Ivermectin - A useful treatment for COVID-19 coronavirus? Some discussion and studies...

[Vibrant62]

For those interested, a summary of Ivermectin data can be found here, including a summary and links to the latest large Meta-Analysis

https://c19early.com - just click on the tab that says 'Ivermectin'. Other repurposed drugs / intervention data summaries can be found under other tabs for those interested.

Key findings of latest Meta-analysis

Ivermectin for COVID-19: real-time meta analysis of 59 studies

97% of 38 early treatment and prophylaxis studies report positive effects (95% of all 59 studies). 28 studies show statistically significant improvements in isolation. Random effects meta-analysis with pooled effects using the most serious outcome reported shows 77% and 85% improvement for early treatment and prophylaxis (RR 0.23 [0.14-0.39] and 0.15 [0.09-0.25]). Results are similar after exclusion based sensitivity analysis: 78% and 87% (RR 0.22 [0.16-0.30] and 0.13 [0.07-0.25]), and after restriction to 34 peer-reviewed studies: 78% and 88% (RR 0.22 [0.14-0.36] and 0.12 [0.05-0.30]). 81% and 96% lower mortality is observed for early treatment and prophylaxis (RR 0.19 [0.07-0.54] and 0.04 [0.00-0.58]). Statistically significant improvements are seen for mortality, ventilation, hospitalization, cases, and viral clearance. 100% of the 18 Randomized Controlled Trials (RCTs) for early treatment and prophylaxis report positive effects, with an estimated improvement of 70% and 83% respectively (RR 0.30 [0.22-0.42] and 0.17 [0.05-0.61]), and 93% of all 30 RCTs. The probability that an ineffective treatment generated results as positive as the 59 studies to date is estimated to be 1 in 17 trillion (p = 0.000000000000059). Heterogeneity arises from many factors including treatment delay, patient population, the effect measured, variants, and treatment regimens. The consistency of positive results across a wide variety of cases is remarkable. Heterogeneity is low in specific cases, for example early treatment mortality. While many treatments have some level of efficacy, they do not replace vaccines and other measures to avoid infection. Only 27% of ivermectin studies show zero events in the treatment arm. Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. All practical, effective, and safe means should be used. Not doing so increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage. Many studies do not specify administration, or specify fasting. Administration with food may significantly increase plasma and tissue concentration. All data to reproduce this paper and the sources are in the appendix. See [Bryant, Hariyanto, Hill, Kory, Lawrie, Nardelli] for other meta analyses, all with similar results confirming effectiveness. Improvement Studies Authors Patients Early treatment 77% [61‑86%] 24 243 3,341 Late treatment 46% [29‑59%] 21 175 6,760 Prophylaxis 85% [75‑91%] 14 108 8,789 Mortality 70% [53‑81%] 22 205 7,690 RCTs only 64% [50‑75%] 30 317 5,275 All studies 71% [63‑77%] 59 526 18,890 Evidence base used for other COVID-19 approvals Medication Studies Patients Improvement Budesonide (UK) 1 1,779 17% Remdesivir (USA) 1 1,063 31% Casiri/imdevimab (USA) 1 799 66% Ivermectin evidence 59 18,890 71% [63‑77%]

[JimO]

Thanks for posting these Vibrant.

[Shiloh]

Why Has "Ivermectin" Become a Dirty Word?
At the worst moment, Internet censorship has driven scientific debate itself underground
Matt Taibbi
17 hr ago


On December 8, 2020, when most of America was consumed with what The Guardian called Donald Trump’s “desperate, mendacious, frenzied and sometimes farcical” attempt to remain president, the Senate’s Homeland Security and Governmental Affairs Committee held a hearing on the “Medical Response to Covid-19.” One of the witnesses, a pulmonologist named Dr. Pierre Kory, insisted he had great news.

“We have a solution to this crisis,” he said unequivocally. “There is a drug that is proving to have a miraculous impact.”

Kory was referring to an FDA-approved medicine called ivermectin. A genuine wonder drug in other realms, ivermectin has all but eliminated parasitic diseases like river blindness and elephantiasis, helping discoverer Satoshi Ōmura win the Nobel Prize in 2015. As far as its uses in the pandemic went, however, research was still scant. Could it really be a magic Covid-19 bullet?

