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Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

nature.com

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Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#101

Post by threecheese »

rory wrote: post #57
tptacek wrote: post #28

Earlier quoted context omitted.

It matters a lot if ivermectin doesn't do anything to stop C19, even if it is otherwise safe (it surely is, dosed professionally). People take ivermectin instead of vaccinating or complying with NPIs. If ivermectin doesn't work, that is a very, very big deal.

> People take ivermectin instead of vaccinating or complying with NPIs Doing one thing but not another doesn't imply you're doing one thing instead of another. Do you truly believe the people ODing on ivermectin would be lining up for vaccinations if it didn't exist?

One doesn't imply the other, but it is certainly happening. People are using (being led to use) ivermectin as a prophylactic against covid, an alternative to the vaccine.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#102

Post by fullstop »

gonational wrote: post #96
fullstop wrote: post #87

Earlier quoted context omitted.

I agree that it is safe at appropriate doses. The issue is that people are self medicating and incorrectly calculating doses, since the product was intended for livestock.

The nationwide report that everybody talked about, pertaining to poison control centers receiving endless calls about this was completely fake. It turned out that rather than 70% of calls it was actually 2% of calls and over half of them were simply people asking questions about dosage. The other nationwide report about the hospitals in Oklahoma being crowded with ivermectin victims to the point where they could not…

I never said a word about any of that. I said that people are self medicating and incorrectly calculating an appropriate dosage, and I am not wrong. [1]

1. https://www.fda.gov/consumers/consumer-updates/why-you-shoul...

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#103

Post by mnw21cam »

marcodiego wrote: post #14
nradov wrote: post #3

Yes the quality of scientific research in this area has been rather bad with rushes to publish and ineffective peer review. Drs. Paul Marik and Pierre Kory recently updated their meta analysis to remove the retracted Elgazzar paper, and still found a significant effect. I'm not endorsing their letter, just pointing out that it exists and isn't mentioned in this Nature article. https://journals.lww.com/americantherape…

Can we infer that since "we need a real large scale controlled trial to settle the issue", the positive effect (if any) is necessarily small?

That's a good inference to make, yes.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#104

Post by sgt101 »

brandonmenc wrote: post #54
ashtonkem wrote: post #30

Earlier quoted context omitted.

People are literally taking horse formulations of ivermectin because doctors are rightfully refusing to prescribe ivermectin for an off label and ineffective use. Oh, and the access to this medicine is “marginalized” BECAUSE IT DOESNT WORK TO TREAT COVID. We generally do not expect doctors to prescribe medicine that will not work or is not appropriate for the patients condition. Complaining about their access being m…

> People are literally taking horse formulations of ivermectin People are taking the horse formulation because most pharmacists won't even fill an off-label prescription for the drug, which - even if it has no effect on COVID - is safe and taken by a quarter billion people every year. Let people take it. It's not harmful. Or, make a big huge deal about people taking it and, well, then it becomes a big huge deal.

I get where you are coming from, but I think that there is a nuance that you have missed. Like many, many drugs - and vaccines - ivemectin has some unpleasant and dangerous side effects in some people rarely. You can see these if you look the drug up :https://www.medicalnewstoday.com/articles/ivermectin-oral-ta... for example.

The point is that if this drug did help people make it through covid (like the vaccines do) then it would be worth the risk of these horrible things happening - if they were rare (they are). But unfortunately it looks like this is not true, so people are taking a risk of having a horrid side effect with no chance of the pill working.

On the other hand if you take the pill to avoid river blindness then the risk of the side effect seems well worth taking to me. But not for covid - 0 benefit for 0.001 risk is not good trade.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#105

Post by sgt101 »

brandonmenc wrote: post #86
vernie wrote: post #84

Earlier quoted context omitted.

Is that really the reason or is it that they can't get a doctor to write them an off-label prescription?

It's probably both, but why would a doctor risk losing their license over this? Yet another unintended consequence. Doctors are supposed to be able to write prescriptions for off-label use.

If they have reason to believe that it's beneficial. If they don't then they are being reckless.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#106

Post by cma »

brandonmenc wrote: post #54
ashtonkem wrote: post #30

Earlier quoted context omitted.

