[HN Gopher] Study findings do not support the use of ivermectin ...
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Study findings do not support the use of ivermectin for patients
with Covid-19
Author : barbazoo
Score : 59 points
Date : 2022-02-18 20:47 UTC (2 hours ago)
(HTM) web link (jamanetwork.com)
(TXT) w3m dump (jamanetwork.com)
| phlipski wrote:
| I look forward to the study confirming that Yes - the Earth is
| still round...
| JackOfCrows wrote:
| [deleted]
| roenxi wrote:
| It is good that people are doing studies, but at this point
| adding one more study isn't really headline news so I'm not sure
| what the up-voters think this will show. There isn't really a
| need for more evidence as far as I'm aware.
|
| What is far more interesting and useful is explanations of _why_
| there are a bunch of studies showing great COVID outcomes when
| patients are paired with Ivermectin (eg, https://ivmmeta.com/).
| The best answer I've heard is the geographic distribution of
| successful studies lines up with parasite-prone countries, so
| they are actually an interesting example of the base-rate effect.
| arn wrote:
| Many of the early studies weren't high quality studies. And as
| I recall a couple were outright fabricated. It takes time to
| run randomized prospective studies and those are coming out
| now.
| ayngg wrote:
| I think the difference is that in places where ivermectin had
| efficacy (India, Sub Saharan Africa, South America), parasitic
| infection was a significant comorbidity. In much of the
| developed world, the most significant comorbidities are things
| like obesity and age (with all of its associated pulmonary and
| respiratory risks).
| ggm wrote:
| So in laymans terms, enough people had untreated and
| undiagnosed parasitic infections that "they got better" was
| curing an undiagnosed comorbidity to a positive C19 and since
| the parasite causes high risk problems eg with kidneys or
| pulmonary risk or breathing, it helped them survive.
|
| Is that it?
| jasonhansel wrote:
| It's also that treatment with dexamethasone may be dangerous
| in patients with preexisting Strongyloides infections. Astral
| Codex Ten has an (admittedly rather speculative) take on
| this: https://astralcodexten.substack.com/p/ivermectin-much-
| more-t...
| smm11 wrote:
| More than two years, and still ...
| evilpotatoes wrote:
| They also didn't start treatment until 7 days post symptoms.
| ggrothendieck wrote:
| If we look at the secondary endpoints note that 3x as many died
| in the control group, 2.5x as many needed mechanical ventilation
| and one third more need to go to the ICU.
| Ivermectin Control n 247 249 Mech
| vent 4 10 ICU 6 8 Died
| 3 10
|
| These may not have been primary endpoints and may not have been
| statistically significant but it does raise the question of
| whether they would have been significant had a larger sample size
| been used.
| PragmaticPulp wrote:
| Once you start dealing with small numbers (e.g. 2% versus 3%)
| then you would need far, far more patients to reach statistical
| significance.
|
| It's tempting to look at things like 8 people visiting the ICU
| in one group but only 6 people in the other group and see that
| 6 < 8, but the problem is that it's too small of a sample size
| to decide if it's significant. The article covers that:
|
| > There were no significant differences between ivermectin and
| control groups for all the prespecified secondary outcomes
|
| The only one that _almost_ comes close is death rate:
|
| > The 28-day in-hospital mortality rate was similar for the
| ivermectin and control groups (3 [1.2%] vs 10 [4.0%]; RR, 0.31;
| 95% CI, 0.09 to 1.11; P = .09)
|
| If this was the only Ivermectin study out there, it would be
| worth following up on. But it's not, and when this is added to
| the rest of the (not-retracted) studies it doesn't really
| change the picture.
|
| At this point it matters less and less anyway. Countries that
| already tried Ivermectin at scale are starting to abandon the
| approach. Legitimately effective COVID drugs like Paxlovid with
| highly significant differences are becoming readily available.
| It's time to stop grasping at straws and accept that it doesn't
| work.
| sinyug wrote:
| Does any study ever suggest that a $0.10 drug with expired
| patents is better than the new and patented $30 alternative? If
| so which benevolent pharmaceutical company funds such studies?
|
| Between doctors prescribing specific medicine "brands" when
| generic alternatives are available, insurance companies denying
| perfectly valid claims and forcing you to challenge their
| decisions in tribunals and similar venues, and pharmaceutical
| companies engaging in questionable behavior,[1] I am very
| reluctant to trust anything championed by this unholy nexus.
|
| [1] There is a multivitamin product from Bayer called Supradyn
| that I have been using for years. Last year, the company changed
| the formulation and halved the doses of most of the ingredients
| while increasing the price by 50% resulting in an effective price
| increase of 300%.
| wombatpm wrote:
| Aspirin regimen for cardiovascular event prevention as an
| example of a cheap drug studied extensively.
| sinyug wrote:
| > Aspirin
|
| Good example. It would be a pleasant surprise to find out
| that these studies were funded by pharma companies.
| danielmg wrote:
| If it worked, they'd study it to find out what the interaction
| was or if it was a metabolite that carried the action. Then
| they'd develop a targetted version of that drug, patent it, and
| cash in _.
|
| It doesn't work. So they haven't.
|
| _A good example is major clinical depression and ketamine.
| barbazoo wrote:
| > Does any study ever suggest that a $0.10 drug with expired
| patents is better than the new and patented $30 alternative? If
| so which benevolent pharmaceutical company funds such studies?
|
| I hear this a lot to explain the lack of studies. What about
| this one here though? Isn't this finally a conclusive study
| debunking all the claims saying Ivermectin alone is a good
| prevention/treatment for COVID-19?
| armchair_ wrote:
| Better than an alternative? Probably not. Worth using at all?
| Sure, if the data supports that conclusion. In particular, a
| lot of labs have been trying a wide variety of drugs to see if
| any have efficacy against covid. Ivermectin... just doesn't.
|
| Here are three meta-analyses indicating that an SSRI with an
| expired patent (fluvoxamine) is potentially effective at
| reducing hospitalization rates for covid:
|
| https://www.thelancet.com/journals/langlo/article/PIIS2214-1...
| https://www.medrxiv.org/content/10.1101/2021.12.17.21268008v...
| https://pubmed.ncbi.nlm.nih.gov/35118917/
| robbiep wrote:
| Not all investigations like this are funded by drug companies.
|
| For example, and as a perfectly balanced counterpoint to the
| one you are trying to make about ivermectin, dexamethasone was
| rapidly identified as a cheap, easily available, out of patent
| medication that significantly reduces morbidity and mortality
| in covid hospitalised patients early in the pandemic by NHS
| doctors
| prohobo wrote:
| I don't understand why Japan, India, and parts of Brazil are
| using ivermectin to treat covid then. Are they just hoping for
| the best?
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