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[flagged] Ivermectin for the Treatment of Covid-19: A Systematic Review and Meta-analysis (oup.com)
26 points by rolph on Sept 2, 2021 | hide | past | favorite | 70 comments



BTW the whole “horse medicine” angle on this is a dramatization. Ampicillin is also a horse medicine, if you buy it from a veterinary supply house. Both medicines are also for humans, if obtained through the right channels.

The scientists who developed Ivermectin were given the Nobel prize for it. For humans. The point here is not to say that proves it works for COVID. The point is just to note that calling it “horse medicine” is hyperbolic.


It's called "horse medicine" when people take Ivermectin tablets intended/dosed for horses.


No kidding, but then other people read that headline and get the wrong idea. For example Drudge Report is screaming that Joe Rogan is taking horse medicine. No, he’s not.


Right. It would be more accurate to say that he is using an unproven treatment and is putting himself and others at risk by not getting vaccinated.


How do you know?


no, it's called horse medicine when people want to imply the people taking it are stupid.


Just wait till they wrap their minds around this chemical killer, Dihydrogen Monoxide.

https://www.dhmo.org/facts.html

It kills more than covid every year!


While you meant it as a joke, your link comments that H2O "is a known causative component in many thousands of deaths" each year.

This low-balls the actual numbers. Worldwide, about 300K people die of drowning - https://ourworldindata.org/grapher/drowning-deaths-by-age-gr... .

"Exposure (heat and cold)" is another ~50K - https://ourworldindata.org/grapher/annual-number-of-deaths-b... .

By comparison: "As of Jun 10, 1,884,146 people have died of COVID-19 in 2021, compared with the 1,880,510 in 2020." - https://www.cidrap.umn.edu/news-perspective/2021/06/global-c...

COVID kills at least 5x more than water in the last two years. And those numbers are from only 1/2-way through 2021.


I’m quite frankly shocked by the quality of discussion here. The HN community could do so much better. There’s unsubstantiated claims on all sides, downvoted comments galore etc. If this is what the geekier than average and probably more literate than average community ends up looking like in the context, no wonder all sorts of conspiracy theories run wild.


Yet another meta study.

I'm interested in this big, randomized clinical study, alas not yet concluded:

https://www.principletrial.org/news/ivermectin-to-be-investi...


The NIH has also prioritized ivermectin for another big, randomized clinical study. This research takes time. People need to be a little patient and not jump to conclusions.

https://www.nih.gov/research-training/medical-research-initi...

For now there are a mix of smaller studies, some of which show no benefit and others which show a significant benefit. Most of those studies had different treatment protocols so the results aren't directly comparable.

https://www.mdpi.com/1999-4915/13/6/989


I'm not. The vaccines are effective.


It's not one or the other. Vaccines work great, but the prevention is not 100% effective.

It seems now doubtful, that we can achieve herd immunity, so we still need something to treat people for which the vaccine doesn't work.

I wouldn't hold my breath on ivermectin though either.


FTA:

Conclusions

Compared with the standard of care or placebo, IVM did not reduce all-cause mortality, LOS, or viral clearance in RCTs in patients with mostly mild COVID-19. IVM did not have an effect on AEs or SAEs and is not a viable option to treat patients with COVID-19.


On the other hand, this meta study found 20 mechanisms of action by ivermectin against covid and general efficacy as treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203399/



That retracted pre-print article wasn't included in this meta analysis.


marijuana then definitely beats out ivermectin.

https://www.news-medical.net/news/20210314/Cannabis-compound...


Ivermectin is out of patent protection so whether it is effective or not (I don’t know, and won’t believe everything I read including replies here), there is huge PR machinery geared up against it from companies that stand to profit from newer, patented, alternatives.


You assert “there is” but do you have any concrete facts? Also, why wouldn’t there be an equally huge PR machinery from the insurance companies fighting for it as, by definition, they stand to loose as much from the use of alternatives?


Um, insurance companies aren't going to care how expensive the thing being insured against is. Their individual customers might, but the basic idea of insurance is more about averaging costs out to be more predictable. They shouldn't have any exposure to general price levels, just to how variable things are.


The way these online memes turn into social issues forcing even reasonable people to pay attention is one of scarier things I've witnessed.


So I only read the abstract, but sounds to me like this study only tested the efficacy in treatment, not prevention. And all of the hub-hub I've heard is around prevention. I wish this paper would have considered that angle too.


Who could have guessed?


Ah but which hand was used to administer Ivermectin: left or right? It only works when administered with the left hand. Most people are right-handed and do not follow the protocol.

Yet another substandard publication by the self-serving academic/Big Pharma cabal.


Meta study, most selected studies administered a single or few doses, none over 5 days.

The doctors reporting success are using it for longer. Consider most anti virals are taken for 10+ days


Fine, I'll bite. Which doctors, and which studies are showing this result?

I spent time reading about Ivermectin and the most reliable info I could find is from the NIH and WHO and neither recommends it for COVID-19:

- https://www.who.int/news-room/feature-stories/detail/who-adv...

- https://www.covid19treatmentguidelines.nih.gov/therapies/ant...

They seem to have reviewed many Ivermectin studies and found all of them low quality and/or insufficiently controlled.

Edit: grammar, formatting


The "root" of the Ivermectin craziness seems to be a study that found an effect against the virus in vitro, probably in cell cultures. Not sure about the details.

