>>8840100 lb
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Some More Thoughts on Hydroxychoroquine and Lyme Disease
Took some interest in this topic with when POTUS mentioned it in his meeting with recovered China virus patients, and again as I saw it in the last bread.
Summaries are included for some of the medical literature on the topic.
HCQ for Lyme - user reviews are mixed. Some anecdotal evidence of benefit - and of risk
https://www.drugs.com/comments/hydroxychloroquine/for-lyme-disease-arthritis.html
Medical rationale for adding HCQ: alkalization to enhance action of antibiotics such as tetracycline class (ie, not primarily direct effect on Lyme microbes).
https://www.amjmed.com/article/S0002-9343(17)30103-1/pdf
HCQ also has some direct effect against Borrelia burgdorferi IN VITRO:
2002 in vitro study study (noted also lb) shows that in a Petri dish HCQ can inhibit and destroy Lyme disease bacteria, both in their active and their cystic phases. HOWEVER, the concentrations are very high - 32 (for active) to over 128 (for cystic) micrograms/mL (µg/mL), whereas therapeutic blood levels for treating lupus were 500 to 2000 nanograms/mL (ng/mL) using standard dosage. 1 µg = 1000 ng. Concentrations in the Petri dish therefore WAY higher than can be safely attained in humans.
In vitro study (full text posted lb): https://link.springer.com/article/10.1007/s10123-002-0055-2
Blood levels: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630115/
Clinical literature however does not have much hopeful data.
Most articles cite the above in vitro study above and the below open-label study and the controlled study.
2003 study using HCQ with a macrolide antibiotic (clarithromycin [Biaxin], azithromycin [Z-pack], or erythromycin). Hypothesis is that HCQ can raise intracellular pH because these antibiotics do not work well in acidic contexts. Treatment was open label - all patients knew they were receiving active drugs, no control group is a limitation of the study. Treatment continued for quite a while - complete responders continued on treatment for another month, partial responders another 1-2 months, and non responders another 3 months before being considered a failure. There were very few cures (5%) and a minority of failures (~20%) and the rest (~75%) were improved - but again, no control group so a drug effect is not clear here.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453770/
2016 Study patients with persistent symptoms of Lyme disease. Compares HCQ+clarithromycin to doxycycline or placebo. All patients received 2 weeks of IV ceftriaxone (cephalosporin antibiotic) before being randomized to the 3 treatment groups. Primary outcome was RAND-36 Health Status Inventory, a measure of quality of life (which symptoms impact). NO treatment group was better than placebo. Note, 12 weeks is as long as the 2003 study above.
https://www.nejm.org/doi/full/10.1056/NEJMoa1505425
2019 analysis of the same data as the 2016 study, focusing on cognitive outcomes. Unsurprisingly, no treatment effect was seen in this one either.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453770/