group responsible for carrying out an independent analysis. study findings.

Dr Mehra assured Agence France Presse on Friday that an "independent academic analysis of the data" was launched. But "the results, conclusions and interpretations of the study remain unchanged", he assured, noting however the "intermediate" nature of this observational study pending the results of clinical trials "necessary to reach a conclusion" on hydroxychloroquine. Asked about the case on Friday, the WHO noted that the suspension of the trials involving hydroxychloroquine was "temporary" and that its experts would give their "final opinion" after examining other elements (notably the interim analyzes of the Solidarity essay), probably by mid-June.

WHO suspends coronavirus hydroxychloroquine trial

  WHO suspends coronavirus hydroxychloroquine trial The WHO also warned that the world is still in the middle of the pandemic's first wave, and a second peak is possible.Meanwhile, Mike Ryan, head of the WHO emergencies programme, warned in the same virtual news conference that, despite countries easing lockdowns, the world is "right in the middle of the first wave" of the outbreak, and a there could be a second peak within the wave.

"The war against chloroquine"

Data should also come from the British trial Recovery, the hydroxychloroquine part of which is continuing. Based on their own mortality data, officials say there is "no compelling reason to suspend recruitment for security reasons". The open letter, signed in particular by Pr Philippe Parola, collaborator of Pr Raoult, was immediately relayed by the latter, quoting Winston Churchill. "'It is not the end. It is not even the beginning of the end. But it may be the end of the beginning' ... Of the war against chloroquine", he said. tweeted.

Winston Churchill: "Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning" ... Of the war against chloroquine.

- Didier Raoult (@raoult_didier) May 29, 2020

But all the signatories of the open letter are far from being defenders of hydroxychloroquine. "I have serious doubts about the benefits of a chloroquine / hydroxychloroquine treatment against Covid-19 and I look forward to the end of this story, but I believe that the integrity of the research cannot be invoked only when an article does not go in the direction of our preconceptions ", commented on Twitter Professor François Balloux, of the University College of London. Also, "it was with a heavy heart that I added my name to the open letter".

Signatories or not, many scientists have relayed their concerns about the impact of this case on science, sometimes with the hashtag #Lancetgate ("Lancet scandal") or #whats_with_hcq_lancet_paper ("what's going on with Lancet study "). "If the Lancet article is a fraud, it will shatter trust in scientists in a lasting way," commented Professor Gilbert Deray of Pitié-Salpêtrière in Paris on Friday. "I await with concern the results of the investigation".

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