Posted on 08/04/2021 4:43:38 PM PDT by gas_dr
Background
Ivermectin, an antiparasitic agent used to treat parasitic infestations, inhibits the replication of viruses in vitro. The molecular hypothesis of ivermectin's antiviral mode of action suggests an inhibitory effect on severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) replication in the early stages of infection. Currently, evidence on efficacy and safety of ivermectin for prevention of SARS‐CoV‐2 infection and COVID‐19 treatment is conflicting.
Objectives
To assess the efficacy and safety of ivermectin compared to no treatment, standard of care, placebo, or any other proven intervention for people with COVID‐19 receiving treatment as inpatients or outpatients, and for prevention of an infection with SARS‐CoV‐2 (postexposure prophylaxis).
Search methods
We searched the Cochrane COVID‐19 Study Register, Web of Science (Emerging Citation Index and Science Citation Index), medRxiv, and Research Square, identifying completed and ongoing studies without language restrictions to 26 May 2021.
Selection criteria
We included randomized controlled trials (RCTs) comparing ivermectin to no treatment, standard of care, placebo, or another proven intervention for treatment of people with confirmed COVID‐19 diagnosis, irrespective of disease severity, treated in inpatient or outpatient settings, and for prevention of SARS‐CoV‐2 infection.
Co‐interventions had to be the same in both study arms.
We excluded studies comparing ivermectin to other pharmacological interventions with unproven efficacy.
Data collection and analysis
We assessed RCTs for bias, using the Cochrane risk of bias 2 tool. The primary analysis excluded studies with high risk of bias. We used GRADE to rate the certainty of evidence for the following outcomes 1. to treat inpatients with moderate‐to‐severe COVID‐19: mortality, clinical worsening or improvement, adverse events, quality of life, duration of hospitalization, and viral clearance; 2. to treat outpatients with mild COVID‐19: mortality, clinical worsening or improvement, admission to hospital, adverse events, quality of life, and viral clearance; (3) to prevent SARS‐CoV‐2 infection: SARS‐CoV‐2 infection, development of COVID‐19 symptoms, adverse events, mortality, admission to hospital, and quality of life.
Main results
We found 14 studies with 1678 participants investigating ivermectin compared to no treatment, placebo, or standard of care. No study compared ivermectin to an intervention with proven efficacy. There were nine studies treating participants with moderate COVID‐19 in inpatient settings and four treating mild COVID‐19 cases in outpatient settings. One study investigated ivermectin for prevention of SARS‐CoV‐2 infection. Eight studies had an open‐label design, six were double‐blind and placebo‐controlled. Of the 41 study results contributed by included studies, about one third were at overall high risk of bias.
Ivermectin doses and treatment duration varied among included studies.
We identified 31 ongoing and 18 studies awaiting classification until publication of results or clarification of inconsistencies.
Ivermectin compared to placebo or standard of care for inpatient COVID‐19 treatment
We are uncertain whether ivermectin compared to placebo or standard of care reduces or increases mortality (risk ratio (RR) 0.60, 95% confidence interval (CI) 0.14 to 2.51; 2 studies, 185 participants; very low‐certainty evidence) and clinical worsening up to day 28 assessed as need for invasive mechanical ventilation (IMV) (RR 0.55, 95% CI 0.11 to 2.59; 2 studies, 185 participants; very low‐certainty evidence) or need for supplemental oxygen (0 participants required supplemental oxygen; 1 study, 45 participants; very low‐certainty evidence), adverse events within 28 days (RR 1.21, 95% CI 0.50 to 2.97; 1 study, 152 participants; very low‐certainty evidence), and viral clearance at day seven (RR 1.82, 95% CI 0.51 to 6.48; 2 studies, 159 participants; very low‐certainty evidence). Ivermectin may have little or no effect compared to placebo or standard of care on clinical improvement up to 28 days (RR 1.03, 95% CI 0.78 to 1.35; 1 study; 73 participants; low‐certainty evidence) and duration of hospitalization (mean difference (MD) −0.10 days, 95% CI −2.43 to 2.23; 1 study; 45 participants; low‐certainty evidence). No study reported quality of life up to 28 days.
