[HN Gopher] Hydroxychloroquine lowers Alzheimer's disease and re...
       ___________________________________________________________________
        
       Hydroxychloroquine lowers Alzheimer's disease and related dementias
       risk
        
       Author : JPLeRouzic
       Score  : 142 points
       Date   : 2022-12-29 16:33 UTC (6 hours ago)
        
 (HTM) web link (pubmed.ncbi.nlm.nih.gov)
 (TXT) w3m dump (pubmed.ncbi.nlm.nih.gov)
        
       | citilife wrote:
       | Hydroxychloroquine is used to treat Lupus by interfering with the
       | communication between cells (not exactly clear in the research
       | tbh). Lupus, Rheumatoid arthritis, and other uses for
       | Hydroxychloroquine appear to be autoimmune responses where the
       | body attacks connective tissue.
       | 
       | If Hydroxychloroquine reduces inflammation and reduces immune
       | responses damaging connective tissue I could see it generally
       | useful for incidents where the body damages itself (such as
       | Alzheimer or dementia)
        
         | ffssffss wrote:
         | > incidents where the body damages itself
         | 
         | I don't think this is right, isn't the etiology of Alzheimers
         | still pretty much completely unknown?
        
         | everdrive wrote:
         | Do we think that mere inflammation-reduction alone is the
         | explanation here?
        
           | napier wrote:
           | There'a nothing "mere" about HCQ's inflammation reduction.
        
       | JamesBarney wrote:
       | HCQ associated with a 12% reduced risk of getting Alzheimer's
       | disease.
        
         | actually_a_dog wrote:
         | Yeah, it's interesting that they mention it as a
         | "neuroprotective therapy" rather than any kind of treatment.
         | That suggests that it doesn't do anything to reverse damage,
         | but can only slow (perhaps halt?) the progression of the
         | disease.
        
       | kybernetyk wrote:
       | horse paste? I mean fish paste?
        
         | bad_username wrote:
         | Worm dehorser
        
         | 8note wrote:
         | Presumably they're observing people prescribed the version for
         | people
        
       | electric_mayhem wrote:
       | [flagged]
        
         | Tuna-Fish wrote:
         | No. Interestingly, the root cause of all these positive
         | correlations might be the same. One thing that
         | Hydroxychloroquine is undeniably good at is that it's a very
         | effective dewormer. Anything that is either caused or made
         | worse by worms, or by the immune system going haywire because
         | of worms, will be improved by Hydroxychloroquine.
         | 
         | So, it helped against covid (in key populations) because one of
         | the key interventions against covid will kill you if you also
         | have worms. So in places like Bangladesh and Pakistan where
         | intestinal worm infections are common, covid outcomes improve
         | because the worms got killed. If this[0] is correct (and it is
         | a very new result, so might as well not be), the positive
         | correlation might well be that your immune system stays calmer
         | if you have no worms.
         | 
         | [0]: https://www.cell.com/cell/fulltext/S0092-8674(22)01463-5
        
           | leot wrote:
           | I think you're confusing hydroxychloroquine with ivermectin.
        
           | foehrenwald wrote:
           | > So, it helped against covid (in key populations) because
           | one of the key interventions against covid will kill you if
           | you also have worms. What intervention?
        
         | sgtnoodle wrote:
         | A lot of modern health woes are turning out to be caused by
         | inflammation, and HCQ is a relatively safe, cheap
         | immunosuppressant. It makes sense that it would help out. As
         | far as conspiracy theories go, it's been profitable for various
         | parties to suppress knowledge of it over the years, as they
         | can't patent it then sell it for extreme markup. I myself take
         | a $10k/month immunosuppressant to treat a condition that HCQ is
         | also effective for.
        
           | Traubenfuchs wrote:
           | > it's been profitable for various parties to suppress
           | knowledge of it over the years, as they can't patent it then
           | sell it for extreme markup
           | 
           | Just like NAC, which the FDA tried to outlaw from being sold
           | as supplement when it's a completely harmless, proven-beyond-
           | doubt miracle drug for anything between significantly
           | reducing bipolar disorder symptoms, preventing symptomatic
           | flu and reducing covid mortality.
        
         | cpr wrote:
         | No, it's available in generic form.
        
       | fexecve wrote:
       | But at what cost?
       | 
       | Not drinking water or eating food leads to lower risk of choking
       | to death, but...
        
         | rednerrus wrote:
         | What is the cost of taking hydroxychloroquine? Seems like a
         | well understood drug with minimal side effects.
        
       | [deleted]
        
       | benj111 wrote:
       | So is my evening G&T good for me, or will quinine not work?
        
         | kcplate wrote:
         | I attribute never having contracted Covid-19, Malaria, and
         | scurvy to my daily G&T therapy.
        
         | TylerE wrote:
         | Modern tonics contain far less quinine than the "real" stuff.
         | Like 95% less
        
       | christkv wrote:
       | If this is true they already have several big patient groups
       | taking it on a daily basis for the rest of their life so should
       | be possible to look at if the prevalence of Alzheimers is lower
       | in those groups.
        
