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gorskon's profile
David Gorski, MD, PhD
David Gorski, MD, PhD
David Gorski, MD, PhD
Verified account
@gorskon

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David Gorski, MD, PhDVerified account

@gorskon

Surgeon/scientist promoting science in medicine and exposing quackery. Editor of Science-Based Medicine. My opinions do NOT represent those of my employers.

Michigan, USA
sciencebasedmedicine.org
Joined October 2009

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    1. David Gorski, MD, PhD‏Verified account @gorskon 30 Mar 2020

      On Friday, Prof. Didier Raoult posted another study of azithromycin and hydroxychloroquine used against COVID-19. It is a single arm observational study of patients with mostly mild (or even asymptomatic) disease that is painfully uninformative.https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/ …

      22 replies 112 retweets 293 likes
      Show this thread
    2. Lina Meng‏ @LinaMengPharmD 30 Mar 2020
      Replying to @gorskon

      [Google translated] Cases of #COVID19 positive patients hydroxychloroquine associated or not with azithromycin, rhythm disturbances or cardiac conduction, cardiac arrests in other French hospitals. Some of these judgments turn out to be "fatal"https://www.lepoint.fr/sante/exclusif-coronavirus-plusieurs-cas-mortels-d-usage-de-la-chloroquine-en-france-30-03-2020-2369285_40.php …

      2 replies 35 retweets 42 likes
    3. Rachel M Wagner MD‏ @drrachelwagner 31 Mar 2020
      Replying to @LinaMengPharmD @gorskon

      Dang I wish this was in English.

      2 replies 0 retweets 1 like
    4. Sean Hopkins 🇨🇦‏ @Onco_Sean 31 Mar 2020
      Replying to @drrachelwagner @LinaMengPharmD @gorskon

      30 adverse cardiac events, 3 deaths reported. Love the orange moron's take on "safe"

      1 reply 0 retweets 2 likes
    5. Rachel M Wagner MD‏ @drrachelwagner 31 Mar 2020
      Replying to @Onco_Sean @LinaMengPharmD @gorskon

      But is there any more information about doses, prior existing conditions or whether they were self administering? It would be helpful.

      2 replies 0 retweets 2 likes
    6. Sean Hopkins 🇨🇦‏ @Onco_Sean 31 Mar 2020
      Replying to @drrachelwagner @LinaMengPharmD @gorskon

      Still undergoing pharmacovigilance. Cases are reported and then the back-tracing happens. No self-medication - prescription only.

      1 reply 0 retweets 2 likes
    7. Sean Hopkins 🇨🇦‏ @Onco_Sean 31 Mar 2020
      Replying to @Onco_Sean @drrachelwagner and

      Had this been patients in a randomized trial we would have had this information upfront, but renegade mass-prescribing does not lend well to gathering information.

      1 reply 1 retweet 4 likes
      David Gorski, MD, PhD‏Verified account @gorskon 31 Mar 2020
      Replying to @Onco_Sean @drrachelwagner @LinaMengPharmD

      Yep. What I fear now is that we'll NEVER really know if these drugs work, or, if they do, what the optimal dosing and combination are, or which patients are most likely to benefit, because no one will agree to be randomized to placebo in a randomized trial.

      6:18 AM - 31 Mar 2020
      • 6 Retweets
      • 22 Likes
      • Gerald R Dever Pearl Paul Catherine Risotto Kari Jerge, MD, FACS (she/her) Tom Brown emmawidlake Alison Humphrey RCP Current Resident
      5 replies 6 retweets 22 likes
        1. Sean Hopkins 🇨🇦‏ @Onco_Sean 31 Mar 2020
          Replying to @gorskon @drrachelwagner @LinaMengPharmD

          100% agree with you. I get off-label prescribing. It happens. I have participated in this with good clinical rationale in one-off patients. High-quality evidence-based medicine is needed for this pandemic, not quackery.

          0 replies 1 retweet 5 likes
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        2. Rachel M Wagner MD‏ @drrachelwagner 31 Mar 2020
          Replying to @gorskon @Onco_Sean @LinaMengPharmD

          I keep sharing the information about clinical trials. Problem is health care providers tend to be too busy right now to participate. I guess... or maybe they are unimpressed by the current data?

          1 reply 0 retweets 0 likes
        3. Sean Hopkins 🇨🇦‏ @Onco_Sean 31 Mar 2020
          Replying to @drrachelwagner @gorskon @LinaMengPharmD

          If the hospital MD's have access to a clinical trial, they are doing themselves a disservice by not using that. The FDA emergency approval and supplies are only for patients without access to trials. I get being busy; however, trials should be the SOC right now.

          0 replies 0 retweets 0 likes
        4. End of conversation
        1. New conversation
        2. Current Resident‏ @tartu85 31 Mar 2020
          Replying to @gorskon @Onco_Sean and

          You don’t think somebody will do an SAR series on them to figure out MOA for off target effects?