Ivermectin compared to placebo or standard of care for outpatient COVID‐19 treatment
We are uncertain whether ivermectin compared to placebo or standard of care reduces or increases mortality up to 28 days (RR 0.33, 95% CI 0.01 to 8.05; 2 studies, 422 participants; very low‐certainty evidence) and clinical worsening up to 14 days assessed as need for IMV (RR 2.97, 95% CI 0.12 to 72.47; 1 study, 398 participants; very low‐certainty evidence) or non‐IMV or high flow oxygen requirement (0 participants required non‐IMV or high flow; 1 study, 398 participants; very low‐certainty evidence). We are uncertain whether ivermectin compared to placebo reduces or increases viral clearance at seven days (RR 3.00, 95% CI 0.13 to 67.06; 1 study, 24 participants; low‐certainty evidence). Ivermectin may have little or no effect compared to placebo or standard of care on the number of participants with symptoms resolved up to 14 days (RR 1.04, 95% CI 0.89 to 1.21; 1 study, 398 participants; low‐certainty evidence) and adverse events within 28 days (RR 0.95, 95% CI 0.86 to 1.05; 2 studies, 422 participants; low‐certainty evidence). None of the studies reporting duration of symptoms were eligible for primary analysis. No study reported hospital admission or quality of life up to 14 days.
Ivermectin compared to no treatment for prevention of SARS‐CoV‐2 infection
We found one study. Mortality up to 28 days was the only outcome eligible for primary analysis. We are uncertain whether ivermectin reduces or increases mortality compared to no treatment (0 participants died; 1 study, 304 participants; very low‐certainty evidence). The study reported results for development of COVID‐19 symptoms and adverse events up to 14 days that were included in a secondary analysis due to high risk of bias. No study reported SARS‐CoV‐2 infection, hospital admission, and quality of life up to 14 days.
Authors' conclusions
Based on the current very low‐ to low‐certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID‐19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.
The other good news for the Regeneron MABs is that they are approved for half-dose subcutaneous injection, not just administration in an infusion center. That seems like a big plus.
This Cochrane analysis is consistent with what you’ve been saying for quite a while now.
These studies always compare the effectiveness of a treatment against the standard of care. But what exactly IS the standard of care? Is there a true standard of care for a new, poorly understood disease about which the science is improving every day? I’m always confounded by the “standard of care” phrase.
Quite a number of parasitic infections can affect the lungs...
The paper may not say it (I’ve not read most of the paper, yet) but I believe a significant safety concern is that if Ivermectin is procured from back channels (”mostly from farm stores to hear it told here”), dosing may be wildly inappropriate.
Heck, how many improvements might be due to belief there will be an improvement, and how many might be that a parallel undiagnosed / unrecognized problem was beneficially treated?
Cochrane article posted here is the cream of the crop regarding level of evidence in medicine based on the Hierarchy of the Strength of the Evidence.
There are good and bad doctors on both sides of this issue. Bad one being those who refuse to consider HCQ, Ivermectin and the like. Also those pushing the zinc, z-paks and Vit-D which all have been mostly dis-proven.
Ivermectin still is possibly effective as the article mentions....await the large RCT. If it is, doubt that it’s the panacea.
Per the FDA: Anyone can report to VAERS. VAERS reports are usually submitted by health care providers, vaccine manufacturers, vaccine recipients (or their parents/guardians). I wonder if some of the reports are fake. I have no proof but just wondering.
*** Good to read. Any chance you may have had COVID and didn’t know it? ***
I suppose it is possible. And that possibility is why I decided to take the ivermectin. Allergies, summer cold, Covid?
I decided to err on the side of caution.
There’s an excellent little book still in print called “How to Lie with Statistics”.
One of the methods used described in the book, is to keep running studies until you get one that gives the results that you want.
Another method is setting up the study in such a way as to influence the outcome, kind of like how we read about polls that show something like Biden having a 60% approval rating. Well, conduct the poll in the right part of the country, and you could probably get those numbers, after you did as many polls as you needed to to finally get them.
