6 ms·

I have seen an increasing amount of Ivermectin promotion recently, and at face value it looks worth pursuing. My biggest concern is the overall shady nature of

I have seen an increasing amount of Ivermectin promotion recently, and at face value it looks worth pursuing. My biggest concern is the overall shady nature of many of its proponents, and specifically when I see posts or individuals that in the same breath have a strong anti-vaccine stance that and are promoting Ivermectin. Obviously the two things have nothing to do with each other, and frankly I can't understand what the agenda is there. Its promising to see something in Science which I hope has a higher bar, although I'm not familiar with the blogs section Edit: > An editorially independent blog from the publishers of Science Translational Medicine. All content is Derek’s own, and he does not in any way speak for his employer.

briefcomment 5y ago
You think it's shady to look into a drug that is out of patent? What is the profit motive there?
joe_the_user 5y ago
Obviously the two things have nothing to do with each other, and frankly I can't understand what the agenda is there. The apparently-rational argument the shady-type make that Ivermectin is so good you don't need vaccines. But I don't think any honest advocates can claim that. The fuzzy-irrational argument is you can't "trust" the medical industrial complex 'cause they're pushing vaccines and suppressing Ivermectin. This stuff is terrible but there's method to their madness.
fernly 5y ago
What connects antivax and untutored Ivermectin promotion is a generalized, reflexive, contrarian rejection of anything perceived as "establishment" science.
- krrrh 5y ago
  For some it’s also an application of the precautionary principle, and a worry that rushing into widespread application of an experimental treatment may present unknown harms. Contra to the contrarians rejecting establishment science, a secondary concern driving the precautionary perspective is a fear that if there are major medium or long term complications then it would lead to a widespread distrust of the scientific establishment itself. The problem is that an epistemic closure around this issue has emerged for a variety of reasons, so the people who are skeptical and willing to talk about it are few in number and looking for allies, so you end up with a rather motley crew. I’m interested in what people like Pierre Kory and Tess Lawrie say on this issue because they seem like credible people without a track record of crankery, and they’ve looked at the same evidence as the WHO and come to different conclusions. Even if they are wrong it is interesting to engrave with and figure out why. And if they are right, it would be good to figure that out sooner rather than later. But any time I stick around in the forums where their work is discussed the comments section is often overrun by unhinged wackos with different motivations.
GreaterFool 5y ago
> a strong anti-vaccine stance that and are promoting Ivermectin I would assume that the core of this sentiment is something like “vaccine is a semi-permanent modification of immune response while ivermectin is a temporary chemical adjustment” I’m just guessing though.
ralph84 5y ago
They have a lot to do with each other. The emergency use authorization for the vaccines was predicated on there being no effective approved alternatives. If there's an effective approved alternative, the vaccines lose their EUA and are back to being clinical trials until full approval. So anti-vax people want an effective treatment to be found to invalidate the EUA. Pro-vax people don't want an effective treatment to be found because it would invalidate the EUA.
- ceejayoz 5y ago
  > Pro-vax people don't want an effective treatment to be found because it would invalidate the EUA. This seems highly unlikely. Do you have a reputable source for this, because thus far I’ve only seen it as a conspiratorial anti-vax talking point.
- javagram 5y ago
  Dexamethasone is a cheap generic drug that has been proven to reduce covid-19 mortality and is being used worldwide including in the USA. The studies showing that it worked occurred before the EUA for the vaccines was issued. It is officially recommended on https://www.covid19treatmentguidelines.nih.gov/therapies/immunomodulators/corticosteroids/ https://www.covid19treatmentguidelines.nih.gov/therapies/imm... I am not sure there is any actual proof that if ivermectin was shown to be, e.g., as effective as dexamethasone in reducing covid-19 mortality that it would stop the FDA from issuing a EUA for a vaccine. After all there is a big difference between a vaccine and a treatment anyway.
  - shaicoleman 5y ago
    > Dexamethasone is a cheap generic drug that has been proven to reduce covid-19 mortality and is being used worldwide including in the USA. The studies showing that it worked occurred before the EUA for the vaccines was issued. It is officially recommended on [nih.gov]... These are the same doctors that recommended the use of corticosteroids when everyone else was recommending against it. These are the same doctors that recommended anti-coagulation treatment when everyone else was recommending against it. These are the same doctors that identified airborne transmission of disease, the WHO is only starting to acknowledge it more than a year later. They were ridiculed and criticised at the time for things that are now standard of care, and proved right time and time again. They are the same doctors that are now recommending Ivermectin, and are now being censored (e.g. senate hearing removed from YouTube) and labelled as spreading medical misinformation. https://www.youtube.com/watch?v=3UTuT9TSRFQ&t=110s https://www.youtube.com/watch?v=3UTuT9TSRFQ&t=110s
exmadscientist 5y ago
