The worst

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June 3, 2020 9h12

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The worst

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Jean-François Cliche

The Sun

BLOG / I may return to this story of hydroxychloroquine in every sense, I don’t see what could be the worse, nor a worse time : a few days after a study published in The Lancet was prompted the world health Organization to suspend clinical trials on the so-called virtues of this medicine against the COVID-19, the prestigious medical journal has issued yesterday an “expression of concern” about it. Hello the nightmare public relations…

Hydroxychloroquine is the molecule commonly used in the treatment of malaria that the doctor in marseille Didier Raoult, in the wake of a small (and questionable) study chinese, has made the decision to administer on a large scale at the hospital where he works. He has pulled some “data” that they described as evidence of efficiency, but that the methodological limitations are so huge, in fact, that they have robbed more than they have convinced the scientific community.

However, and don’t ask me how it happened because I have no idea, this story is coming into resonance with a certain movement that is populist. The defenders of hydroxychloroquine describe Dr. Raoult as a genius, a kind of Galilee, who would be given a fair trial on the part of the”elite” medical paris. The refusal of the health authorities to generalize the use of this medicine against the COVID-19 is interpreted as a conspiracy of “elites” to prevent the little people are to be treated. Other studies (and there are many) that have found no benefit with hydroxychloroquine, are suspected of having been guided by the “Big Pharma”. In short, as we say in technical jargon, the fair is stuck.

The study published in The Lancet, even if it was not a clinical trial in good and due form, had at first sight all the appearance of an end point, in part because of its size (it colligeait the data of 96 000 patients treated for the COVID-19 in hospitals around the world) and in part because it concluded that not only hydroxychloroquine (in conjunction or not with other medications) didn’t help, but that it was associated with an excess of cardiac death.

But now, scientists (who are not part of the “clan Raoult”) have quickly begun to voice serious doubts about the study in The Lancet. For example : the numbers of the patients treated in Africa were asking for measurement instruments that african hospitals had little to ever afford ; the data, which claimed to cover a period from December until the 14th of April, included australian patients, of which 73 would be dead, so that in date of 21 April, Australia accounted for 67 deaths related to the COVID-19 ; the study claimed to have had access to the data of 63 000 patients in north american on a total of 66 000 in mid-April, which would have involved nearly (and improbably) all the hospitals of the continent would have collaborated with the authors. Without counting the question marks surrounding the firm Surgisphere, who claimed to have collected these data — see here for a good overview.

In sum, these figures appear to have been made of all parts. And the New England Journal of Medicine has also expressed “concern” recently the subject of a different study on the hydroxychloroquine made by the same research team. For those who are not familiar with the procedures of science : when a scholarly journal publishes an expression of concern, it means that she has doubts about the validity/honesty of an article that was published, that an investigation is ongoing, and it is possible that its conclusion brings the review to the “unpublish” or to change it.

At the risk of repeating myself : in a context where supporters of chloroquine have a strong penchant for conspiracy theories, I don’t see what could have happened worse than a history of false data about the largest study published to date. As it was expected, moreover, they give to heart joy on social networks :

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But, not their offense, I don’t think this scandal will change the portrait as that. Of course, we can easily understand why they interpret this as a victory — it is clear, from the point of view of “public relations”. But the overall picture remains unchanged, at least on the following points :

– This episode (re -) demonstrates that, overall, there is no cabal against the hydroxychloroquine in the scientific community — beyond Surgisphere, means. These are scholars who have sounded the alarm, many of which are yet very, very critical of the methods of Didier Raoult. It is a sign strong enough that researchers are generally honest people who are interested in the truth, no matter who she gives a reason in the end.

– This is still only one study. Several others before it had found no convincing indication that hydroxychloroquine cure or prevent really the COVID-19. On this subject, see this literature review recently, published may 27 in the Annals of Internal Medicine, which concluded that the evidence of benefits or harm of “very weak and contradictory”.

– The risks for patients with cardiac problems, to them, are known since very long time, and this scandal does not change anything.

Now all that remains is to hope two things. One, that this sad episode does not worsen too much the distrust of the science — because after all, all of this demonstrates how the research is self-corrects. Of the two, WHO should go back on its decision to suspend the clinical trials, a decision she had taken in the wake of the study in The Lancet.

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