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

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

#241

Post by threeseed »

cableshaft wrote: post #111
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?

A friend of mine found a doctor to prescribe it but his pharmacy won't fill it. He is so pissed. He was only planning to take small doses here or there as he's a teacher and around sick kids all the time, as if it were like Zinc to hopefully help reduce the severity of Covid-19 if he does get it, but despite going through the effort and succeeding in finding a doctor willing to prescribe it (and my friend even signed…

> pharmacy shouldn't be allowed to decide not to fill it, as if they know better than your doctor

They are legally required to make decisions about whether or not to fill it.

They are not just some supermarket cashier.

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

#242

Post by nradov »

mlyle wrote: post #239
nradov wrote: post #221

Earlier quoted context omitted.

The RCT is the gold standard, but observational studies can be sufficient to establish causality when the effect size is large enough with a clear dose response curve. No one has ever conducted an RCT to prove that cigarette smoking causes lung cancer, but we're pretty sure that it does.

> to establish causality when the effect size is large enough with a clear dose response curve. And when there's some plausible underlying mechanism that can be studied by more rigorous means. Otherwise, observational studies can find correlation, not causation-- and they're not even very robust at that.

No the dose response curve alone can be sufficient. Remember that the FDA has approved multiple SSRI drugs for treating clinical depression despite a lack of understanding on the actual mechanism of action. There are several plausible hypotheses but we really don't know why they work.

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

#243

Post by flavius29663 »

danaris wrote: post #66
sjwalter wrote: post #50

Earlier quoted context omitted.

And in the meantime, if you buy into the crazed insanity of "pandemic! pandemic! omg we'll all die", then it makes tonnes of sense to treat people with a highly-available, incredibly safe medication that frontline clinicians all over earth are reporting success with, especially a drug that has been dosed ~4 billion times over two generations, that has been most often dosed by illiterate people and delivered by non-do…

Penicillin is also a highly-available, incredibly safe medication that's been given billions of times. It still doesn't make any sense to try giving it to COVID patients, because there's no reasonable way it would actually help them . Just because a particular medication is unlikely to kill you doesn't mean it's a good idea to promote its use against a particular threat, when that threat is completely unrelated to wh…

Sorry, but you are wrong. Antibiotics are used in the treatment of severe viral infections, because your body is not able to fight secondary infections with bacteria very well. Antibiotics are given to help your body in cases of bad viral infections. Covid-19 is no exception. https://www.thelancet.com/journals/langlo/article/PIIS2214-1...

The point is: there are more mechanisms by which our body can be helped fight covid, and the Ivermectin proponents say that it works only in the early days of the infection, not like a full cure.

There are more ways to fight this disease, you are aware that the virus itself is not what's killing most people, right? Most people die because their body overreacts to the virus and damages the lungs (that is why standard treatment includes steroids to calm down the antibodies). A drug doesn't have to kill off the virus to win.

I have no idea if Ivermectin is helpful or not, but the trashing in the media (even calling it horse dewormer - while it's a human drug as well) before there is any proof against it is just bad, it makes me think there are ulterior motives for this.

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

#244

Post by mlyle »

nradov wrote: post #242
mlyle wrote: post #239

Earlier quoted context omitted.

> to establish causality when the effect size is large enough with a clear dose response curve. And when there's some plausible underlying mechanism that can be studied by more rigorous means. Otherwise, observational studies can find correlation, not causation-- and they're not even very robust at that.

No the dose response curve alone can be sufficient. Remember that the FDA has approved multiple SSRI drugs for treating clinical depression despite a lack of understanding on the actual mechanism of action. There are several plausible hypotheses but we really don't know why they work.

A dose response curve in an observational study is irrelevant for establishing causation.

There is a dose-response relationship between umbrellas outside and rainfall., but umbrellas do not cause rainfall.

And the SSRI point is tangential: they were approved based on RCT evidence. Observing umbrella use and concluding it causes rainfall, even though we don't know of a reason why umbrella use would cause rainfall, is quite different.

