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Ivermectin shows clinical benefits in mild to moderate COVID19: RCT double-blind
- rolph 5y agoa) "In vitro studies have shown the efficacy of Ivermectin (IV) to inhibit the SARS—CoV-2 viral replication, but questions remained as to in-vivo applications" [0] b) "Sixty-three patients with positive PCR result were randomized into three arms of the study. There was 1 withdrawal, thus 62 patients completed the study" [0] c) "We cannot conclude in this study that Ivermectin has a place in prophylaxis, but this warrants investigation." [0] [0] https://academic.oup.com/qjmed/advance-article/doi/10.1093/qjmed/hcab035/6143037 https://academic.oup.com/qjmed/advance-article/doi/10.1093/q...
- skyde 5y agothanks
- benzofuran 5y agoTrial group of 62 patients and no parasite screening in those patients - yawn. But could be interesting grounds for a more significant and controlled study with patients with comorbidities.
- nradov 5y agoDo we have any data on the base rate of parasite infections in Lagos?
- benzofuran 5y agoDepends where -just found a paper showing 54% of school children tested by sample (not seeking medical attention) in at least one area of Lagos. Probably lower in adults but it's not a sub-1% number or even close to it. So were the results due to the anti-parasitic action or something else?
- tptacek 5y agoIf you look on Twitter there are other methodological concerns people have with this study. The more important thing is just that it's relatively old, and there have been meta-analyses done; like, lots of people are studying the ivermectin question, and the weight of the evidence doesn't seem to be positive. Here's Cochran's meta-study; Cochran is, from what I can tell, very well-regarded. It appears to include this study. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015017.pub2/full?cookiesEnabled https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD... Later For what it's worth: the boy rebuts this with the observation that you'd expect worsening symptoms for patients with actual parasitic infection, since there's an immune response to necrotic parasite tissue when ivermectin works. None of us here are ivermexperts though!
- pen2l 5y agoYour link appears to not work, but for others' convenience I think this is what you meant to link: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015017.pub2/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD... Separately, I'm having trouble parsing your comment, but I'm curious so I will ask: when you say "the boy rebuts", who is the boy here, yourself? Or..? Maybe I'm just not familiar with this turn of phrase.
- tptacek 5y agoSorry, my goofy kid is a graduating biochemistry senior and I keep him around the house for deployment in message board disputes.
- pen2l 5y agoWe begin to see why you are #1 in the leaderboard; you have help. But concerning controversy surrounding ivermectin I found this interesting text: An important controversial point to consider in any rationale is the 5 µM required concentration to reach the anti-SARS-CoV-2 action of ivermectin observed in vitro,17 which is much higher than 0.28 µM, the maximum reported plasma concentration achieved in vivo with a dose of approximately 1700 µg/kg (about nine times the FDA-approved dosification).24 25 In this sense, basic fundamentals for assessing ivermectin in COVID-19 at a clinical level appear to be insufficient. Among other reasons, we believe this might have led WHO to exclude ivermectin from its Solidarity Trial for repurposed drugs for COVID-19,12 which raises questions about the pertinence of conducting clinical studies on ivermectin. from BMJ, "Misleading clinical evidence and systematic reviews on ivermectin for COVID-19" -- https://ebm.bmj.com/content/early/2021/05/26/bmjebm-2021-111678 https://ebm.bmj.com/content/early/2021/05/26/bmjebm-2021-111...
- shadilay 5y agoThe whole Ivermectin controversy has been so strange given that it's known to be safe. If it's effective great and if not then there's no harm.
- yeuxardents 5y agoIf its effective it means there is a treatment available. If there is a treatment available in the beginning stages of ncov19 then the justification for EUA, by law, becomes invalid. And pfizer and pharma companies lose billions and billions of dollars. Hence why it has been so strange...
- nradov 5y agoYou seem to have a misunderstanding of the law. The FDA is allowed to issue EUAs even when other treatments exist.
- yeuxardents 5y agoIt is you who is mistaken. Under an EUA, FDA may allow the use of unapproved medical products, or unapproved uses of approved medical products in an emergency to diagnose, treat, or prevent serious or life-threatening diseases or conditions when certain statutory criteria have been met, including that there are no adequate, approved, and available alternatives.
- nradov 5y agoNo I have it exactly right and you still don't understand the law. The FDA has wide latitude in how they interpret the word "adequate". And while it's possible that ivermectin may prove effective for COVID-19 treatment, as of today it's still not formally "approved" for that use. Doctors can prescribe it to COVID-19 patients but it's considered off-label use.
