Working in the Pharma Industry (Rheumatology specific), I have 1st hand knowledge of the following information I'm going to share.

• Plaquenil (Hydroxychloroquine Sulfate) - is an oral Rx 1st Step Therapy in diagnoses of Rheumatoid Arthritis, Lupus, and malaria.

1st Step Therapy - means that American Medical Insurance Companies and physicians in their Rx approval departments deemed that Plaquenil, HCQ Sulfate, must be tried and failed before a Patient will be permitted to try a more invasive Rx treatment such as a biologic.

Plaquenil, (Hydroxychloroquine Sulfate) is classified as a DMARD.
DMARD: Disease-modifying anti-rheumatic drugs

Biologics - TNF Inhibitors, are a special type of DMARD that is injected at home, administered via IV in a hospital or at MD's office.

"They weaken your ability to fight germs, so you may get infections while taking biologics."

My initial thoughts were on all RA Patients taking biologics, TNF Inhibitors, during this Coronavirus pandemic, imagine all of the Rheumatoid Arthritis Patients taking biologics that have a compromised autoimmune system...how badly will they be affected?!?

Risk of biologic Rx use in the elderly as it weakens the immune system leaving susceptibility of infections like #Ecoli.

https://www.rheumatologynetwork.com/arthritis/use-biologic-agents-geriatric-population

#Hydroxychloroquine is SAFE!
HCQ is prescribed to children with the diagnosis of JIA, Juvenile Idiopathic Arthritis.

"Chloroquine was modified to hydroxychloroquine to significantly reduce the possible side effects..."

https://www.jia.org.uk/hydroxychloroquine-for-children-and-young-people

Plaquenil, (HCQ Sulfate), is 1st line therapy for Rheumatoid Arthritis, which means you have to try and fail this drug, Plaquenil, before stepping to a biologic Rx like Humira or Enbrel, which are heavily advertised on TV and much more expensive ($2,500+).

John Hopkins University video on Patients on Auto-Immune Suppressants as biologics at greater risk for #COVID19 and basically how these Patients are between two limited options. Rock and a hard place.

This is a Rheumatology Specialty Rx Form for biologics. The HCQ, Plaquenil, is so safe that it's 1st-Line-Therapy BEFORE your insurance companies approve use of a biologic. It must be TRIED and FAILED and DOCUMENTED to be approved for most biologics.

If you notice, there's a box that the MD has to check 'Yes or No,' regarding whether Tuberculosis is ruled out. Insurance companies have to verify that no infections like TB are present before prescribing a biologic as it would be detrimental to the health of the Patient.

You can't be prescribed a biologic if you are sick.
MD's wait until you are feeling better or clear of infections. Plus insurance companies require tests of negative for TB prior to approval of a biologic.

Biosimilars vs Biologics.
*(Biosimilars = Generic version of brand name Biologics, once exclusivity expires prior to 2025 will be available)*

Demographic of age taking biologics.

http://biosimilarscouncil.org/wp-content/uploads/2019/03/Biosimilars-Council-Patient-Access-Study.pdf&ved=2ahUKEwibn8yJ5L_pAhVLB50JHROiCxUQFjARegQIChAB&usg=AOvVaw3maJMSs_K0FeXWxr4u0HSS&cshid=1589886639829

Per Biosimilars Council Org, study/report above, in 2014 3.1 million Americans were using 1 out 7 biologics.

• US population: 331 million
• 2014, 3.1 million Americans on biologics
• 0.0000000094% of Americans in 2014 were on biologics.
• % of >65 years could not be found.

"...utilization demographics show that two out of three patients being
treated with these products are women; 86 percent of the total patients are above the
age of 40; and 42 percent are either poor or low-income patients (see Fig. 2)."

Q drop 4040 with CDC link to data of COVID-19 deaths, pneumonia, flu, and #'s:

Q drop 4040 with link to CDC provisional death count:
• Sudden fall in pneumonia and flu deaths?
• Falsely reporting?
• 11,356 COVID-19
• 54,217
https://www.cdc.gov/nchs/data/health_policy/Provisional-Death-Counts-COVID-19-Pneumonia-and-Influenza.pdf

Can bioweapons target specific ethnic groups or age-specific populations? Like the elderly?
#TheMoreYouKnow https://m.washingtontimes.com/news/2020/may/14/china-deception-fuels-fears-biological-weapons-eth/

With what is known about #SARSCOV2 #COVID19 #WuhanVirus #CoronaVirus, it targets the elderly and people who are autoimmune compromised or other underlying health conditions.

Now couple that with about 3.1 million Americans, ranging from 20-80+ use biologics.

The elderly, especially, are at greater risk of infection while using a biologic that helps their current diagnosis for taking it. Yet it leaves them vulnerable for Coronavirus and other Respiratory infections during this pandemic.

I can surely believe the virus was engineered to target the elderly and with 3.1 million+ Americans taking some biologic, weakening their immune system, it falls harder on the elderly taking biologics. If they stop, their existing conditions worsen and they're damned if they do.

@SecAzar @realDonaldTrump @NSAGov @StateDept @SecPompeo @ChuckGrassley @RepRatcliffe @RepDougCollins @RonJohnsonWI @WhiteHouse @HHSGov

Lastly, regarding biologics, injections, most patients prefer oral therapies versus injectable medications. Food for thought when people are offered #Hydroxychloroquine+ or a #vaccine.
Oral vs Injection. #KnowledgeIsPower

https://pubmed.ncbi.nlm.nih.gov/22422352/