Kory had been trying to make such a case, but complained to the Senate that public efforts had been stifled, because “every time we mention ivermectin, we get put in Facebook jail.” A Catch-22 seemed to be ensnaring science. With the world desperate for news about an unprecedented disaster, Silicon Valley had essentially decided to disallow discussion of a potential solution — disallow calls for more research and more study — because not enough research and study had been done. Once, people weren’t allowed to take drugs before they got FDA approval. Now, they can’t talk about them.

“I want to try to be respectful because I think the intention is correct,” Kory told the committee. “They want to cut down on misinformation, and many doctors are claiming X, Y, and Z work in this disease. The challenge is, you’re also silencing those of us who are expert, reasoned, researched, and extremely knowledgeable.”

Eight million people watched Kory say that on the C-SPAN video of the hearing posted to YouTube, but YouTube, in what appears to be a first, removed video of the hearing, as even Senate testimony was now deemed too dangerous for public consumption. YouTube later suspended the Wisconsin Senator who’d invited Kory to the hearing, and when Kory went on podcasts to tell his story, YouTube took down those videos, too. Kory was like a ghost who floated through the Internet, leaving suspensions and blackened warning screens everywhere he went.

One of the challenges of the pandemic period is the degree to which science has become intertwined with politics. Arguments about the efficacy of mask use or ventilators, or the viability of repurposed drugs like hydroxychloroquine or ivermectin, or even the pandemic’s origins, were quashed from the jump in the American commercial press, which committed itself to a regime of simplified insta-takes made opposite to Donald Trump’s comments. With a few exceptions, Internet censors generally tracked with this conventional wisdom, which had the effect of moving conspiracy theories and real scientific debates alike far underground.

A consequence is that issues like the ivermectin question have ended up in the same public bucket as debates over foreign misinformation, hate speech, and even incitement. The same Republican Senator YouTube suspended for making statements in support of ivermectin, Ron Johnson, has also been denounced in the press for failing to call the January 6th riots an insurrection, resulting in headlines that blend the two putative offenses.

“You have these ideas about the need to censor hate speech, calls for violence, and falsity,” Kory says, “and they’ve put science on the same shelf.”...

Read more: https://taibbi.substack.com/p/why-ha...become-a-dirty

[Vibrant62]

I think that the primary issues here are nicely highlighted by Dr. John Campbell in his video here - https://www.youtube.com/watch?v=Of5_oiuqDp8

The issues raised are equally applicable to ALL repurposed drugs that have potential benefits, and are off-patent. There appears to be some very serious systemic failings of health and regulatory authorities at present that are allowing this situation to perpetuate, and this is becoming increasingly apparent and the evidence more stark as each day goes by. This is not a good situation for any country and its health authorities, the pharmaceutical companies themselves, nor their populations - if there are legal snags that mean acceptance of these repurposed drugs would compromise EUAs, then change the legislation to provide room for both/all approaches.

Fairly soon I hope that the penny will drop that no country can afford the ongoing economic damage caused by the pandemic, and to limit treatments to vaccines alone OR to solely go for novel treatment interventions under emergency use is simply unaffordable and if there are significant failures (severe long term effects) anywhere, then the backlash at every level will be severe.. The numbers of Long Covid sufferers is up to 30% of those affected, and there is NO indication that vaccination can protect from Long Covid, as mild and asymptomatic infections will still occur. In addition to all the other costs of actual infections, the costs of repeated vaccinations and the many subsequent interventions required to tackle the known sequelae of Covid infection (long term lung damage, myocarditis, type 1 diabetes, ME/CSF type conditions to name a few, not to mention the current concerns of neurologists over a potential avalanche of Parkinson's type disease, and the possibility of a huge uplift in cancers directly caused by the oxidative stress caused by active Covid infection, independent of severity of infection) are enough to bankrupt every country, including those in the West, not just from the direct costs but from the costs of losing a large chunk of your economically active populations. We need to throw everything at this - vaccination, PLUS (cheap) repurposed drugs PLUS novel interventions - there will still be needs for more specialist approaches where Pharma can make their profits, not to mention all the specialist meds that are / will be needed for long covid and its sequelae where no current treatments exist.

Surely there is more than enough profit to allow room for all these approaches at the same time, and everywhere across the globe.

