5 ms·

Trial group of 62 patients and no parasite screening in those patients - yawn. But could be interesting grounds for a more significant and controlled study wit

Trial 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 ago
Do we have any data on the base rate of parasite infections in Lagos?
- benzofuran 5y ago
  Depends 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 ago
If 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 ago
  Your 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 ago
    Sorry, my goofy kid is a graduating biochemistry senior and I keep him around the house for deployment in message board disputes.
    - pen2l 5y ago
      We 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...

Trial 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 ago

Do we have any data on the base rate of parasite infections in Lagos?

benzofuran 5y ago
Depends 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 ago

If 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 ago
Your 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 ago
  Sorry, my goofy kid is a graduating biochemistry senior and I keep him around the house for deployment in message board disputes.
  - pen2l 5y ago
    We 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...