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GaetanBurgio's profile
Dr Gaetan Burgio, MD, PhD.
Dr Gaetan Burgio, MD, PhD.
Dr Gaetan Burgio, MD, PhD.
@GaetanBurgio

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Dr Gaetan Burgio, MD, PhD.

@GaetanBurgio

Group leader, Australian National University ANU, Australia. Geneticist working on infections & #CRISPR. Opinions and views ....

Canberra, Australia
researchers.anu.edu.au/researchers/bu…
Joined August 2014

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    1. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

      From the last couple of days the hype over the Chloroquine (CQ) and Hydroxychloroquine (HCQ) treatment for #COVID19 has bothered me a lot. So I have decided to dig into the available & published data. What is the evidence right now for treating #COVID19 patients with CQ or HCQ?

      141 replies 1,523 retweets 2,732 likes
      Show this thread
    2. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

      Let's start with the in-vitro evidence. 2 papers (link below). In short CQ and HCQ reduces #SARSCoV2 viral load in Vero2 cells. Results shows a EC50 around 1 to 100 µM depending on the regimen and initial viral load https://www.nature.com/articles/s41421-020-0156-0 … and https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa237/5801998 …pic.twitter.com/JXh6tchYoO

      4 replies 65 retweets 199 likes
      Show this thread
    3. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

      I short it shows that CQ and HCQ works against #SARSCoV2 in-vitro & seems to be working better in curative. Toxicity results are OK. Not surprising as CQ was previously showed as potent inhibitor of SARS-CoV & affect terminal glycosylation of ACE2 https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-2-69 …

      5 replies 58 retweets 201 likes
      Show this thread
    4. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

      In fact CQ was demonstrated in inhibiting the viral load of a lot of viruses, flaviviruses or retroviruses as it modulates the Ph of the cells (endosomes). for example a old review on it herehttps://www.ncbi.nlm.nih.gov/pubmed/14592603 

      2 replies 39 retweets 180 likes
      Show this thread
    5. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

      So now let's go into the human clinical trial data for #COVID19 as those were recently a lot publicized. Are these results promising enough to counsel everyone to take CQ or HCQ as prophylactic or curative against #COVID19 ?

      1 reply 37 retweets 141 likes
      Show this thread
    6. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

      Currently according to http://ClinicalTrial.gov , 6 trials using CQ or HCQ are underway for the treatment of prophylaxis of #COVID19 https://clinicaltrials.gov/ct2/results?cond=covid19&term=chloroquine&cntry=&state=&city=&dist=&Search=Search …pic.twitter.com/7lp71Lyh7i

      1 reply 58 retweets 186 likes
      Show this thread
      Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

      But the one that interests me is the French open-labeled non randomized clinical trial on HCQ + Azithromycin against #COVID19 infection, largely publicized. Details are here https://www.mediterranee-infection.com/wp-content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf …pic.twitter.com/KPbaUgIgAf

      8:50 PM - 20 Mar 2020
      • 64 Retweets
      • 197 Likes
      • AMARESH KUMAR Mario van Woensel Relentless Sherri A_bitter_ brew_of_neurotic_anger ACM Procureur Atterré🔻 rhoemch Aris
      6 replies 64 retweets 197 likes
        1. New conversation
        2. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

          This is a small clinical trial (n=42 in total). Inclusion criteria in short moderate #COVID19 infection (positive viral load). Exclusion criteria, allergy, long QT syndrome.... In total 42 enrolled, 6 drop out including 3 in ICU. Total 20 HCQ vs 16 controls.

          2 replies 41 retweets 165 likes
          Show this thread
        3. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

          Clinical presentation seemed similar between HCQ & control but sample size is so low, difficult to conclude really. Seriously underpowered. Outcome from the study is based on viral load only and not on clinical outcome and I can see a major flaw here as clinical outcome critical.pic.twitter.com/XgaDnm34bh

          5 replies 78 retweets 321 likes
          Show this thread
        4. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

          So 16 patient received no treatment, 14 patients received HCQ only (200 mg/ day) and 6 patients received HCQ (200 mg/day) + Azithromycin to prevent surinfection (on clinical judgement). The treatment was for 10 days and outcome on viral load (nasopharyngeal swabs)

          4 replies 34 retweets 150 likes
          Show this thread
        5. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

          The results showed a reduction of the viral load from HCQ and HCQ + Azithromycin treated patients compared to controls. Looks spectacular but wait .... No error base on these graphs. So I looked at the suppl datapic.twitter.com/UdN2y6779X

          7 replies 62 retweets 233 likes
          Show this thread
        6. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

          Looking at supplementary Table 1, most of the controls had viral load qualitatively detected or the PCR was not done !!!! . Only 4 out of 16 controls had a proper measure of the viral load !!!! This is insane !pic.twitter.com/hDhKewVcTu

          25 replies 173 retweets 661 likes
          Show this thread
        7. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

          In short, all this hype on the clinical trial is based on a open label, non randomized and underpowered clinical trial on HCQ treatment against #COVID19 with viral load as an outcome that was not properly measured in 2/3 of the control cohort !!!

          15 replies 271 retweets 712 likes
          Show this thread
        8. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

          So to answer the question: What is the evidence of justifying using HCQ or CQ as a prophylactic or curative treatment against #COVID19. The simple or short answer is NONE. To ascertain it, we need a proper and powered randomized clinical trial

          30 replies 384 retweets 866 likes
          Show this thread
        9. Dr Gaetan Burgio, MD, PhD.‏ @GaetanBurgio 20 Mar 2020

          While I understand we are in a #COVID19 pandemic, there is no reason or whatsoever to throw away all the evidence based medicine and not doing rigorous science or a randomized clinical trial !

          53 replies 167 retweets 871 likes
          Show this thread
        10. End of conversation
        1. Damon Lisch‏ @DamonLisch 21 Mar 2020
          Replying to @GaetanBurgio

          I am frankly surprised that this passed peer review.

          0 replies 0 retweets 0 likes
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        1. Hannah Gordon PhD, MSCI (she/her)‏ @brieski 21 Mar 2020
          Replying to @GaetanBurgio

          Thanks for this! You say this is “the one that interests you”—is this because it was flaunted as the best or it that it’s truly is horrible done? Are there better executed clinical trials that support CQ/HCQ other than this mess?

          0 replies 0 retweets 0 likes
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