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0 0.5 1 1.5 2+ Mortality -2% Improvement Relative Risk Rivera et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 506 patients in the USA No significant difference in mortality Rivera et al., Cancer Discovery, doi:10.1158/2159-8290.CD-20-0941 Favors HCQ Favors control
Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study
Rivera et al., Cancer Discovery, doi:10.1158/2159-8290.CD-20-0941
Rivera et al., Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer.., Cancer Discovery, doi:10.1158/2159-8290.CD-20-0941
Jul 2020   Source   PDF  
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Retrospective cancer patients, showing adjusted OR 1.03 [0.62-1.73] for HCQ. The study reports the number of HCQ+AZ patients but they do not provide results for HCQ+AZ (only HCQ + any other treatment). Significant confounding by indication and compassionate use is likely.
risk of death, 2.4% higher, RR 1.02, p = 0.92, treatment 44 of 179 (24.6%), control 59 of 327 (18.0%), adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rivera et al., 22 Jul 2020, retrospective, USA, peer-reviewed, 45 authors.
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Abstract: Published OnlineFirst July 22, 2020; DOI: 10.1158/2159-8290.CD-20-0941 Research Article Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study Donna R. Rivera1, Solange Peters2, Orestis A. Panagiotou3, Dimpy P. Shah4, Nicole M. Kuderer5, Chih-Yuan Hsu6, Samuel M. Rubinstein7, Brendan J. Lee7, Toni K. Choueiri8, Gilberto de Lima Lopes Jr.9, Petros Grivas10,11, Corrie A. Painter12, Brian I. Rini7, Michael A. Thompson13, Jonathan Arcobello14, Ziad Bakouny8, Deborah B. Doroshow15,16, Pamela C. Egan17, Dimitrios Farmakiotis18, Leslie A. Fecher19, Christopher R. Friese20, Matthew D. Galsky15,16, Sanjay Goel21, Shilpa Gupta22, Thorvardur R. Halfdanarson23, Balazs Halmos21, Jessica E. Hawley24, Ali Raza Khaki10, Christopher A. Lemmon22, Sanjay Mishra25, Adam J. Olszewski17, Nathan A. Pennell22, Matthew M. Puc26, Sanjay G. Revankar14, Lidia Schapira27, Andrew Schmidt8, Gary K. Schwartz24, Sumit A. Shah27, Julie T. Wu27, Zhuoer Xie23, Albert C. Yeh10, Huili Zhu15, Yu Shyr6, Gary H. Lyman11, and Jeremy L. Warner7,28 on behalf of the COVID-19 and Cancer Consortium Cancer Research. Published OnlineFirst July 22, 2020; DOI: 10.1158/2159-8290.CD-20-0941 Among 2,186 U.S. adults with invasive cancer and laboratory-confirmed SARSCoV-2 infection, we examined the association of COVID-19 treatments with 30-day all-cause mortality and factors associated with treatment. Logistic regression with multiple adjustments (e.g., comorbidities, cancer status, baseline COVID-19 severity) was performed. Hydroxychloroquine with any other drug was associated with increased mortality versus treatment with any COVID-19 treatment other than hydroxychloroquine or untreated controls; this association was not present with hydroxychloroquine alone. Remdesivir had numerically reduced mortality versus untreated controls that did not reach statistical significance. Baseline COVID-19 severity was strongly associated with receipt of any treatment. Black patients were approximately half as likely to receive remdesivir as white patients. Although observational studies can be limited by potential unmeasured confounding, our findings add to the emerging understanding of patterns of care for patients with cancer and COVID-19 and support evaluation of emerging treatments through inclusive prospective controlled trials. aBstRact SIGnIfICAnCE: Evaluating the potential role of COVID-19 treatments in patients with cancer in a large observational study, there was no statistically significant 30-day all-cause mortality benefit with hydroxychloroquine or high-dose corticosteroids alone or in combination; remdesivir showed potential benefit. Treatment receipt reflects clinical decision-making and suggests disparities in medication access.
Late treatment
is less effective
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