I would like a decent explanation and justification from the NIH, the UKs MHRA and the EMA (not to mention the WHO) as to why they continue to block these interventions. Meta-analyses are supposed to be the highest form of evidence, and these are now consistently on the side of ivermectin use in Covid 19. Why are these being ignored? See https://c19ivermectin.com and hit the ivermectin tab. Why have studies not been conducted, completed and reported on in the US /UK/ EU if that was the objection - the evidence has been there for a long time now? Where are these studies? The perpetuation of the current situation cannot be justified - this is peoples lives at stake, their livelihoods and more... not just a simple thought exercise. These problems are a real and present danger, and this is not a game or a profit/loss exercise; if a novel variant arises with a total vaccine escape we need a darned sight more to hand than vaccinations alone, now, and we do appear to have options in a number of repurposed drugs (if they were not being blocked).

[JJackson]

"Meta-analyses are supposed to be the highest form of evidence"
Vibrant Meta-analyses can be useful but only if the the trials included are comparable and adequately powered. The problem with ivermectin is I do not think these criteria are met. I do not know if it is going to be a useful therapeutic but hope there will be a solid large scale trial soon (I heard there is likely to be) but I do not think the trials to date have been big enough to be conclusive and not standardised in a way that allows a really useful meta pooling of the data.

[Vibrant62]

I hope you are correct. This analysis seems pretty robust https://journals.lww.com/americanthe...6kcamlsO18X7sg .

[Shiloh]

COVID Patient in Coma Gets Ivermectin After Court Order
By Marcia Frellick
injection

May 6, 2021 -- A 68-year-old woman with COVID-19, who has been in intensive care in an Illinois hospital for a month, started receiving the controversial drug ivermectin (Stromectol) this week after her family sued the hospital to have someone administer it, according to a report in the Chicago Tribune.

Nurije Fype's daughter, Desareta, filed suit against Elmhurst Hospital, part of Edward-Elmhurst Health, asking that her mother receive the treatment, which is approved as an anti-parasite drug but not approved for the treatment of COVID-19. Desareta Fype has been granted temporary guardianship of her mother.

The FDA has warned against ivermectin's use for treating COVID-19, but a high-profile group of doctors has spoken passionately in favor of it.

The FDA has published guidance titled ,"Why You Should Not Use Ivermectin to Treat or Prevent COVID-19" on its website. The National Institutes of Health said there is not enough data to recommend either for or against its use in treating COVID-19.

On Friday, DuPage County Judge James Orel ruled Fype should be allowed to get the treatment.

Three days later, according to the Daily Herald, the lawyer for the hospital, Joseph Monahan, argued the hospital could not find a hospital-affiliated doctor to administer the ivermectin.

The Herald reported the judge told the hospital to "get out of the way" and allow any board-certified doctor to administer the drug.

When Fype's doctor was unable to administer it, the legal team found another doctor, Alan Bain, DO, to do it. Monahan said Bain was granted credentials to work at the hospital so he could administer it Monday evening...

Read more: https://www.webmd.com/lung/news/2021...er-court-order

[Vibrant62]

A very good article is here that provides insights into the debate.

Covid-19: Ivermectin’s politicisation is a warning sign for doctors

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n747 (Published 01 April 2021)Cite this as: BMJ 2021;373:n747

The drug ivermectin has divided the medical community in South Africa and elsewhere, with some arguing it can both prevent and treat covid-19. Bibi-Aisha Wadvalla explains how the case encapsulates the central argument: do doctors or scientists know best?

[Shiloh]

Source: https://www.forbes.com/sites/jvchama...h=6b81cd2f7237

Jun 23, 2021,06:55am EDT|38 views
Oxford Launches New Trial Of Ivermectin For Covid Treatment
JV ChamaryContributor

Oxford University has launched a clinical trial to test whether Ivermectin works in treating Coronavirus Disease.

The drug is typically used to treat diseases caused by parasite infections, including onchocerciasis or 'river blindness' from the nematode worm Onchocerca volvulus.

But the use of Ivermectin for Covid treatment is controversial, and the European Medicines Agency (EMA) advises against its use outside randomized clinical trials.

Although it's promoted as a cure for Covid in some countries, such as Brazil, most scientific studies on its effectiveness have involved poorly-controlled experiments or a small number of participants. There's little evidence the drug definitely works....

[JJackson]

Good, the trial, I had heard was likely, is in the US so we may get both.

