3 ms·

Repeatedly when Ivermectin was widely deployed, you see consistenly sharp drops in cases within two weeks, shortly followed by drops in hospitalizations and dea

Repeatedly when Ivermectin was widely deployed, you see consistenly sharp drops in cases within two weeks, shortly followed by drops in hospitalizations and deaths. https://covid19criticalcare.com/ivermectin-in-covid-19/epidemiologic-analyses-on-covid19-and-ivermectin/ https://covid19criticalcare.com/ivermectin-in-covid-19/epide... The same thing has been consistenly reproduced in dozens of trials, including dozens of RCTs. https://pubmed.ncbi.nlm.nih.gov/34145166/ https://pubmed.ncbi.nlm.nih.gov/34145166/ https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab358/6316214 https://academic.oup.com/ofid/advance-article/doi/10.1093/of... And you don't need a big RCT for everything. You need to do a risk/benefit analysis and ensure that it makes clinical sense. Doctors talk between each other and share what works for their patients and what doesn't. If there's near zero risk and cost, and it's shown repeatedly to save at least 60% of lives then erring on the side of caution would be to use it. The cost of doing nothing is millions of deaths and trillions in economic damage. Even the failed RCTs show improvement, just not a statistically significant one. This is usually due to bad trial design: too small doses, too late treatment, widespread self medication in the placebo group, undisclosed financial interests, no exclusion of vaccinated or those who already had COVID, etc. For comparison, Remdesivir has 539 reported deaths, Ivermectin has 20 deaths total over 4 billions doses, which makes it order of mangitude safer. http://www.vigiaccess.org/ http://www.vigiaccess.org/ Remdesivir was approved based on a single sponsored RCT that showed negligible improvement, and yet it was approved, and yet a safe drug studies by hundreds of scientists isn't in dozens of trials isn't. Ivermectin is not a panacea, that's why it should be combined with other things that are safe and have evidence of improved outcomes (e.g. Vitamin D, Vitamin C, Quercetin, Zinc). https://covid19criticalcare.com/covid-19-protocols/i-mask-plus-protocol/ https://covid19criticalcare.com/covid-19-protocols/i-mask-pl...

gus_massa 5y ago
> Even the failed RCTs show improvement, just not a statistically significant one. This is usually due to bad trial design: This is usually caused by report and publication bias. All the similar studies that show no improvement or a bad outcome are never published. > And you don't need a big RCT for everything. You need to do a risk/benefit analysis and ensure that it makes clinical sense. Doctors talk between each other and share what works for their patients and what doesn't. Here is were we disagree. Except for cases when it's impossible (like open heart surgery), it's necessary to do a good RCT. Doctors sharing anecdotes is not reliable, for example it has a lot of confirmation bias. I've read very similar arguments to justify using hydroxychloroquine without a good RCT last year.
- shaicoleman 5y ago
  > I've read very similar arguments to justify using hydroxychloroquine without a good RCT last year The big RCTs for Hydroxychrloriquine used almost toxic doses in very late treatment stages, when there's no viral replication. These were studies that were designed to fail in order to discredit early treatments. The corruption of medical sciences has happened many times before (e.g. tobacco industry, asbestos, Vioxx, opioids...) HCQ is only effective in the early viral replication stage, (the first few days after symptoms). For example, in a peer-reviewed study of 29K patients for early treatment, it showed a 73% reduction in death. https://www.sciencedirect.com/science/article/pii/S1567576921002721 https://www.sciencedirect.com/science/article/pii/S156757692... If you only include early treatment studies, you do see that HCQ definitely helps. https://hcqmeta.com/#fig_fpearly https://hcqmeta.com/#fig_fpearly https://hcqmeta.com/#exc https://hcqmeta.com/#exc That said, the results for HCQ compared to Ivermectin are less consistent, it only works early stages, it has no anti-inflammatory effect, the improvements are smaller, and there are more adverse effects. The risk/benefit there is smaller, but it's still much better than the current approach which is take paracetamol until you're sick enough to go the hospital. There are zero RCTs for paracetamol. If you're curious about the case for Ivermectin, this is a good video to start with: https://www.youtube.com/watch?v=LkIKCbwBcLU&t=708s https://www.youtube.com/watch?v=LkIKCbwBcLU&t=708s

gus_massa 5y ago

> Even the failed RCTs show improvement, just not a statistically significant one. This is usually due to bad trial design: This is usually caused by report and publication bias. All the similar studies that show no improvement or a bad outcome are never published. > And you don't need a big RCT for everything. You need to do a risk/benefit analysis and ensure that it makes clinical sense. Doctors talk between each other and share what works for their patients and what doesn't. Here is were we disagree. Except for cases when it's impossible (like open heart surgery), it's necessary to do a good RCT. Doctors sharing anecdotes is not reliable, for example it has a lot of confirmation bias. I've read very similar arguments to justify using hydroxychloroquine without a good RCT last year.

shaicoleman 5y ago
> I've read very similar arguments to justify using hydroxychloroquine without a good RCT last year The big RCTs for Hydroxychrloriquine used almost toxic doses in very late treatment stages, when there's no viral replication. These were studies that were designed to fail in order to discredit early treatments. The corruption of medical sciences has happened many times before (e.g. tobacco industry, asbestos, Vioxx, opioids...) HCQ is only effective in the early viral replication stage, (the first few days after symptoms). For example, in a peer-reviewed study of 29K patients for early treatment, it showed a 73% reduction in death. https://www.sciencedirect.com/science/article/pii/S1567576921002721 https://www.sciencedirect.com/science/article/pii/S156757692... If you only include early treatment studies, you do see that HCQ definitely helps. https://hcqmeta.com/#fig_fpearly https://hcqmeta.com/#fig_fpearly https://hcqmeta.com/#exc https://hcqmeta.com/#exc That said, the results for HCQ compared to Ivermectin are less consistent, it only works early stages, it has no anti-inflammatory effect, the improvements are smaller, and there are more adverse effects. The risk/benefit there is smaller, but it's still much better than the current approach which is take paracetamol until you're sick enough to go the hospital. There are zero RCTs for paracetamol. If you're curious about the case for Ivermectin, this is a good video to start with: https://www.youtube.com/watch?v=LkIKCbwBcLU&t=708s https://www.youtube.com/watch?v=LkIKCbwBcLU&t=708s