The thing that really defeats the ivermectin argument is simply effect size (or, equivalently, drug effectiveness). For a drug to be useful, it needs to have a larger effect than existing therapies. The larger the effect, the more useful. And the larger the effect, the easier it will show up in studies. Ivermectin's trial results are mediocre at best. So it can't be that powerful a treatment. It's probably helping a bit, or at least not hurting, but it's not a wonder drug. We'd have seen that if it were! So then you get into the usual lines of bullshit, as we saw before with the hydroxychloroquine people. "Augment with unicorn horn dust" and "dose more" and "dose earlier" and all that. But COVID-19 is the sort of disease that is impractical to dose too early, so "must dose very early" just means "drug is useless". Thus the facts are clear: even if ivermectin works, it isn't useful. It was a great hypothesis to test. It failed in the clinic. So it's irresponsible to continue beating against it when we have better avenues to pursue.
- ds206 5y ago
  But Ivermectin IS a wonder drug for other things. It's been around for decades and billions of doses have been taken. It's not just some random drug. Having said that, it remains to be seen if can work for covid too.
  - exmadscientist 5y ago
    > It's not just some random drug. Yes, its safety profile and production are well-established. But as far as covid is concerned, it is some random drug. Metformin is also a wonder drug, should we bet our lives on it for covid? No? You say there are more useful things? I really don't understand why people think this drug can work. It was trialled. It neither passed with flying colors nor flamed out. That's... pretty much what most drug candidates do. It doesn't really "remain to be seen" here: there's plenty of evidence for "doesn't move the needle".
- macinjosh 5y ago
  The fact that is it’s effective at early stages does not make it useless. It could be taken prophylacticaly if you know you’re going to be in a high risk situation like a roommate tests positive.
MattGaiser 5y ago
> a strong anti-vaccine stance that and are promoting Ivermectin. Obviously the two things have nothing to do with each other, and frankly I can't understand what the agenda is there. One of the people I know is one of these people. Pro Ivermectin and anti vaccine. It’s tied together by their belief that COVID was overblown, an attempt by the government to seize control, or an attempt by big pharma to make piles selling COVID vaccine. Or all three. Basically to this person, Ivermectin being a cure is proof that the government/doctors/pharma manufactured the crisis.
gus_massa 5y ago
> It's promising to see something in Science which I hope has a higher bar, although I'm not familiar with the blogs section. I'm a regular reader of this blog. I have an specialization in Chemistry in the Secondary School, so I can vouch that his articles about Chemistry are solid (and adobe my knowledge level). I'm convinced that the articles about the pharmaceutical industry are correct, but that's a little more far away from my specialization. About Ivermectin, someone posted a few days ago a site that collect all the favorable evidence. I read a few of the papers and in my opinion it's not convincing. The papers are studies with a small number of persons, or with a small difference or instead of the control group they compare with dubious numbers. Essentially, the same conclusion of this blog post, but I only skimmed a few papers and he probably read most of them carefully. If I were you, I'd thrust his opinions more than mine, but in this case we agree.
- renewiltord 5y ago
  > have an specialization in Chemistry in the Secondary School Not familiar with American idioms. What does this mean? Secondary School is what you go to after Primary School where I come from, but clearly you can’t mean that.
  - jjgreen 5y ago
    I think the OP is Brazilian (submissions include links to blog), in which case Secondary extends to 18, so equivalent to A-level in the UK for example.
    - gus_massa 5y ago
      Almost. I'm from Argentina. I'm not sure about the translation, and the system has changed recently, so the current information may be different. My "Secondary School" was from 13 to 18 (6 years). https://es.wikipedia.org/wiki/Educaci%C3%B3n_Secundaria_T%C3%A9cnica https://es.wikipedia.org/wiki/Educaci%C3%B3n_Secundaria_T%C3... You had one additional year than a normal "Secondary School" here, it [1] includes normal classes in the morning but less History/Geography/Whatever and in my case more Chemistry, a lot of Chemistry. Half of the days in the afternoon we had practical classes, making Chemistry experiments. At the end, I get a the "Secondary School" degree that enables me to go to the university and also some official habilitation to run a small chemistry factory or laboratory (oversimplifying the legal details) (probably is more accurate to say that I can supervise a few persosns in a factory or a lab). Other students instead of Chemistry classes had Masonry classes and got an habilitation to build a small house (up to 2 stories?) and other Electronic classes, ... Each School has a different specialization, a bunch of specializations. Edit: [1] The last 4 years. And the first 2 years have also more technical classes than a usual school, but they mix other stuff like basic electricity or metalworking.
collyw 5y ago
I find it rather troubling, lumping scepticism of these experimental, emergency authorized vaccines in the same category as existing vaccines that have had decades of use and well known safety profiles . It puts you into "yes" or "no "camps, without acknowledging potential unknown problems with these rushed vaccines. There are no long term studies. I am not anti-vaccine, but I don't think we should be as gung-ho as we are with these vaccines, especially on young people who are at very low risk from covid. Vaccinating children seems immoral.