          1 reply 0 retweets 0 likes
        3. Sean Hopkins 🇨🇦‏ @Onco_Sean 31 Mar 2020
          Replying to @tartu85 @gorskon and

          That will not usurp the need for clinical outcomes. This is not like a biologic that we have direct knowledge of an MOA that can be replicated over time. Many drugs that have an MOA know still fail in treating patients.

          1 reply 0 retweets 1 like
        4. Show replies
        1. New conversation
        2. Zeblai Scalpa‏ @BlaiseScalpa 31 Mar 2020
          Replying to @gorskon @ShermansMarch2 and

          Sorry for french version but we’ll have a 1300 cases study, double blind placebo and I guess with a serious randomisation & evaluation herehttp://www.lefigaro.fr/flash-actu/covid-19-une-vaste-etude-pour-clore-le-debat-sur-la-chloroquine-20200331 …

          2 replies 5 retweets 4 likes
        3. This Tweet is unavailable.
        4. Show replies
        1. New conversation
        2. Rachel M Wagner MD‏ @drrachelwagner 1 Apr 2020
          Replying to @gorskon @Onco_Sean @LinaMengPharmD

          https://pdf.sciencedirectassets.com/272288/AIP/1-s2.0-S0399077X20300858/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjECYaCXVzLWVhc3QtMSJGMEQCID4YLi0o%2BagzFtKwPFbskh89KksXtNAyLt%2BXKOBOqNUMAiAL6htHN5yLNPBkUaR2XvL4DtGp6SzfhU%2BYlxT1tA%2FG%2BCq0AwgvEAIaDDA1OTAwMzU0Njg2NSIMRcEIx21HIFg0hXwrKpEDcK7X2a2HA3K%2Bfc9Nnx57gEj9gcdRz17hFuoS4ms%2BR0M7Wc3F9HxDRyR39dR4emoC30wUiH7cInj55sUqJMlGVMxE3U%2Bv6%2Bsl%2BIK9y5vtPVjmju5wc7SXZ5LVGLW1DyeXQYXzkWZj%2BJVw3Ahnn6Th9Bh43GY8sLCGdiKpgj0M5AvgmclqbbiNw3agfQIhzVVAgDJzw906EmuZMXY%2FmpAuDC40HiDGdjNQBMrW8h2ghfJLK6M8CJM4k8pXEecr6TYOgDz827vZ7AQ1lgsK1j3Pp4C9FU7kUiQmKwWe0nnw%2BTmi8oCarM7Xdy99Iz8AINZyqKr4elY6o15WYIi%2FmBYjzltkrxIxwVnoiya5TjqQZ4%2FKpNkiz0k3%2FUeBVAO9%2BO3tK3ZfhZA%2FaIJ418nPQhKQ2%2FSKE0XWz6TNDcpR%2BbVSNkpYKmcnMhiZhovvULl7e%2BTGbVVPPwxKWSB8uawO6i9%2F3ugJkfRCnUZKFTrZ%2F%2FBN9dVP%2FbkP%2BYU8RVJFYzplD9l9L2BEMG%2F%2FHxlTFWe3qqxXdMMw2rSS9AU67AFfKYWHuN29OWNtt3NVwSXWlJfvgyXosU8B1llZXWJOrJsXOnIRg3P%2BJTpYcNqWboxvJP0g%2BuJQZM0mhXh%2FR1Heh8mlH0ysj%2B91IdqO2ZxGYo0C%2BIHHjTdOZ1y9NlBz9KfZ7kqHDUjJWI%2FqwO6BA6UcNklnvlJLWN3miF2VVFpSU91Sh2D98RpBStdRrdw8VKj1EXGt92pIo5SbqdTRMQTeI4xbNyD0jw3OiTqX2fw52sFLjKFVrds8YuP%2BmVHxDw9VQMwWdJ2xiu8bsoIi0aQq2nPxSc4HitDqKiwtnnOieT2AvxFDC%2FqebIa7mg%3D%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20200401T144710Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYUX7UBCX4%2F20200401%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=964ea22258b2716b1801b2f3df3ec6cba609cb087dead305aea2c7805b024173&hash=5a1a5c1513ce633f1adb87a9f816d6438feaaf2919c54600c1411dd738d462e2&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S0399077X20300858&tid=spdf-9a107a18-88e8-496f-aa31-771da6b6cce5&sid=493be4ff3b9fd2499e19e5d-f3c947052883gxrqa&type=client …

          1 reply 1 retweet 1 like
        3. Sean Hopkins 🇨🇦‏ @Onco_Sean 1 Apr 2020
          Replying to @drrachelwagner @gorskon @LinaMengPharmD

          To stay consistently on message, they should have randomized twice the number of patients and reported that. But very important in framing the hypothesis that is being generated and studied in larger trials. My note as a pharmacist is the patient that developed prolonged Qt.

          0 replies 0 retweets 1 like
        4. End of conversation

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