         | jeffbee wrote:
         | It seems like researchers would be able to gather data from the
         | natural experiment due to some places in the world where this
         | drug is routinely used against malaria.
        
           | actually_a_dog wrote:
           | I can see an awful lot of potential confounding factors
           | there, though. Life expectancy in most countries in Africa,
           | for instance, isn't even long enough for non-early onset AD
           | to develop. You'd expect less AD just because half or more of
           | the population is going to die from other stuff at 65 or
           | earlier.
           | 
           | https://www.statista.com/statistics/1218173/life-
           | expectancy-...
        
         | fbdab103 wrote:
         | From reading the abstract, it looks like they picked up on this
         | association from arthritis patients.
        
           | mtlmtlmtlmtl wrote:
           | That makes me instantly sceptical that the arthritis and/or
           | associated conditions might have played a role. I'm sure
           | they've controlled for that as much as possible, but it's
           | easy to miss some confounding factor since the cause and
           | mechanism of AD is poorly understood. That makes it harder to
           | tease out what confounders to look for.
        
       | AbrahamParangi wrote:
       | HCQ is a much misunderstood substance as a result of the
       | political furor around it.
       | 
       | It is not a miracle drug and it is not useless for all medical
       | purposes. It is a relatively mild anti-malarial drug with some
       | anti-inflammatory properties. It is prescribed for autoimmune
       | disorders in addition to malaria. Its anti-inflammatory/immune
       | regulation effects are probably not that strong but its safety
       | profile is well understood.
        
         | asdajksah2123 wrote:
         | [flagged]
        
           | ummonk wrote:
           | "for something for which there was no initially no evidence"
           | - that's not true. There was evidence that it had antiviral
           | properties against covid-19 in vitro. This is extremely weak
           | evidence (most compounds which are effective in vitro are
           | ineffective when administered to an actual human in safe
           | doses, as HCQ proved to be), but it isn't "no evidence".
        
           | ars wrote:
           | > for something for which there was no initially no evidence
           | 
           | That's not true:
           | 
           | "The FDA has, however, issued an emergency use authorization
           | for the drug.
           | 
           | In press releases, the FDA has stressed that "there are no
           | currently approved treatments for COVID-19." However, the
           | agency says both hydroxychloroquine and chloroquine phosphate
           | "have shown activity in laboratory studies against
           | coronaviruses,""
           | 
           | This is back in 2020, so yes, there was some evidence. Later
           | studies showed it didn't work - but that wasn't known in
           | 2020.
        
           | ben_w wrote:
           | At least one of the snake oil salesman was a politician,
           | which caused there to be as much of a political furor about
           | HCQ as Ivermectin, the vaccines, the masks, the lockdowns,
           | etc.
        
           | thepasswordis wrote:
           | This is such a depressing comment to read.
           | 
           | Yes, there _was_ political furor over it. The original people
           | who were supporting the _possibility_ that this drug MIGHT be
           | useful against covid were legitimate doctors and researchers.
           | 
           | Some politicians got overly excited about that, some
           | politicians got overly upset about that. All of the
           | legitimate discussion happening around it got lost in the
           | crossfire of annoying politicians.
        
             | tptacek wrote:
             | It didn't work. It was, in fact, COVID snake oil.
             | 
             | Meanwhile: exactly zero people campaigned that HCQ was an
             | evil substance that should be taken off the market.
             | Opponents of COVID snake oil weren't Lupus deniers.
             | 
             | This entire thread is completely off topic; it's the kind
             | of thing we get ourselves mired in when we don't have the
             | expertise to engage with the actual story, which is whether
             | or not HCQ is protective against Alzheimers.
        
             | api wrote:
             | It went like this:
             | 
             | 1. Some legitimate research suggests that it might be
             | useful against COVID.
             | 
             | 2. Quacks announce that it definitely is the miracle drug
             | against COVID that "THEY" don't want you to know about.
             | 
             | 3. Legitimate doctors counter the quacks and explain that
             | its utility against COVID is not proven.
             | 
             | 4. Trumpist Populists back the quacks because if the
             | establishment is against it it must be good. It must be
             | something "THEY" don't want you to know about.
             | 
             | 5. Democrats and other anti-Trumpists react hard in the
             | other direction and conclude that it must be quack
             | nonsense. There is no chance it could be legitimate because
             | quacks and populists said it was legitimate.
             | 
             | 6. Legitimate researchers from (1) are utterly forgotten
             | because now it's politicized and rational discourse is
             | impossible. In the end all we have is evidence-free
             | screaming and conspiracy theories.
             | 
             | Same exact sequence of events happened with Ivermectin, the
             | debate over whether vaccine mandates were needed, debates
             | over the utility of the vaccines themselves, the question
             | of whether having had COVID is equivalent to having been
             | vaccinated (or better?), and many other topics.
             | 
             | People need to learn that statements without evidence are
             | like the "null" value. They mean precisely nothing,
             | especially if they are from people without expertise.
             | 
             | Meaning "precisely nothing" means that they are neither a
             | positive indicator nor a contrarian indicator. They are
             | meaningless noise that should be completely ignored.
        