briefcomment 5y ago

You think it's shady to look into a drug that is out of patent? What is the profit motive there?

joe_the_user 5y ago

Obviously the two things have nothing to do with each other, and frankly I can't understand what the agenda is there. The apparently-rational argument the shady-type make that Ivermectin is so good you don't need vaccines. But I don't think any honest advocates can claim that. The fuzzy-irrational argument is you can't "trust" the medical industrial complex 'cause they're pushing vaccines and suppressing Ivermectin. This stuff is terrible but there's method to their madness.

fernly 5y ago

What connects antivax and untutored Ivermectin promotion is a generalized, reflexive, contrarian rejection of anything perceived as "establishment" science.

krrrh 5y ago
For some it’s also an application of the precautionary principle, and a worry that rushing into widespread application of an experimental treatment may present unknown harms. Contra to the contrarians rejecting establishment science, a secondary concern driving the precautionary perspective is a fear that if there are major medium or long term complications then it would lead to a widespread distrust of the scientific establishment itself. The problem is that an epistemic closure around this issue has emerged for a variety of reasons, so the people who are skeptical and willing to talk about it are few in number and looking for allies, so you end up with a rather motley crew. I’m interested in what people like Pierre Kory and Tess Lawrie say on this issue because they seem like credible people without a track record of crankery, and they’ve looked at the same evidence as the WHO and come to different conclusions. Even if they are wrong it is interesting to engrave with and figure out why. And if they are right, it would be good to figure that out sooner rather than later. But any time I stick around in the forums where their work is discussed the comments section is often overrun by unhinged wackos with different motivations.

GreaterFool 5y ago

> a strong anti-vaccine stance that and are promoting Ivermectin I would assume that the core of this sentiment is something like “vaccine is a semi-permanent modification of immune response while ivermectin is a temporary chemical adjustment” I’m just guessing though.

ralph84 5y ago

They have a lot to do with each other. The emergency use authorization for the vaccines was predicated on there being no effective approved alternatives. If there's an effective approved alternative, the vaccines lose their EUA and are back to being clinical trials until full approval. So anti-vax people want an effective treatment to be found to invalidate the EUA. Pro-vax people don't want an effective treatment to be found because it would invalidate the EUA.

ceejayoz 5y ago
> Pro-vax people don't want an effective treatment to be found because it would invalidate the EUA. This seems highly unlikely. Do you have a reputable source for this, because thus far I’ve only seen it as a conspiratorial anti-vax talking point.
javagram 5y ago
Dexamethasone is a cheap generic drug that has been proven to reduce covid-19 mortality and is being used worldwide including in the USA. The studies showing that it worked occurred before the EUA for the vaccines was issued. It is officially recommended on https://www.covid19treatmentguidelines.nih.gov/therapies/immunomodulators/corticosteroids/ https://www.covid19treatmentguidelines.nih.gov/therapies/imm... I am not sure there is any actual proof that if ivermectin was shown to be, e.g., as effective as dexamethasone in reducing covid-19 mortality that it would stop the FDA from issuing a EUA for a vaccine. After all there is a big difference between a vaccine and a treatment anyway.
- shaicoleman 5y ago
  > Dexamethasone is a cheap generic drug that has been proven to reduce covid-19 mortality and is being used worldwide including in the USA. The studies showing that it worked occurred before the EUA for the vaccines was issued. It is officially recommended on [nih.gov]... These are the same doctors that recommended the use of corticosteroids when everyone else was recommending against it. These are the same doctors that recommended anti-coagulation treatment when everyone else was recommending against it. These are the same doctors that identified airborne transmission of disease, the WHO is only starting to acknowledge it more than a year later. They were ridiculed and criticised at the time for things that are now standard of care, and proved right time and time again. They are the same doctors that are now recommending Ivermectin, and are now being censored (e.g. senate hearing removed from YouTube) and labelled as spreading medical misinformation. https://www.youtube.com/watch?v=3UTuT9TSRFQ&t=110s https://www.youtube.com/watch?v=3UTuT9TSRFQ&t=110s

exmadscientist 5y ago

The thing that really defeats the ivermectin argument is simply effect size (or, equivalently, drug effectiveness). For a drug to be useful, it needs to have a larger effect than existing therapies. The larger the effect, the more useful. And the larger the effect, the easier it will show up in studies. Ivermectin's trial results are mediocre at best. So it can't be that powerful a treatment. It's probably helping a bit, or at least not hurting, but it's not a wonder drug. We'd have seen that if it were! So then you get into the usual lines of bullshit, as we saw before with the hydroxychloroquine people. "Augment with unicorn horn dust" and "dose more" and "dose earlier" and all that. But COVID-19 is the sort of disease that is impractical to dose too early, so "must dose very early" just means "drug is useless". Thus the facts are clear: even if ivermectin works, it isn't useful. It was a great hypothesis to test. It failed in the clinic. So it's irresponsible to continue beating against it when we have better avenues to pursue.