- yeuxardents 5y agoExcept you are still dancing around the topic here. The OP being responded to here, which is clearly widely available if you pay any attention to the news, is that the mainstream, FDA, CDC and pharma companies are seeking to extremely downplay, or outright declare ivermectin to be out of line, without doing any research, AND ignoring already existing clinical studies that show it to be efficacious. Thats the conversation, not splitting hairs on what is or is not adequate. FDA won't even seem to bother EVALUATING if it IS in fact adequate. Instead these players are acting like it does not exist, or is deadly, when it has a 30+ year history of clearly not being so. Edit: Hence my point about the billions of dollars in loss. Were the FDA to declare ivermectin efficacious and adequate then the EUA's would likely have to be rescinded. If not, then people would still have an alternative treatment to the vaccines, and thus pharma would lose billions to alternative treatment anyway. Option: Take 30+ year medicine with proven track record or take experimental vaccines that have not completed FDA approval or clinical trials, no cross sectional longitudinal studies of effects? https://www.law.cornell.edu/uscode/text/21/360bbb-3 https://www.law.cornell.edu/uscode/text/21/360bbb-3
- cjhveal 5y agoPlease only take this medication by prescription from a medical doctor. Even if these results are replicated, there is a huge difference between 12mg/day IV for 5 days under medical supervision and consuming a tube of apple flavored paste containing 6 grams of ivermectin. Ivermectin is neurotoxic at high doses and can absolutely kill you.
- rbanffy 5y ago> only take this medication by prescription from a medical doctor. And, if they prescribe it for treating COVID, look for a better doctor.
- josephcsible 5y agoTrust the doctors! Unless a doctor disagrees with me, then forget that doctor and trust me instead.
- foota 5y agoIt's more like, trust institutional medicine, and if your doctor doesn't, then find a new doctor.
- l8rlump 5y agoI'm not sure if this qualifies as "institutional" medicine, but here's the professor who invented the triple therapy protocol for peptic ulcers: https://www.dailymotion.com/video/x7wwdo6 https://www.dailymotion.com/video/x7wwdo6 https://www.youtube.com/watch?v=POfIMGS2D6A https://www.youtube.com/watch?v=POfIMGS2D6A
- belltaco 5y agoSomeone said the exact same thing to me when HCQ was pushed with bad quality studies by certain doctors to Fox News hosts who then pushed it to Trump. Higher quality studies later found it wasn't useful. So there.
- marricks 5y agoI saw a post on NIH studies showing possible benefits and people dismissing it because it wasn't a preponderance of evidence. Totally valid to dismiss a selected sample but made me realize there was more of a basis for its usage than, let's say, bleach. That said, I was wrong, removed. I guess it's too much to ask for people to trust the recommended medicine, perhaps we should get more pro-vaccine conspiracy theories out there =/
- nradov 5y agoThis study was in vivo, not in vitro.
- skyde 5y agodid you read the study? They explicitly say :"We cannot conclude in this study that Ivermectin has a place in prophylaxis, but this warrants investigation." This does not seem to match the HackerNews title very well ;)
- nradov 5y agoYes I read the study. It involved in vivo use of ivermectin in human subjects. The study authors acknowledged that further research is needed. What's the problem?
- skyde 5y agoI will save everybody the time to read it! See result below: Days to negative in the three trial arms: Ivermictine: avg= 6.0 95% CI= (4.61–7.38) Control: avg= 9.15 95% CI= (5.68–12.62) there was only 20 patient in the control group this would give a margin of error of 21.91% for that 95% confidence interval. Most statisticians agree that the minimum sample size to get any kind of meaningful result in this case would be ~385
- deleted 5y ago[deleted]
- bratao 5y ago"Sample size: A convenient sample size of 60 with 20 in each arm, was planned. However, 62 were ultimately randomized." Sounds very underpowered
- throwaway224466 5y agoAnd yet every study backing up the efficacy and safety of the covid vaccine for particular subsets has around 20 total participants, often times with an invalid control group in place....but I'm sure you eat that up and share away
- im-poor 5y agoI believe Moderna’s Phase 3 involved 30,000 people, just FYI.