               | thepasswordis wrote:
               | 2-6 could also be described as 'political furor'.
        
               | ummonk wrote:
               | I'd argue only 4-6 is 'political furor'.
        
               | ars wrote:
               | This should be higher, that's exactly how it went.
               | 
               | The FDA even said: "both hydroxychloroquine and
               | chloroquine phosphate "have shown activity in laboratory
               | studies against coronaviruses,"", but they stressed it
               | was not proven yet. i.e. your step 1 was based on current
               | evidence.
               | 
               | Then everything went insane exactly as you describe.
        
             | polishTar wrote:
             | This seems a bit revisionist. Nobody got upset at people
             | getting excited, everyone was excited about its potential
             | initially. The annoyance came specifically about certain
             | politicians endorsing its use, without any disclaimers,
             | without evidential support, and even _after_ the evidence
             | showed it didn 't work.
        
               | AustinDev wrote:
               | [flagged]
        
               | ummonk wrote:
               | There is nothing in that article to indicate those
               | studies may have been biased.
        
               | remote_phone wrote:
               | [flagged]
        
             | freejazz wrote:
             | "The original people who were supporting the possibility
             | that this drug MIGHT be useful against covid were
             | legitimate doctors and researchers."
             | 
             | You can't be serious
        
               | thepasswordis wrote:
               | The original person who suggest HCQ, and pushed for its
               | use was this guy:
               | https://en.wikipedia.org/wiki/Didier_Raoult
        
               | comeonbro wrote:
               | Didier Raoult was the original person who _received
               | western popular media coverage_ for it.
               | 
               | It had been part of the scientific conversation for over
               | a month* before his involvement (an eternity in 2020
               | time), eg
               | https://www.nature.com/articles/s41422-020-0282-0
        
               | zimpenfish wrote:
               | Are you saying he's a legitimate doctor and researcher?
               | 
               | Because
               | https://en.wikipedia.org/wiki/Didier_Raoult#Controversies
               | has him being censured for falsifying diagrams, being
               | credibly accused of "ethical, procedural, and
               | methodological problems" in his HCQ trial, and conducting
               | illegal clinical trials on people who could not legally
               | consent.
               | 
               | I mean, sure, he _might be_ credible but his track record
               | suggests otherwise.
        
               | littlestymaar wrote:
               | Who has been well-known in France for his hot takes in
               | media about how sun rays don't cause skin cancer or how
               | alcohol is more beneficial than harmful. He was also
               | involved in an long list of academic malpractices
               | (including faking data in research papers, but that's
               | mostly related to the fact that he has put his name way
               | too many papers from people in his lab to review them
               | all).
               | 
               | He's basically a former good scientist with excellent
               | political skills which helped him climb to the top and
               | has been slowly been corrupted by his own hubris.
        
               | thepasswordis wrote:
               | You're moving the goalposts here.
               | 
               | The fact is that the original claims about HCQ weren't
               | coming from politicians, they were coming from doctors.
               | You might not _like_ the doctors, those doctors might
               | have heterodox ideas, _but that is okay_.
        
               | ummonk wrote:
               | The claim was that they were " _legitimate_ doctors and
               | researchers ". He clearly was not considered a legitimate
               | researcher anymore.
        
               | josephcsible wrote:
               | This is a no true Scotsman fallacy, just like "no true
               | implementation of socialism has ever failed" is.
        
               | thepasswordis wrote:
               | Look at the guys career history, awards won, research
               | published etc. Yeah, he was wrong about HCQ, but the idea
               | that he is just some fake doctor, or not legitimate in
               | some way is as disinformative as the idea that some
               | mysterious "they" is hiding HCQ from everybody.
        
               | [deleted]
        
               | vixen99 wrote:
               | If you don't accept that statement how about providing
               | some evidence for the contrary. 'You can't be serious'
               | says nothing.
        
               | Supermancho wrote:
               | To be fair, providing evidence of no evidence, is not
               | worth the effort.
        
               | freejazz wrote:
               | It definitely doesn't say nothing. It says that I don't
               | believe the poster can be serious. I don't. It's not my
               | burden to disprove unreasonable assertions.
        
               | remote_phone wrote:
               | The use of ivermectin and hcq were started because
               | doctors were trying to develop a protocol to help with
               | treating Covid in 2020 and there was anecdotal evidence
               | that it worked.
        
               | dham wrote:
               | Spray and pray drug therapies work. That's how the best
               | drugs have been invented. The fact that Doctors would
               | rather just let a patient die then try a few known drugs
               | was very sad. It was known in April that ventilators
               | didn't really work. Tons of doctors on youtube blowing
               | the whistle.
        
