Ivermectin shows clinical benefits in mild to moderate COVID19: RCT double-blind(academic.oup.com)
academic.oup.com
Ivermectin shows clinical benefits in mild to moderate COVID19: RCT double-blind
https://academic.oup.com/qjmed/advance-article/doi/10.1093/qjmed/hcab035/6143037
60 comments
Please 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.
> only take this medication by prescription from a medical doctor.
And, if they prescribe it for treating COVID, look for a better doctor.
And, if they prescribe it for treating COVID, look for a better doctor.
Pretty sure if your case of Covid is severe enough to warrant treatment, you will not be calling around looking for a second opinion just because your doc prescribed an Rx that might be “internet controversial”.
Frankly I trust my doctor more than I trust FB, YouTube, and the government.
Frankly I trust my doctor more than I trust FB, YouTube, and the government.
Well… if we start from the premise I am desperate enough to throw reason out the window, then yeah, why not take horse dewormer, malaria drugs, fish tank cleaner, crystals and prayer?
Honestly…people who toss out the whole “horse dewormer” talking point should also refuse to take penicillin if your doctor prescribed it because they also give that drug to horses too.
It’s not just a “horse dewormer” folks, it’s a “people dewormer” that has also been used in anti-viral treatments as well. Argue that’s it’s not effective, but stop pretending that this isn’t a drug that is prescribed to people all over the world.
It’s not just a “horse dewormer” folks, it’s a “people dewormer” that has also been used in anti-viral treatments as well. Argue that’s it’s not effective, but stop pretending that this isn’t a drug that is prescribed to people all over the world.
I would also add, before you argue that it's ineffective, please consider it in the context of its place in the "triple therapy". We use drug combinations to treat things like cancer and peptic ulcers because of synergies. My understanding is that the ivermectin and doxycycline help zinc to get into our cells and the zinc is what does the work to inhibit virus replication.
I think you are going to have a hard time convincing someone who only refers to ivermectin as a “horse dewormer” to think of it beyond whatever their summary talking points tell them. That is why the talking point is to try and mislead folks as it being only a veterinary Rx, they don’t have to go into details…just dump the misinfo out there.
BTW, I’m not arguing for or against it for Covid. I am just saying that if my doctor decided to prescribe it for me, I’m going to trust their judgement, because I trust them.
BTW, I’m not arguing for or against it for Covid. I am just saying that if my doctor decided to prescribe it for me, I’m going to trust their judgement, because I trust them.
There's probably a proper term for this but it seems to me there's a lot of absolute-izing language being thrown around, on issues that aren't absolute. Eg, anyone not 100% onboard with immediately taking whatever vaccine is on offer is an anti-vaxxer. Anyone interested in searching out possible off-label uses of ivermectin might as well just cease and desist because we all know ivermectin is just for killing worms in horses.
It's designed to shut down any reasoned discourse or critical thinking and I'm surprised it's still working.
It's designed to shut down any reasoned discourse or critical thinking and I'm surprised it's still working.
Yep, “dichotomous thinking”.
Trust the doctors! Unless a doctor disagrees with me, then forget that doctor and trust me instead.
Trust the doctor, unless the doctor exhibits irrational behaviour and shows signs of being unable to interpret scientific literature.
It's more like, trust institutional medicine, and if your doctor doesn't, then find a new doctor.
I'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.youtube.com/watch?v=POfIMGS2D6A
https://www.dailymotion.com/video/x7wwdo6
https://www.youtube.com/watch?v=POfIMGS2D6A
Someone 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.
You seem to be confused. The studies which "later found it wasn't useful" were fabricated, as was discovered mere days after they hit the news. They weren't even plausible.
The initial studies were bad quality, they just removed the people who got admitted to ICUs from the treatment group. They were run by a doctor known to be a charlatan. They were pushed to Trump as a magic way to calm the people and market down.
I don't get why people like you think the world is so US centric. The world doesn't give a flying fuck about giving Trump a very slight lower chance of getting re-elected, much less kill their people and their economy for it. I don't see how studies across the world were fabricated, there's no reason for, say, India to kill millions of their citizens and destroy their economy by faking studies about HCQ when they don't hate Trump and may have even liked him.
You're the one that's confused, here's an analysis on HCQ from someone that has worked on drug discovery for decades.
https://www.science.org/content/blog-post/hydroxychloroquine...
You're a not a drug researcher.
And I don't think Trump pushed Ivermectin? If it works so well as you think, one would think the Democrats would be all over it so they can say Biden cured Covid and restored the economy.
I don't get why people like you think the world is so US centric. The world doesn't give a flying fuck about giving Trump a very slight lower chance of getting re-elected, much less kill their people and their economy for it. I don't see how studies across the world were fabricated, there's no reason for, say, India to kill millions of their citizens and destroy their economy by faking studies about HCQ when they don't hate Trump and may have even liked him.
You're the one that's confused, here's an analysis on HCQ from someone that has worked on drug discovery for decades.
https://www.science.org/content/blog-post/hydroxychloroquine...
You're a not a drug researcher.
And I don't think Trump pushed Ivermectin? If it works so well as you think, one would think the Democrats would be all over it so they can say Biden cured Covid and restored the economy.
a) "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/q...
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/q...
thanks
"Sample size: A convenient sample size of 60 with 20 in each arm, was planned. However, 62 were ultimately randomized."
Sounds very underpowered
Sounds very underpowered
And 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
I 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 =/
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 =/
This study was in vivo, not in vitro.
did 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 ;)
This does not seem to match the HackerNews title very well ;)
Yes 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?
I 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
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
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.
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.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!
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.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!
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.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.
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.
Sorry, my goofy kid is a graduating biochemistry senior and I keep him around the house for deployment in message board disputes.
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-2021-111...
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-2021-111...
Do we have any data on the base rate of parasite infections in Lagos?
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?
[deleted]
You know what shows great clinical benefits?
Getting vaccinated.
Getting vaccinated.
Awesome! Let's let medical professionals and the like make the decision about recommending it!
They are back. Spamming hacker news every day with debunked studies.
shadilay(1)
Much bigger study showing statistically significant benefits
https://www.ijidonline.com/article/S1201-9712(21)00100-4/pdf
That 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.
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.
>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/
Looks at the graphs there, and then check out a few of the studies with low p-values.
That's not my understanding from reading here: https://ivmmeta.com/
Looks at the graphs there, and then check out a few of the studies with low p-values.
If you go to 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.
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.
Ivermectin 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.
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.
I'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/
They will make more profit on the evergreen version of ivermectin they're working on.