- throwaway224466 5y agoDo you know the control group details and when they will be complete? I'm talking about things like "New study for Covid vaccine use on pregnant women shows to be safe and beneficial"...then the study includes ~20 women (read that yesterday, front page of google news)
- im-poor 5y agoThe government publishes all of the results. You can take a look yourself: https://clinicaltrials.gov/ct2/show/NCT04470427 https://clinicaltrials.gov/ct2/show/NCT04470427 There are a lot of studies done on small sample sizes. It some sense it’s necessary: if something is unsafe on a small sample, it’s more than likely unsafe on a large sample.
- resource0x 5y agoMuch bigger study showing statistically significant benefits https://www.ijidonline.com/article/S1201-9712(21)00100-4/pdf https://www.ijidonline.com/article/S1201-9712(21)00100-4/pdf
- tptacek 5y agoThat study is included in the meta-studies discussed here, all of which apparently lose all statistically-significant support for ivermectin once the fraudulent Egyptian study is removed from the data set. You can, for instance, find the Tlaxcalan study in the Cochrane meta-study I linked upthread. All these kinds of comments seem premised on the idea that nobody is studying ivermectin, and that any research results, even if just in 60 patients in Lagos, must be huge news. But lots of people are studying ivermectin! If it's effective, we should be seeing clear results.
- greenhatman 5y ago>all of which apparently lose all statistically-significant support for ivermectin once the fraudulent Egyptian study is removed from the data set That's not my understanding from reading here: https://ivmmeta.com/ https://ivmmeta.com/ Looks at the graphs there, and then check out a few of the studies with low p-values.
- gus_massa 5y agoIf you go to https://ivmmeta.com/ https://ivmmeta.com/ I suggest to ignore all the non RCT studies because they are usually very bad. There are only 31 RTC studies. Most of them are very small and not even statically significant. It is a known problem that studies that show no effect or a bad effect are never published due to report and publication bias. So it's better to ignore the not statically significant studies. So there are only 6 of the 31 RTC studies that are statically significant. If Ivermectin has no effect, we expect to see like 1.5 studies that are "statistically significant" due to a flukes. We don't know how many other studies have been tried but never published, so let's be very conservative and assume that if Ivermectin has no effect, we would get 2 studies that are "statistically significant" due to a flukes. There are 6. I read a few of them and have very strange things. Not smoking guns, but big red flags. So ... can you choose your favorite 3 statistically significant? I'll dismiss 2 as flukes and hopefully I can explain why the other study has a very big red flag and is not reliable.
- wobblyasp 5y agoAwesome! Let's let medical professionals and the like make the decision about recommending it!
- b0sk 5y agoThey are back. Spamming hacker news every day with debunked studies.
- resource0x 5y agoThe debunking was repeatedly debunked by numerous studies.
- throwaway224466 5y agoThe HN crowd is all about stats and data until it intersects with their WOKEness.
- throwaway224466 5y agoIvermectin is proven to work, but it's out of patent. That means pharmaceutical companies can't profit from it. Hence the Ivermectin FUD campaign. Big Pharma will do everything in their power, including manipulate the media, to buy time while they develop new oral Covid drugs with a slightly tweaked chemical composition (just enough for them to legally profit off it). Knowing they have a certain % of the population that will blindly follow and argue for them helps.
- nradov 5y agoI'm skeptical of those conspiracy theories. Merck is the biggest of pharma and they still manufacture ivermectin. Apparently they're still making some profit on it. https://www.merck.com/research-and-products/products-list/ https://www.merck.com/research-and-products/products-list/
- unanswered 5y agoThey will make more profit on the evergreen version of ivermectin they're working on.
- chaimanmeow 5y agoAfrica in general is faring relatively very well against the SARS2 epidemic, despite having the lowest vaccination rates and being disadvantaged as far as medical spending and medical and sanitary infrastructure. One possible explanation is the widespread use of Ivermectin in that continent (because of widespread parasites). There are of course other reasons too. For instance, it helps that they don't have a population that is 42%+ obese. (Though Ghana is on track to soon having a similar percentage of the adult population being overweight "Rates of overweight/obesity increased nearly 139 percent over a 15-year period from 1993–2008" --- https://www.usaid.gov/sites/default/files/documents/1864/Ghana-Nutrition-Profile-Mar2018-508.pdf https://www.usaid.gov/sites/default/files/documents/1864/Gha... ). https://www.cdc.gov/obesity/data/adult.html https://www.cdc.gov/obesity/data/adult.html
- kaminar 5y agoOpenvaers.com
- shawnb576 5y agoYou know what shows great clinical benefits? Getting vaccinated.