             | x86_64Ubuntu wrote:
             | None of the legitimacy ascribed to HCQ compares to the
             | legitimacy of the vaccine. The only reason HCQ rose to
             | prominence was because of COVID denialism, not because of
             | actual scientific or therapeutic concerns as a reasonable
             | alternative to the vaccine.
        
               | remote_phone wrote:
               | False. We didn't have a vaccine available until early
               | 2021. People were scrambling to find a therapeutic way to
               | treat Covid and there was anecdotal evidence that hcq and
               | ivermectin might work. They wanted large scale trials but
               | they were unscientifically denied which made people very
               | suspicious about the reasons why.
               | 
               | Yes, they turned out to be ineffective but the reaction
               | against them was mindblowingly biased and filled with
               | propaganda.
        
               | 312c wrote:
               | > They wanted large scale trials but they were
               | unscientifically denied which made people very suspicious
               | about the reasons why.
               | 
               | False. There was an large scale international trial and
               | it showed that HCQ did little to nothing to treat covid.
               | 
               | https://www.who.int/news/item/04-07-2020-who-
               | discontinues-hy...
        
           | ComplexSystems wrote:
           | There was quite a lot of political furor, including treating
           | it as much more dangerous than it really is to prevent people
           | from using it off label as COVID prophylaxis.
        
           | schlafschaf wrote:
           | [flagged]
        
             | peter422 wrote:
             | If you are willing to dilute a few large, high quality
             | studies with a multitude of small or low quality ones, then
             | I'm fairly sure you could conclusively prove anything
             | regardless of reality.
        
               | schlafschaf wrote:
               | Right, you could. For example you could "prove" that
               | masks work by citing a single hairdresser that didn't
               | spread covid while wearing a mask and so dilute decades
               | of evidence against masks. Goes both ways, see?
               | 
               | It's one thing to debate the effectiveness of something
               | and quite an other to declare that the only/main reason
               | for a certain stance is moral deficiency.
               | 
               | Btw did you know that there were promising trails for
               | using hcq against sars cov 1 and even hiv? https://www.th
               | elancet.com/journals/laninf/article/PIIS1473-3...
               | 
               | Turns out HCQ has antiviral properties. Hmmmm.
        
               | ummonk wrote:
               | There have been large scale controlled studies on masking
               | (via recommending mask usage, sending masks, etc. to a
               | randomly selected group of villages / districts). They
               | showed that masking has a moderate effect on COVID
               | spread.
        
               | themaninthedark wrote:
               | At the beginning of the Covid-19 pandemic but after the
               | announcement that was made to "prevent a paucity of masks
               | for health care workers", there were several studies that
               | came out showing how masks were ineffective! The
               | methodology of course was to get someone with COVID, put
               | a mask on them and them have them cough into a petri
               | dish. Then check the dis to see if COVID was present, it
               | was so obviously masks were bad. The science had spoken.
               | 
               | These studies were posed all over the place including HN
               | as proof that you didn't need masks.
               | 
               | Then a little while later, someone changed their mind or
               | something and all of a sudden we all needed masks, even
               | homemade cloth ones would do. Or even a bandana on your
               | face.
               | 
               | The point is that if there is a political will, science
               | will be made up to support or debunk it. Which is bad for
               | science and society in general.
               | 
               | I have no idea about HCQ or it's usefulness but I have a
               | feeling that if it had a different political backing then
               | we might be talking about HCQ deniers instead of HCQ
               | conspiracy supporters because we had the same thing with
               | masks.
        
               | peter422 wrote:
               | Are you aware that things have changed in the last two
               | and a half years?
               | 
               | The CDC has been talking about the limitations of cloth
               | masks for over a year!
               | 
               | If you want to be upset at the lack of perfect guidance
               | initially, fine, but don't pretend it's still that way.
        
               | schlafschaf wrote:
               | Bangladesch right? The one that showed that red masks (or
               | was it purple) worked better. It's hard to get this stuff
               | right but it's such a double standard. The hcq guys are
               | morally condemmed while people eat up anything that looks
               | good for masks no matter how shoddy. I get it, you all
               | want to do something that helps and be seen doing it. But
               | it aint masks. Dropping 10kg though...
        
               | ummonk wrote:
               | It showed that masks worked. Unscientific people with an
               | agenda then sliced and diced it into smaller subgroups
               | (such as purple masks) where there was insufficient
               | statistical power to consistently show whether masks
               | worked for all the subgroups.
        
         | keepquestioning wrote:
         | Now explain how it could affect Alzheimers
        
           | WaxProlix wrote:
           | > some anti-inflammatory properties
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214864/
           | 
           | Lots of literature 1 google/ddg search away for you, but
           | there's an example.
        
           | [deleted]
        
           | maerF0x0 wrote:
           | >We additionally show that HCQ exerts dose-dependent effects
           | on late long-term potentiation (LTP) and rescues impaired
           | hippocampal synaptic plasticity prior to significant
           | accumulation of amyloid plaques and neurodegeneration in
           | APP/PS1 mice.
           | 
           | iirc (I am not qualified!!) Alzheimers relates to plaques in
           | our brain, and this sounds to me like it fixes a precursor to
           | the plaque accumulation (the loss of plasticity?)
        