People are literally taking horse formulations of ivermectin because doctors are rightfully refusing to prescribe ivermectin for an off label and ineffective use. Oh, and the access to this medicine is “marginalized” BECAUSE IT DOESNT WORK TO TREAT COVID. We generally do not expect doctors to prescribe medicine that will not work or is not appropriate for the patients condition. Complaining about their access being m…

> People are literally taking horse formulations of ivermectin People are taking the horse formulation because most pharmacists won't even fill an off-label prescription for the drug, which - even if it has no effect on COVID - is safe and taken by a quarter billion people every year. Let people take it. It's not harmful. Or, make a big huge deal about people taking it and, well, then it becomes a big huge deal.

> is safe and taken by a quarter billion people every year.

Usually yearly or bi-yearly. Not bi-weekly. There is much less safety data on doses that frequent.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#107

Post by shadowgovt »

xtracto wrote: post #95
shadowgovt wrote: post #36

Earlier quoted context omitted.

How many users have been taking it in human-designed doses, given that it's not generally prescribed for COVID-19 (and therefore those who are taking it for that purpose are mostly self-medicating)?

Outside of the US is prescribed quite often. It is in the Mexican Health System Protocol ([1] page 6) and has been widely researched [2] in there. Also, in Mexico Ivermectin was widely available (without prescription) before Covid19. It is commonly used in children against lice, and also in the general population as a dewormer once a year (in Mexico, people are used to take these type of medications once a year). I u…

My mistake; my comment was extremely US-centric.

In the US, there isn't a taboo against taking it because it's generally animal-prescribed; it's used as a human anti-parasitic here too. The issue is that people are self-medicating with veterinary-supply doses because it isn't prescribed for COVID-19 (as it's not indicated for treating it).

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#108

Post by h2odragon »

xtracto wrote: post #95
shadowgovt wrote: post #36

Earlier quoted context omitted.

How many users have been taking it in human-designed doses, given that it's not generally prescribed for COVID-19 (and therefore those who are taking it for that purpose are mostly self-medicating)?

Outside of the US is prescribed quite often. It is in the Mexican Health System Protocol ([1] page 6) and has been widely researched [2] in there. Also, in Mexico Ivermectin was widely available (without prescription) before Covid19. It is commonly used in children against lice, and also in the general population as a dewormer once a year (in Mexico, people are used to take these type of medications once a year). I u…

> (I would never consume a medicine made for animals)

Why not?

I either pay $150+ all up for a doctor visit, prescription, etc for antibiotics, or $20 for a bottle of "fish antibiotics" at the feed store. Either way I get amoxicillin; but from the feed store I get 3x the amount and in smaller capsules which makes adjusting dose easier.

We stock the "horse paste" ivermectin for our half dozen hounds, I've been known to have a lick of it myself when ive been out barefoot in the mud, just in case. we have whipworm out here and they're not likely to take in humans but when they do its nasty.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#109

Post by sgt101 »

mechE321 wrote: post #71

The Bayesian gambler in me wants to think this: The studies on ivermectin seem to be split between "good effect" and "no effect," and there don't seem to be any (by my extremely informal review! going off of memory here) in the camp of "bad effect." Seems reasonable to take ivermectin as a decent gamble to me while we wait on the dang science to get its head out of its butt.

I would like to meet you in a casino. Type "Invermectin side effects" into any search engine, read the links. These are "bad effects".

The fraudulent studies (y'know, including dead patients, patients that never existed, drugs that weren't administered and so on) have shown a good effect.

The real studies unfortunately showed no effect.

My advice to you; don't gamble. Ever.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#110

Post by hackingforfun »

gonational wrote: post #96
fullstop wrote: post #87

Earlier quoted context omitted.

I agree that it is safe at appropriate doses. The issue is that people are self medicating and incorrectly calculating doses, since the product was intended for livestock.

The nationwide report that everybody talked about, pertaining to poison control centers receiving endless calls about this was completely fake. It turned out that rather than 70% of calls it was actually 2% of calls and over half of them were simply people asking questions about dosage. The other nationwide report about the hospitals in Oklahoma being crowded with ivermectin victims to the point where they could not…

> If the TV tells you something, you do not have to believe it.

Where do you think most of the people taking ivermectin heard about it? They probably have no idea how ivermectin would actually work, but heard it from some conservative talk show host that they trust more than scientists backing the actual COVID vaccine. I'm astonished by how totally backwards all of this is.

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