[Vibrant62]

One thing we need to check closely are the study protocols, and if the proposed dosage regimen is likely to be therapeutic, based on the earlier trial protocols that show benefits - hopefully they will have some sort of dose ranging element to it. The Cochrane Institute came up with a good study protocol which can be found here https://www.cochrane.org/CD015017/HA...ating-covid-19

[Shiloh]

Podcast Episode
#1671 - Bret Weinstein & Dr. Pierre Kory
The Joe Rogan Experience
Jun 22
175 min
Episode Description

Dr. Pierre Kory is an ICU and lung specialist who is an expert on the use of the drug ivermectin to treat COVID-19. Bret Weinstein is an evolutionary biologist, visiting fellow at Princeton, host of the DarkHorse podcast, and co-author (with his wife, Heather Heying) of the forthcoming "A Hunter-Gatherer's Guide to the 21st Century."

View at: https://open.spotify.com/episode/7uV..._branch=1&nd=1

[Emily]

May 20, 2021 | USA
The Drug that Cracked Covid by Michael Capuzzo
New York Times best-selling author Michael Capuzzo writes in Mountain Home the riveting, unbelievable story behind the story of why a family whose mother was dying of COVID, had to obtain a court-order to compel the hospital to give her a life-saving medicine. Capuzzo calls upon his journalist colleagues to “open their minds to legitimate, unreported doctors and therapies and write about all sides of the Ivermectin story, like journalists always have. It is a historic opportunity. For the first time in the long journey from Gutenberg to Google, journalists may be the ones to save the world.
https://covid19criticalcare.com/wp-content/uploads/2021/05/The-Drug-that-Cracked-Covid-by-Michael-Ca…

[JJackson]

BMC Infect Dis . Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized, double-blind, placebo-controlled trial

https://flutrackers.com/forum/forum/welcome-to-the-scientific-library/treatments/918632-bmc-infect-dis-ivermectin-to-prevent-hospitalizations-in-patients-with-covid-19-ivercor-covid19-a-randomized-double-blind-placebo-controlled-trial

Results: The mean age was 42 years (SD ± 15.5) and the median time since symptom onset to the inclusion was 4 days [interquartile range 3-6]. The primary outcome of hospitalization was met in 14/250 (5.6%) individuals in ivermectin group and 21/251 (8.4%) in placebo group (odds ratio 0.65; 95% confidence interval, 0.32-1.31; p = 0.227). Time to hospitalization was not statistically different between groups. The mean time from study enrollment to invasive mechanical ventilatory support (MVS) was 5.25 days (SD ± 1.71) in ivermectin group and 10 days (SD ± 2) in placebo group, (p = 0.019). There were no statistically significant differences in the other secondary outcomes including polymerase chain reaction test negativity and safety outcomes.

[Emily]

I wish they had disclosed the placebo. They welcomed questions, though. I noticed a couple of the HCQ studies used vitamins.
They do have the dosing in the PDF. (I don't know how this compares to COVID treatment protocols being used.)

"The dose of ivermectin used was the approved dose in
Argentina for the treatment of other diseases, such as
parasitic diseases, and it was staggered according to
weight. Those weighing up to 80 Kg received 2 tablets of
6 mg (mg) each at inclusion and another 2 tablets of 6
mg each 24 h after the first dose (total 24 mg). Those
weighing more than 80 kg and up to 110 kg received 3
tablets of 6 mg each at inclusion and another 3 tablets of
6 mg each 24 h after the first dose (total 36 mg). Those
weighing more than 110 kg received 4 tablets of 6 mg
each at inclusion and another 4 tablets of 6 mg each 24
h after the first dose (total 48 mg). Individuals randomized
to placebo received the equivalent number of placebo
tablets to the ivermectin weight-based dosage, at
baseline and again after 24 h."