             | pelorat wrote:
             | The plaques are a side effect of something we don't
             | understand yet. Treating the plaque or slowing it is not a
             | solution, we need to find and fix the cause.
        
               | emodendroket wrote:
               | Quite apart from the validity of this study, isn't a
               | purely palliative measure still valuable?
        
               | mattkrause wrote:
               | Literally billions of dollars has been spent, futilely,
               | on the idea that removing plaques would stop/reverse the
               | symptoms of Alzheimer's Disease.
               | 
               | This "amyloid hypothesis" has not been a smashing
               | success, to put in mildly.
        
               | ummonk wrote:
               | It's not clear that treating amyloid plaque is actually
               | palliative for Alzheimer's patients.
        
           | api wrote:
           | Being anti-inflammatory?
        
         | x86_64Ubuntu wrote:
         | How is HCQ misunderstood due to the recent political furor?
         | It's been used since the 1950s.
        
           | caddemon wrote:
           | It's a little weird that this pilot research* made the front
           | page of HN, in that respect there probably is a political
           | factor.
           | 
           | But for the research itself I agree, there's no indication
           | this article was in any way motivated by COVID or contains
           | any misunderstandings of HCQ.
           | 
           | (* the sample is large but since it's purely observational in
           | a very specific population it obviously requires follow-up
           | work)
        
           | treeman79 wrote:
           | [flagged]
        
             | baggachipz wrote:
             | It's not that he "supported" it, he touted it as a COVID-19
             | cure (an utterly baseless claim) when mask-wearing and
             | distancing were the only available true preventers of
             | transmission at the time. He politicized it, not the "other
             | side".
        
               | h43z wrote:
               | It's not an utterly baseless claim
               | https://c19hcq.org/meta.html
        
             | tptacek wrote:
             | No, they declared it ineffective for COVID and unsafe when
             | taken without physician supervision, both of which are true
             | statements.
        
           | dtgriscom wrote:
           | It was promoted by a politically-homogenous group of people
           | as a COVID-19 cure
           | 
           | https://theintercept.com/2021/09/28/covid-telehealth-
           | hydroxy...
        
       | NikkiA wrote:
       | Really going all-in on trying to find an off-label use that'll
       | allow them to repatent this, aren't they?
        
         | DanBC wrote:
         | I don't think you re-patent an off-label use, you re-patent a
         | minor modification. See for example ketamine to eskatamine; or
         | citalopram to escitalopram.
         | 
         | Once you have the new med you use the courts to prevent the
         | off-label use. See eg lucentis or avastin for Wet AMD.
        
         | dariusj18 wrote:
         | Or someone has a lot in stock and wants to offload it ;)
        
         | tptacek wrote:
         | "Re-patent"?
        
         | x86_64Ubuntu wrote:
         | Yes, HN has something of a COVID-19 denialism streak.
        
           | dang wrote:
           | HN is divided on topics where society at large is divided. It
           | would be strange if it weren't.
           | 
           | It's also a highly international forum and divisive topics
           | play very differently in different places. Readers often
           | mistake a comment for something weird and radical coming from
           | a person nearby, when in fact it's an unremarkable comment
           | coming from a person far away. It's unfortunate that this
           | leads to so many brutal online arguments. In person, people
           | instinctively modulate their communication with respect to
           | such variables; online they don't, because the information
           | isn't available and we can't make it available.
           | 
           | https://news.ycombinator.com/item?id=23308098
        
       | canadiantim wrote:
       | That's great news. Alzheimer's and dementia are so such
       | terrifyingly difficult conditions to try and help someone with.
       | Glad we're finding atleast some possibilities to help. Does
       | anyone know of anything others like this?
        
       | mortehu wrote:
       | I post this comment quite frequently on HN, but yet again this is
       | not a randomized controlled trial, but rather an observational
       | study. On top of that, they state several insignificant
       | statistics using the point estimate (e.g. "Hydroxychloroquine
       | initiators had an 8% lower rate of Alzheimer's disease and
       | related dementias compared to methotrexate initiators (95%
       | confidence interval 17% to 0%)" (paraphrased).
        
         | ed25519FUUU wrote:
         | In this case at least the sample is good. 100k people with
         | rheumatoid arthritis, who are likely taking HCQ for the rest of
         | their lives.
        
