See, thing is, most of the studies that supported the idea that there is a large benefit for ivermectin appear to be either fraudulent or so poorly conducted that they might as well be fakepic.twitter.com/OQvRFR38tC
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On the other hand, the only large, well conducted trials seem to find either no benefit or at best quite a modest one
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Indeed, if you remove just two trials from your analysis - Elgazzar and Niaee - there is not a single RCT that has found a benefit for mortality, and on aggregate the result is pretty solidly

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What then separates ivermectin from other repurposed drugs? Popularity?pic.twitter.com/aKSrYM3CfG
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Anyway, this doesn't mean that we should stop the ongoing large trials into ivermectin, but I do think it's an interesting point worth considering. Take away the fraud, rewind to the actual evidence, and what remains?
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Replying to @GidMK
In terms of trials that are well-designed, non-fraudulent, powered enough to show important outcomes, peer reviewed and published? Vallejos and Mahmud.
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Replying to @EdoajoEric @GidMK
Vallejos N= around 250 per arm if I remember correctly, showed a 34% reduction in hospitalization that didnt reach statistical significance with 0.2mg/kg-ish x 2 doses. Mahmud N=250 per arm fixed 12mg ivm dose+doxy showed 50% less deterioration which was statistically significant
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Replying to @EdoajoEric @GidMK
This is more robust evidence than that which informs about 90% of infectious disease professional guidelines.
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Replying to @EdoajoEric
That I don't really know, but I'm not sure us using bad evidence for most stuff is necessarily a good reason to use inconclusive evidence for ivermectin either
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Replying to @GidMK
There are numerous reasons why infectious diseases has relied on expert opinion and observational data to inform most of its practice, primarily ethics, and feasibility. In the case of covid, neither is the case, we really should have had conclusive data by now.
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But in this case it isn't really observational evidence of the quality that's incorporated into recommendations - the obs evidence is mostly not of sufficient quality to include in any recommendations either. Also, lots of fraud there too
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