“Studies show” means absolutely nothing.
Another method is setting up the study in such a way as to influence the outcome,
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And like they did with HCQ. They jacked up the doses to known unsafe levels, delayed the treatment till the person was too sick, Tested it without the zpak, zinc etc. Studies designed to fail. And there was the study that was entirely bogus — had to be retracted, but not before several trials were discontinued due to the conclusions of the bogus study.
Then we’re castigated for *not following the science*, being *science deniers*, *anti-vaxxers*, etc.
Even alleged “reputable” medical journals, like The Lancet and now NEJM are showing how unreliable they are.
Why should we trust them when they’ve proven themselves untrustworthy?
Trust but verify.
Trust the dealer but cut the cards.
Me - I pretend to trust them and give them a little test or two-hand them the rope and let them run with it.
And when they fail to be honest, I keep a poker face-but I know to never ever ever trust them.
Do you really think the US Patent and Trademark Office evaluates the medical efficacy of these applications?>>>>>>>>>>>>>
Do not put wordss in my mouth. You have a vivid imagination.
it is illegal by pharmaceutical regulation in many States to use these drugs in an off label application for Covid-19. It shows that the pUS patent office is ignoring one of the prime hurtles to obtaining a patent, the patented item or idea must NOT be illegal to recieve a patent.
As an extreme example, say I have invented an efficient, effortless way to genocide murder masses of human beings.The patent office would refuse the patent because genocide is illegal.
In this case the drugs are banned for off lable use in most Democrat controlled states. The patent office chose not to take notice of this fact in granting the patent, whichi is actually quite interesting. The Swamp missed a chance.Thats good news.
You are correct
And pray tell, what is ‘ the proper care’ currently being offered, outpatient, in the first 3 days after symptoms develop?
Throughout this pandemic, the standard of care offered when someone is first diagnosed is “ isolate at home, drink fluids, take tylenol, go to the hospital if you can’t breathe’
So how does prescribing 3 doses of ivermectin, or passing out ziverdo ( zinc, doxycycline, ivermection) kits, used in India Japan and Mexico ( of which I have several at home, onhand ) in an early pre- hospitalization outpatient protocol “ delay proper care”?
And if a patient is deteriorating and facing a vent, are you saying giving them ivermectin takes the place of “proper care” instead of adding to it?
Drs like this are why no family member of mine will submit themselves to a hospital that does not incorporate ivermectin in the treatment plan, as described by EVMS, Paul Marik protocol.
Vlad Zelenko has commented that the two greatest risk factors facing covid patients, are the govt they live under, and the doctor they choose.
You do realize that anecdotal reports indicate that ivermectin, if it is successful, starts to work fast, results show in 2-3 days and it can be prescribed and taken at home…right?
Yet home treatment for early diagnosis consists of….nothing.
Well, take tylenol maybe.
Wanna bet which has killed more people? Ivermectin, or tylenol?
Going back a few decades, the statement was :
"Statistics don't lie,
..statisticians do lie !"
Try the information here:
At the 17 minute mark, they discuss the use of prophylactic MAB ‘s as an outpatient therapy for at risk patients.
If you are concerned, it might be worth contacting your doctor to see if this is available in your area.
Of course, I am one of those who think the vaccine is the best deterrent, if you are not in an at risk group for that,
At some point, we each have to choose our own path.
You’re so full of crap it staggers the human mind.
The mg/kg of bodyweight dose for horses and humans is the same.
So use the plunger on the dispenser to go to your body weight, and you have the right dose.
You DO know that the discoverers of Ivermectin got the 2015 NOBEL PRIZE IN MEDICINE for it, and there have been over 3.7 billion doses given to humans, right?
And it’s off-patent and therefore can’t make Pfizer, Moderna, and Faux-Xi their billions, right?
A significant safety concern is rumor-mongers, CNN addicts, and BigPharma shills and whores such as yourself.
You’re a lying troll. Sod off Swampy.
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