       | carbocation wrote:
       | When interpreting the observational literature (including my own
       | work) I find it helpful to think like a threat actor: how can
       | this association be broken?
       | 
       | Note that this is an article making huge claims about Alzheimer's
       | but is published in Molecular Psychiatry. Given that signal, I'm
       | just going to look at the abstract and not read the full text.
       | 
       | Here, the study population is patients with rheumatoid arthritis.
       | This tells you up front that we don't have a typical population,
       | but a highly selected one.
       | 
       | The use of HCQ is observational, not randomly assigned.
       | 
       | So, how could HCQ look protective even if it had no effect on
       | Alzheimer's biology?
       | 
       | 1. Maybe more rheumatoid arthritis patients should be on HCQ.
       | It's a disease-modifying drug, after all. So it may be the case
       | that people with better care, or more wealth, are more likely to
       | be on HCQ. And that could be associated with other lifestyle
       | factors that are never fully accounted for in an observational
       | analysis.
       | 
       | 2. Or it could be the case that people with dementia are less
       | likely to have their HCQ prescriptions renewed, so the arrow of
       | causation could even be reversed.
       | 
       | Additionally, one could imagine that HCQ might actually protect
       | against Alzheimer's disease in people with rheumatoid arthritis--
       | but not in a general population. That would be very big news, but
       | would require further study.
       | 
       | And sure, it could be the case that HCQ reduces Alzheimer's risk
       | in everyone. But you'd need a lot more evidence to buy that.
        
         | AstixAndBelix wrote:
         | It might be that among the causes of dementia, inflammation
         | plays a decent role, which is also the cause of rheumatoid
         | arthritis
        
           | carbocation wrote:
           | Yes, I think the hypothesis is conceptually interesting. But
           | rather than thinking about how it could be true, I try to
           | think about how the data could be misleading. I do this to
           | try to avoid making broader claims in my own work than I
           | should.
        
         | ummonk wrote:
         | I think the study is somewhat more robust than you're letting
         | on, since it compares HCQ against an alternative rheumatoid
         | arthritis drug - Methotrexate. It's possible that the choice of
         | prescribed drug itself is correlated with some other
         | confounding factor, but it's certainly less likely to be so
         | compared to HCQ vs nothing.
         | 
         | Also, the study itself is clear about the amount of evidence
         | needed to validate whether HCQ actually reduces Alzheimer's
         | risk: "This hypothesis merits testing through adequately
         | powered clinical trials in at-risk individuals during
         | preclinical stages of disease progression."
        
           | loosescrews wrote:
           | In that case, couldn't it be that Methotrexate makes the risk
           | worse rather than Hydroxychloroquine reducing the risk?
        
           | travisp wrote:
           | Methotrexate is standard of care, considered "strongly
           | recommended" over hydroxychloroquine (source:
           | https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.24596 )
           | for rheumatoid arthritis. If I read the paper right,
           | hydroxychloroquine may be favored in "low disease" states.
           | 
           | So I would certainly expect some sort of difference in
           | patient population. It would suggest those initiated on
           | hydroxychloroquine would normally have less severe rheumatoid
           | arthritis (or have some other difference that their doctor
           | would choose to not use methotrexate by default), although I
           | don't know if that's the case in reality.
        
             | carbocation wrote:
             | Not having prescribed either since I was a PCP years ago, I
             | would just say that I agree with this line of inquiry.
             | 
             | If both drugs were equally good and were pretty much used
             | at random, then they could be good instruments. But if
             | there is confounding by indication, then it's harder to get
             | value out of an analysis that compares them.
             | 
             | It doesn't mean the conclusions are wrong (and nor does my
             | comment above), it just tempers my interpretation.
        
         | surfsvammel wrote:
         | This summary right here is what I would like to accompany any
         | medical study that pop up online. Thanks for helping us stay
         | skeptical (doesn't mean that I'm not hopeful and that the
         | claims is true)
        
       | emccue wrote:
       | See I believe this.
       | 
       | There are remarkably fewer demented people as a result of people
       | taking Hydroxychloroquine.
        
         | mattboardman wrote:
         | Relishing in other people's actions that were driven out of
         | fear during a crisis when our institutions (media and state)
         | failed to keep public trust for millions. Empathy, even for
         | those who make foolish decisions is difficult but necessary,
         | you should try to understand rather than judge.
        
           | ergonaught wrote:
           | Why is empathy "necessary"?
           | 
           | Why "should" someone try to understand rather than judge?
           | 
           | What's the actual rationale for it?
           | 
           | What is the mutually agreed desired result of acting in those
           | ways?
        
             | mattboardman wrote:
             | >why is empathy necessary?
             | 
             | I don't really have an objective answer for you. I do find
             | personal value in empathy, I get less mad when I can
             | understand why someone did something I disagree with. It
             | doesn't change what they did nor does it excuse it.
             | 
             | >What is the mutually agreed desired result of acting in
             | those ways
             | 
             | Harmony.
        
             | troutwine wrote:
             | Keeping just to the utilitarian perspective, cooperative
             | strategies in humans overwhelmingly have better outcomes in
             | both individual well-being and output (innovation,
             | manufacturing, zero-sun games). Cooperation is extremely
             | hard to achieve and sustain without some empathy for your
             | peers. Similarly, judgement runs counter to group cohesion,
             | except in the divergent strategy of establishing an Us/Them
             | dynamic, sustainable in the short term but leading to
             | homogeneity, worse outcomes.
             | 
             | Tossing the utilitarian perspective, being transactional
             | and self-serving in your daily life tends to get you
             | invited to less parties.
        