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

#245

Post by ashtonkem »

chana_masala wrote: post #190
koboll wrote: post #65

Earlier quoted context omitted.

It's weak evidence because COVID-19 observational studies are riddled with confounders due to COVID patients generally throwing everything at it they can to try and stay alive. The exact same pattern occurred with hydroxychloroquine. Lots of small observational studies showed promise. Then it repeatedly failed large RCTs. It turns out that the people with the resources to use HCQ also had the resources to use other t…

So what were those other things, then?

Dexamethasone, Remdesivir, and monoclonal antibodies are part of the go to treatments for severe Covid cases. They’re the major exotic bits of what they gave trump when he got sick, along with a bunch of over the counter stuff (zinc, vitamin D, melatonin, etc.) My understanding is that the monoclonal antibodies are the really expensive treatments.

The Dexamethasone one is an interesting story. It started out as a more controversial “throw everything at the wall and see what sticks” solution by a specialist who knew steroids well. Later studies have shown a strong effect on survival, so it’s become a fairly uncontroversial part of the tool kit for severe Covid.

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

#246

Post by threeseed »

swader999 wrote: post #173
brandonmenc wrote: post #54

Earlier quoted context omitted.

> 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.

Ivermectin from horse paste cleared up all of my long covid symptoms except for lung inflammation which prednisone fixed after the ivm. Pretty incredible. Felt better after a few hours and after each subsequent daily dose of five total. A lot of the studies don't seem to be using enough doses or they use too low of a dose. I was at .06g/kg body weight per dose. Also you need to take it with zinq!

HN should delete this post and probably your account.

You are actively encouraging people to get on a path that ends up in overdose and death.

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

#247

Post by shapefrog »

rory wrote: post #47
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…

Although it has more dangers than ivermectin, why shouldn't you have access to ketamine if you feel it helps you? A lot of people believe it has off-label benefits for their mental health, and maybe it does. Perhaps we just have different general perspectives on the individual and society.

Why not all drugs of all types. Why call it an opiod crisis and not just here is what happens when you give everyone whatever drugs they hear on the internet make you feel good?

First you deny someone ivermectin, next minute you are saying only 1 oxycotin with your beer.

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

#248

Post by rajin444 »

VikingCoder wrote: post #233
rory wrote: post #25

Ivermectin probably doesn't do anything to fight Covid-19, but the American media has really shown their corruption in the way they've treated it. It's clearly a safe drug to take in human-designed doses, and it's cheap to produce. Laughing at people for poisoning themselves with "horse dewormer" instead of pointing out that they are turning to the vet store because their access to medicine has been marginalized is s…

> Unproven != disproven. How many people have been convinced by the supposed effectiveness of Ivermectin and Hydroxychloroquine that they then decided to not get vaccinated? It's really not as simple as "unproven != disproven".

How many people were convinced of the "95+%" effectiveness of the vaccine only to learn that it fades? Why weren't they told it would fade up front?

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

#249

Post by shapefrog »

h2odragon wrote: post #108
xtracto wrote: post #95

Earlier quoted context omitted.

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 t…

I take it you have no problem eating dog food for your 3 square meals a day plus a few of those chew biscuits for a snack?

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

#250

Post by swader999 »

dhimes wrote: post #193
swader999 wrote: post #173

Earlier quoted context omitted.

Ivermectin from horse paste cleared up all of my long covid symptoms except for lung inflammation which prednisone fixed after the ivm. Pretty incredible. Felt better after a few hours and after each subsequent daily dose of five total. A lot of the studies don't seem to be using enough doses or they use too low of a dose. I was at .06g/kg body weight per dose. Also you need to take it with zinq!

Did you self-medicate, or were you under the direction of a medical doctor?

My doctor told me to wait it out, anywhere up to twelve more months. Yes, I self medicated. Suicide would have been my other choice had I not had Ivermectin - felt like I was slowly dying to begin with. It was very debilitating and impossible to work.
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