[JJackson]

It looks like it may have a uses as a prophylactic

Use of Ivermectin as a Potential Chemoprophylaxis for COVID-19 in Egypt: A Randomized Clinical Trial.

https://flutrackers.com/forum/forum/welcome-to-the-scientific-library/treatments/919122-use-of-ivermectin-as-a-potential-chemoprophylaxis-for-covid-19-in-egypt-a-randomized-clinical-trial

Results: Ivermectin group included 203 contacts (to 52 index cases) aged 39.75±14.94 years; 52.2% were males. Nonintervention group included 101 contacts (to a total of 24 index cases) aged 37.69±16.96 years, 49.5% were males. Fifteen contacts (7.4%) developed COVID-19 in the ivermectin arm compared to 59 (58.4%) in the nonintervention arm (P <0.001). The protection rate for ivermectin was more prominent in contacts aged less than 60-year-old (6.2% infected compared to 58.7% if no treatment). Ivermectin in the protection against SARS-CoV-2 infection had an OR of 12.533 and 11.445 (compared to nontreatment) in both univariate and multivariate models, respectively. Side effects of ivermectin were reported in 5.4%; they were mild. Conclusion: Ivermectin is suggested to be a promising, effective and safe chemoprophylactic drug in management of COVID-19.

[JJackson]

See Shiloh's post below the first trial that I had seen that which showed a clear benefit now seems to have been fraudulent and has been retracted.

[Shiloh]

Source: https://www.news24.com/health24/medi...cerns-20210716


26m ago
A study showing promising evidence of ivermectin for Covid-19 retracted amid ‘ethical concerns’
accreditation
Compiled by Zakiyah Ebrahim

There has been a lot of discussion on ivermectin as a possible prophylaxis and treatment for Covid-19.
In November, a study studying the value of the drug for Covid showed promising findings, and was highly cited in other papers.
But independent researchers conducted in-depth investigations and found that the original study was potentially based on fraud, inconsistencies, and plagiarism.

An extensive preprint study showing that the anti-parasitic drug, ivermectin, played a significant role in reducing the risk of Covid-19 infection, hospitalisation, and death has been withdrawn due to "ethical concerns".


The research was led by Dr Ahmed Elgazzar from Benha University in Egypt and was published on Research Square in November 2020. It was presented as the results of a multi-centre, 600-patient study evaluating the use of the drug in preventing and treating Covid-19. ..

[Vibrant62]

I have several issues with this report (see post above), the largest being the implication that removal of this one study completely invalidates the findings of all the others. It also leans towards a high degree of bias in terms of the tone and conclusions of the author. Indeed, the meta-analyses will need correcting if their findings hold up following additional scrutiny, but if you look e.g. https://www.ncbi.nlm.nih.gov/pmc/art...jt-28-e434.pdf, then yes, the study in question has been included in this meta-analysis. If the researcher's findings are validated, then it will need updating... but it was still only one of 24 RCTs examined, and if you look at each of the arms, the patient numbers in each were not so great as to massively alter the findings and negate any benefit as is implied (in contrast with the conclusions stated in this article by its author).

Either way, I hope that the currently underway trials in e.g. the UK PRINCIPAL trial are expedited, as if ivermectin works, the need for it is now, not next year or the year after.

[Emily]

It might have something to offer for long haulers. I saw a couple of legit seeming reports of improvement in a couple of women on Twitter. Here's a news report.

https://news.wttw.com/2021/07/02/covid-19-long-haulers-turning-ivermectin-relief-questions-over-drugs-effectiveness

I put a research article in the library about finding lingering virus in the intestinal tracts of long haulers. Since ivermectin was designed to treat intestinal parasites, the concentrations there could be strong enough to knock it out and allow the immune system to regulate itself again. Maybe the Chinese were onto something doing those anal swabs!

[Mary Wilson]

Is Ivermectin for Covid-19 Based on Fraudulent Research?

3 days ago
Gideon M-K

Ivermectin is an antiparasitic medication used to treat various types of worms and similar diseases. It’s pretty safe, widely in use across the world, and in most ways a useful medication to have on hand if you think you’ve been exposed to contaminated human feces, or if you just need to disinfect your sheep.

However, there has been a lot of hubbub over ivermectin for another reason. According to a number of ad-hoc groups across the world, as well as some scientific studies, ivermectin is a silver bullet against COVID-19. And while there may be some question about whether ivermectin works, with the World Health Organization recommending that it only be used to treat COVID-19 in the context of a clinical trial, there is also a lot of optimism about using it as a treatment. Half a dozen countries have officially promoted ivermectin as a drug for COVID-19, and it has likely been given to tens of millions of people across the world at this point, with prices skyrocketing as a result.
...

https://gidmk.medium.com/is-ivermectin-for-covid-19-based-on-fraudulent-research-5cc079278602

[sharon sanders]

bump this