             | joenot443 wrote:
             | >Why is empathy "necessary"
             | 
             | This is a philosophical question that man has sought to
             | answer since the Stone Age. Much smarter people than us
             | have dedicated their lives to the study of ethics and come
             | up with wildly differing ideas, I don't think you're going
             | to find an objective answer here.
        
             | shawnz wrote:
             | I think it will be easy for you to come up with some
             | possible answers to these questions if you have some
             | charity for their argument.
        
               | brookst wrote:
               | People who pride themselves on lacking empathy are kind
               | of trapped because no one can explain in a way that
               | doesn't require some empathy to understand.
        
           | mint2 wrote:
           | "When our media and state failed to keep public trust" on
           | this topic the only reason people didn't trust the media was
           | because the prior potus himself was undermining the truth and
           | encouraging the ones promoting falsehoods. Don't blame the
           | media for quack Covid "cures", it is was coming from a
           | certain individual and his backers. Which did include right
           | wing media, but not media in general
           | 
           | Edit, shooting the messenger doesn't change fact. But If it's
           | cathartic and helps one cope with reality and face
           | "unpleasant" facts, I don't mind.
        
             | ebisoka wrote:
             | Now for some actual facts...
             | 
             | https://c19hcq.org/
             | 
             | HCQ for COVID-19 374 studies from 6,195 scientists 496,030
             | patients in 55 countries
             | 
             | Statistically significant improvement for mortality,
             | hospitalization, recovery, cases, and viral clearance.
             | 
             | 62%, 19% improvement for early and late treatment CI
             | [52-70%], [14-23%]; 36, 247 studies
             | 
             | 23% improvement in 8 early treatment RCTs CI [-20-51%]
             | 
             | 72% less death in 15 early treatment trials CI [57-81%]
        
               | [deleted]
        
               | adamredwoods wrote:
               | We've been through this already.
               | 
               | >> On 5 June, researchers in the United Kingdom announced
               | the results from the largest trial yet, Recovery, in a
               | press release. In a group of 1542 hospitalized patients
               | treated with hydroxychloroquine, 25.7% had died after 28
               | days, compared with 23.5% in a group of 3132 patients who
               | had only received standard care. "These data convincingly
               | rule out any meaningful mortality benefit," wrote the
               | investigators, who ended the study early and promised to
               | publish the full results as soon as possible.
               | 
               | https://www.science.org/content/article/three-big-
               | studies-di...
        
               | ebisoka wrote:
               | That one study is part of the meta analysis that I posted
               | : https://c19hcq.org/recovery.html
               | 
               | It was a late treatment study, and in the summary you can
               | read "Late treatment and high dosages may be harmful"
        
               | mint2 wrote:
               | Your source itself says " Late treatment and high dosages
               | may be harmful"
               | 
               | And the summary doesn't discuss the commonly cited
               | confounding factor of parasites.
               | 
               | If only there was some preventative measure that was more
               | sound... oh wait
               | 
               | Edit: once again if downvoting is cathartic and helps one
               | face "unpleasant" facts then go for it. I literally
               | pointed out what that comments source's intro states.
               | That being objectionable really speaks for itself.
        
               | ebisoka wrote:
               | Late treatment and high dosages may be harmful" and it
               | goes on "while early treatment consistently shows
               | positive results. "
               | 
               | The treatment study they did in my country had a result
               | of 30% less dead.
               | 
               | But then came the obviously fake hcq study that was
               | published in the lancet (lancetgate) that stopped all
               | research into hcq, just think how many lives could have
               | been saved otherwise.
        
             | mattboardman wrote:
             | Whether you blame Fox news, CNN, Trump, the deep state, the
             | CDC, doesn't matter when addressing the failures of the
             | state and the media. They lost trust with the public. This
             | is measurable in polls and has created a divide in the
             | American people. The result is that individuals and fringe
             | institutions gained ground with millions of Americans;
             | misinforming them and creating controversies that should
             | not have happened.
             | 
             | If the mainstream media and the state didn't lose trust
             | then why would people turn to less credible sources?
             | Because everyone is dumb/crazy? If that is the conclusion
             | people are coming to it seems rather harsh and elitist in
             | my opinion.
        
               | mint2 wrote:
               | Blaming the media as a whole when one well define group
               | was promoting the misinforming is not sensical.
        
               | mattboardman wrote:
               | I think it's more than fair to blame the media, which has
               | had centuries to build up their reputation and
               | credibility. They were incapable of preserving public
               | trust during a national crisis. They have all the
               | advantages over individuals or fringe organizations. We
               | aren't talking about a few thousand people that got
               | indoctrinated into a cult, we are talking about millions
               | of people, some highly educated, who turned away from the
               | mainstream media altogether.
        
               | mint2 wrote:
               | That's not the way psychology works but okay.
        