ds206 5y ago
But Ivermectin IS a wonder drug for other things. It's been around for decades and billions of doses have been taken. It's not just some random drug. Having said that, it remains to be seen if can work for covid too.
- exmadscientist 5y ago
  > It's not just some random drug. Yes, its safety profile and production are well-established. But as far as covid is concerned, it is some random drug. Metformin is also a wonder drug, should we bet our lives on it for covid? No? You say there are more useful things? I really don't understand why people think this drug can work. It was trialled. It neither passed with flying colors nor flamed out. That's... pretty much what most drug candidates do. It doesn't really "remain to be seen" here: there's plenty of evidence for "doesn't move the needle".
macinjosh 5y ago
The fact that is it’s effective at early stages does not make it useless. It could be taken prophylacticaly if you know you’re going to be in a high risk situation like a roommate tests positive.

MattGaiser 5y ago

> a strong anti-vaccine stance that and are promoting Ivermectin. Obviously the two things have nothing to do with each other, and frankly I can't understand what the agenda is there. One of the people I know is one of these people. Pro Ivermectin and anti vaccine. It’s tied together by their belief that COVID was overblown, an attempt by the government to seize control, or an attempt by big pharma to make piles selling COVID vaccine. Or all three. Basically to this person, Ivermectin being a cure is proof that the government/doctors/pharma manufactured the crisis.

gus_massa 5y ago

> It's promising to see something in Science which I hope has a higher bar, although I'm not familiar with the blogs section. I'm a regular reader of this blog. I have an specialization in Chemistry in the Secondary School, so I can vouch that his articles about Chemistry are solid (and adobe my knowledge level). I'm convinced that the articles about the pharmaceutical industry are correct, but that's a little more far away from my specialization. About Ivermectin, someone posted a few days ago a site that collect all the favorable evidence. I read a few of the papers and in my opinion it's not convincing. The papers are studies with a small number of persons, or with a small difference or instead of the control group they compare with dubious numbers. Essentially, the same conclusion of this blog post, but I only skimmed a few papers and he probably read most of them carefully. If I were you, I'd thrust his opinions more than mine, but in this case we agree.

renewiltord 5y ago
> have an specialization in Chemistry in the Secondary School Not familiar with American idioms. What does this mean? Secondary School is what you go to after Primary School where I come from, but clearly you can’t mean that.
- jjgreen 5y ago
  I think the OP is Brazilian (submissions include links to blog), in which case Secondary extends to 18, so equivalent to A-level in the UK for example.
  - gus_massa 5y ago
    Almost. I'm from Argentina. I'm not sure about the translation, and the system has changed recently, so the current information may be different. My "Secondary School" was from 13 to 18 (6 years). https://es.wikipedia.org/wiki/Educaci%C3%B3n_Secundaria_T%C3%A9cnica https://es.wikipedia.org/wiki/Educaci%C3%B3n_Secundaria_T%C3... You had one additional year than a normal "Secondary School" here, it [1] includes normal classes in the morning but less History/Geography/Whatever and in my case more Chemistry, a lot of Chemistry. Half of the days in the afternoon we had practical classes, making Chemistry experiments. At the end, I get a the "Secondary School" degree that enables me to go to the university and also some official habilitation to run a small chemistry factory or laboratory (oversimplifying the legal details) (probably is more accurate to say that I can supervise a few persosns in a factory or a lab). Other students instead of Chemistry classes had Masonry classes and got an habilitation to build a small house (up to 2 stories?) and other Electronic classes, ... Each School has a different specialization, a bunch of specializations. Edit: [1] The last 4 years. And the first 2 years have also more technical classes than a usual school, but they mix other stuff like basic electricity or metalworking.

collyw 5y ago

I find it rather troubling, lumping scepticism of these experimental, emergency authorized vaccines in the same category as existing vaccines that have had decades of use and well known safety profiles . It puts you into "yes" or "no "camps, without acknowledging potential unknown problems with these rushed vaccines. There are no long term studies. I am not anti-vaccine, but I don't think we should be as gung-ho as we are with these vaccines, especially on young people who are at very low risk from covid. Vaccinating children seems immoral.