Hydroxychloroquine versus placebo in the treatment of non-hospitalised patients with COVID-19 (COPE – Coalition V): A double-blind, multicentre, randomised, controlled trial

Avezum, Álvaro; Oliveira, Gustavo B.F.; Oliveira, Haliton Alves de; Lucchetta, Rosa Camila; Pereira, Valéria F A; Dabarian, André Luiz; Vieira, Ricardo D ́O; Silva, Daniel Valadão; Kormann, Adrian; Tognon, Alexandre Pereira; Gasperi, Ricardo de; Hernandes, Mauro Esteves; Feitosa, Audes D. M.; Piscopo, Agnaldo; Souza, André S; Miguel, Carlos H; Nogueira, Vinicius O; Minelli, César; Magalhães, Carlos Costa; Morejón, Karen Mirna Loro; Bicudo, Letícia S; Souza, Germano E C; Gomes, Marco Antônio Mota; Fo, José J F Raposo; Schwarzbold, Alexandre Vargas; Zilli, Alexandre Cabral; Amazonas, Roberto Bleuel; Moreira, Frederico Rafael; Alves, Lucas Bassolli de Oliveira; Assis, Silvia R L; Neves, Precil Diego Miranda de Menezes; Matuoka, Jéssica Yumi; Boszczowski, Icaro; Catarino, Daniela Ghidetti Mangas; Veiga, Viviane Cordeiro; Azevedo, Luciano César Pontes; Rosa, Régis Goulart; Lópes, Renato D.; Cavalcanti, Alexandre Biasi; Berwanger, Otávio

doi:10.1016/j.lana.2022.100243

Cited by 27 publications

(59 citation statements)

References 28 publications

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“…The Relative Risk (RR) estimate from “COPE” for Hydroxychloroquine vs Placebo for COVID-19-related hospitalisation was 0.77 (95%CI [0.52–1.12]). 1 The pooled RR estimate reported by the authors, which was updated using the data from “COPE,” was similar (RR = 0.77 (95%CI [0.57–1.04])). 1 Although these estimates are compatible with no effect, they are also compatible with a reduction of 40% in the RR of hospitalisation.…”

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confidence: 80%

“… 1 The pooled RR estimate reported by the authors, which was updated using the data from “COPE,” was similar (RR = 0.77 (95%CI [0.57–1.04])). 1 Although these estimates are compatible with no effect, they are also compatible with a reduction of 40% in the RR of hospitalisation. Given Hydroxychloroquine's wide availability and low cost, and that there were no safety issues in “COPE,” a RR reduction of this magnitude could represent an important clinical benefit to COVID-19 outpatients at high risk of hospitalisation, e.g., those who have comorbidities, are not vaccinated, and have no access to costly therapies.…”

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confidence: 80%

“… 3 Therefore, “COPE” was a nondefinitive RCT. Current pooled estimates 1 are also nondefinitive, which precludes Hydroxychloroquine's routine use.…”

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confidence: 99%

“…In their comment about Hydroxychloroquine and “COPE” 1 (the largest RCT so far on Hydroxychloroquine for early treatment of COVID-19), Schwartz et al. 2 claimed that “ultimately, Hydroxychloroquine did not have clinical benefit,” 2 and that, therefore, “we can finally close the curtains on Hydroxychloroquine for COVID-19.” 2 These two claims are misleading.…”

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confidence: 99%

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Hydroxychloroquine for early treatment of COVID-19: Absence of evidence is different from evidence of absence

Furlan

2022

The Lancet Regional Health - Americas

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confidence: 80%

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confidence: 80%

“… 3 Therefore, “COPE” was a nondefinitive RCT. Current pooled estimates 1 are also nondefinitive, which precludes Hydroxychloroquine's routine use.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Hydroxychloroquine for early treatment of COVID-19: Absence of evidence is different from evidence of absence

Furlan

2022

The Lancet Regional Health - Americas

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“…Besides, the lack of efficacy of HCQ and HCQ/AZ for outpatient treatment [ 85 ], the absence of benefit of early treatment with HCQ for decreasing hospitalization [ 86 ], or the increased risk of major cardiovascular events with no effects on viral clearance rates, were reported in outpatients with early and mild COVID-19 disease [ 87 ]. More recently, in March 2022, a double-blind, multicenter, randomized, controlled trial attempted to increase the statistical power by including 1372 patients that were randomly allocated to HCQ or placebo [ 88 ], and further showed that in outpatients with mild/moderate forms of COVID-19, treatment with HCQ did not reduce the risk of hospitalization [ 89 ].…”

Section: Antimalarial Drugsmentioning

confidence: 99%

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

et al. 2022

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More than two years have passed since the viral outbreak that led to the novel infectious respiratory disease COVID-19, caused by the SARS-CoV-2 coronavirus. Since then, the urgency for effective treatments resulted in unprecedented efforts to develop new vaccines and to accelerate the drug discovery pipeline, mainly through the repurposing of well-known compounds with broad antiviral effects. In particular, antiparasitic drugs historically used against human infections due to protozoa or helminth parasites have entered the main stage as a miracle cure in the fight against SARS-CoV-2. Despite having demonstrated promising anti-SARS-CoV-2 activities in vitro, conflicting results have made their translation into clinical practice more difficult than expected. Since many studies involving antiparasitic drugs are currently under investigation, the window of opportunity might be not closed yet. Here, we will review the (controversial) journey of these old antiparasitic drugs to combat the human infection caused by the novel coronavirus SARS-CoV-2.

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Science and Ethics of “Curing” Misinformation

Freiling

Krause

Scheufele

2023

AMA Journal of Ethics

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A growing chorus of academicians, public health officials, and other science communicators have warned of what they see as an ill-informed public making poor personal or electoral decisions. Misinformation is often seen as an urgent new problem, so some members of these communities have pushed for quick but untested solutions without carefully diagnosing ethical pitfalls of rushed interventions. This article argues that attempts to "cure" public opinion that are inconsistent with best available social science evidence not only leave the scientific community vulnerable to long-term reputational damage but also raise significant ethical questions. It also suggests strategies for communicating science and health information equitably, effectively, and ethically to audiences affected by it without undermining affected audiences' agency over what to do with it.Current Myopia About Misinformation "I believe that misinformation is now our leading cause of death," US Food and Drug Administration Commissioner Robert Califf tweeted in April 2022, "and we must do something about it." 1 Diagnoses like this one are understandable. Normative democratic ideals assume that the best available scientific evidence informs both societal and individual decisions and crowds out misperceptions, disinformation, or conspiratorial thinking. Because of what it sees as a recent deviation from these norms in our current information environment, the World Health Organization has warned about an "infodemic," 2 or a deluge of information-some of it inaccurate-that makes it difficult for citizens to separate signal from noise.

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Hydroxychloroquine versus placebo in the treatment of non-hospitalised patients with COVID-19 (COPE – Coalition V): A double-blind, multicentre, randomised, controlled trial

Cited by 27 publications

References 28 publications

Hydroxychloroquine for early treatment of COVID-19: Absence of evidence is different from evidence of absence

Hydroxychloroquine for early treatment of COVID-19: Absence of evidence is different from evidence of absence

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

Science and Ethics of “Curing” Misinformation

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