               | torstenvl wrote:
               | It is the media as a whole. It isn't accurate to insist
               | that it's only Fox News promoting misinformation about
               | election fraud or HCQ, in the face of MSNBC promoting
               | misinformation about the mortality of COVID, or promoting
               | misinformation about hydroxychloroquine, or CNN promoting
               | misinformation about BLM riots, or both of them promoting
               | misinformation about Russian active measures, etc., or
               | vice versa. It is emphatically all media. To say
               | otherwise is just engaging in partisan flamewar.
               | 
               | With regard to HCQ, the evidence supporting its use was
               | from small scale studies and not reproducible (hence why
               | Fox News's take was misinformation); however, there _was_
               | evidence that it improved survivability, especially in
               | some less-developed countries, so saying  "no evidence"
               | or even "bogus" like MSNBC did was also misinformation.
               | 
               | (Personal theory: Comorbodity of COVID and other
               | conditions HCQ is effective against was a confounding
               | factor in less-developed countries; and the remaining
               | delta is due to HCQ's immunosuppressant qualities calming
               | the cytokine storm.)
        
               | mint2 wrote:
               | A comment chain here will not reconcile the bubble
               | realities. I disagree strongly with your comment, as you
               | seem to with mine. It's not going to go anywhere from
               | here.
        
             | dude187 wrote:
             | The public health agencies worked hard to rightfully
             | shatter all trust in them from those who are aware and pay
             | attention
        
             | [deleted]
        
             | thrwawy74 wrote:
             | I agree with you. There were several agencies putting out
             | responsible messaging and trying to keep public trust.
             | Ultimately it was a failure. Millions of people didn't
             | trust the gov and turned to alternatives like this. I'm not
             | sure why you're being downvoted. Key figureheads undermined
             | public trust.
        
               | fwungy wrote:
               | The government's information was obviously was filled
               | with inconsistencies that were obvious to anyone with the
               | slightest prior mistrust of them.
               | 
               | Ivermectin has a long history of safe and beneficial
               | usage in the developing world, billions of doses. Yet it
               | was actively discouraged as "horse medicine" here. Anyone
               | with experience or relatives in the developing world
               | would immediately question the veracity of such a
               | discouragement.
        
               | dragon-hn wrote:
               | It was discouraged (correctly in hindsight) because there
               | was no evidence it would do anything for Covid.
               | 
               | It was called horse medicine because the unfortunate
               | people that fell for the kooks resorted to vet sources
               | for it because doctors correctly refused.
               | 
               | I can't believe the revisionist history on this.
        
               | fwungy wrote:
               | No IP = no research = no evidence.
               | 
               | Welcome to $cience 2022.
        
               | dragon-hn wrote:
               | What a lazy response. At least you got the no evidence
               | part right.
               | 
               | For about a year governments around the world were
               | willing to do _anything_ to get past Covid ASAP. To
               | ignore that and chalk this up to a lazy conspiracy theory
               | has less than zero merit.
        
           | jimmaswell wrote:
           | I don't see it as necessarily relishing, just a dark joke.
        
             | emccue wrote:
             | ^
        
         | dang wrote:
         | Please don't post unsubstantive and/or flamebait comments to
         | HN. It's not what this site is for, and destroys what it is
         | for.
         | 
         | If you wouldn't mind reviewing
         | https://news.ycombinator.com/newsguidelines.html and taking the
         | intended spirit of the site more to heart, we'd be grateful.
        
       | ShredKazoo wrote:
       | I thought I read somewhere that it's easy to overdose on
       | hydroxychloroquine? If so I'd be worried about a forgetful senior
       | accidentally taking a double or triple dose.
        
         | BryantD wrote:
         | I'm not a doctor but it doesn't look highly risky. The usual
         | adult dose for malaria is 2000 mg over the course of two days.
         | Long term usage may be a different matter.
         | 
         | I suspect that concerns about safety were because people were
         | using it off brand without medical supervision these last
         | couple of years, which is less safe.
        
         | seanhunter wrote:
         | THis is true of most medications and as a result there are a
         | lot of solutions that have been developed to help people ensure
         | they get their drug regime right. Firstly, a lot of people in
         | altzheimer's care will have full or part-time carers to
         | help[1].
         | 
         | Secondly there are things like "pill organizers"/dossette
         | boxes[2] where the pharmacy will actually dispense the drugs
         | into a container which is designed to make it simple to ensure
         | people take their correct daily dosage of drugs.
         | 
         | [1] Here in the UK the national health provides some community
         | care and there are also voluntary organisations. Obviously
         | individuals can also pay privately to have enhanced levels of
         | support.
         | 
         | [2] https://en.wikipedia.org/wiki/Pill_organizer
        
         | [deleted]
        
         | miked85 wrote:
         | Wouldn't this be true for almost any medication? I'm not aware
         | of anything unique about this one.
        
           | dtgriscom wrote:
           | Different medications have different ratios between their
           | effective doses and their harmful doses. The smaller the
           | ratio, the more sensitive the results to an overdose.
           | 
           | https://en.wikipedia.org/wiki/Therapeutic_index
        
         | [deleted]
        
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