Everything else is anecdotal. Quite a few Covid-19 patients do survive, and when doctors prescribe it, they are not doing randomized controlled trials, so they can easily fool themselves and others into thinking Ivermectin works.


In vitro and at concentrations that are not attainable in a human, assuming it actually works in the body and doesn't have side effects.



Pierre Kory is one name I know.

The are randomized trials being conducted, wait for better science to come in before writing it off.

Is it so bad to have a medicine for treatment? Should we not be looking at all possibilities still? There are open questions about the long term and variety effectiveness of vaccines. Seems best to have as many tools in our medical toolbox as possible.


Nobody says that Ivermectin definitely doesn't work. What's being said is that there isn't sufficient evidence that it does work, and that until such evidence exists, people should stick to proven measures and shouldn't spread unproven claims.

Spreading unproven claims could, for example, cause people to rely on Ivermectin instead of getting vaccinated, which would be an extremely dangerous bet with almost nothing to win and almost everything to lose.


People are definitely minimizing the dangers from COVID while maximizing the dangers of the vaccine.

(politics alert)

This is being stoked by certain media and political organizations. It's a political wedge issue--GOP stokes their base, keeps/gets new voters on this issue, then gets in power and robs the country/planet by doing the bidding of donors/corps/lobbyists.



Those doctors are not conducting controlled trials.

Also, to treat someone for 10+ days it would be useful to have them survive the first five days, right?


What is the reasonable test process you're suggesting to verify the effectiveness of the drug against COVID? What is your basis for believing the drug will work if only given "longer" despite showing zero effect in the existing tests?


Randomized controlled trial, just like every other drug. They are in fact being done currently.

I put low weight on this study because I've only been prescribed anti viral treatments that last 10 or 14 days of pills.

How do you claim zero effect while there is conflicting reports? Is only "the other team" capable of fraudulent claims and studies?


This idiocy is killing people. Stop peddling it. Get the vaccine.


How do you jump from open mindedness about anti viral treatments to not getting the vaccine?

I don't get where the anti-anti-viral for treatment comes from. We know the vaccine is not 100% effective. Why are you against also having medicines for when people get sick?


Medicines for when people get sick are great. Everybody loves those. However this medicine doesn't work for this sickness, as has been shown here, in this very study.

How do you jump from a scientific study telling you something doesn't work, to "open mindedness about anti viral treatments"? Ivermectin is ley-lines and crystals for the 21st century.


This study did not use ivermectin like a normal antiviral dosage, I don't think it's conclusive.

You can't take one meta study and make claims that it doesn't work. What happened to the randomized controlled trials argument?


Except ivermectin won the 2015 Nobel prize in medicine.

The minute crystals win the Nobel prize in medicine, let me know. I’ll buy a nice stock.


Not for treating COVID-19 though. You're obviously unaware, but the 19 in COVID-19 is the year it was first discovered. The 2015 Nobel prize happened in 2015, again, the clue is in the name.


You compared it to crystals, which are not recognized by the scientific community for anything.

As you can see from my posted study, there is a lot of evidence that ivermectin is efficacious against covid, and some that it isn’t. I suspect those are similar to the now retracted study denigrating Hydroxychloroquine


Oh antivax has many more causes than just ivermectin. Many religious fundamentalists think it's the mark of the beast, and anti-goverment people are against it for reasons that have nothing to do with ivermectin, or just the fact that the vaccine companies are shielded from immunity.


Get both?


Ivermectin has a lot more side effects and no proven effect on Covid-19. So no, don't take it for this reason.

It gets worse when people use the doses intended for horses and cows.


Citation needed for “more side effects” this is a Nobel prize winning drug which has a markedly safe profile. Not like the vaccines which fda admits have no long term data available.


Just google Ivermectin. There is no shortage of information. No sane honest person can portray that list of side effects as less than those seen with the vaccine. There is no such thing as a "safe" medication, it's always a risk-benefit analysis and dose-dependency.

It is complete insane bullshit to believe those vaccines might somehow exhibit "long term" side effects that have eluded the whole world for more than six months after hundreds of millions of applications. No vaccine has ever done that, not even those who didn't make it through clinical trials.


If you stated that 2nd paragraph at an FDA meeting you’d be laughed out of the room.

Voixx was pulled from the market 5 years after approval when they finally determined it caused heart attacks. It took a lot of work to figure that out. There a multiple examples of fatal or severe side effects popping up years later. And every single one said “weve never seen it before” or “there is no scientific reason it should do that”.

The landscape is littered with drugs where people waved their hands and said “there is no way this drug is harmful” and that we’re subsequently found to be so.

Not saying people shouldn’t get vaccinated, I did. But your claim is ridiculous.


Note: you are talking about drugs, not vaccines. There is a big difference in how they act and especially in the frequency they are given. This results in significant differences in the associated risks.

And even then, in the case of Voixx it was a comparison against other drugs that ultimately made regulators pull the plug. Additionally, the manufacturer concealed the side effects, so the argument about long-term effects is even weaker.


The insanity is to be more afraid of unknown risks of vaccination than known risks of infection and the risk of relying on unproven treatments that are harmful or ineffective.


Actually there was that flu vaccine that triggered narcolepsy very rarely in young people after 12 - 24 months. But this is the only example i heard of.


Yes, but very rarely, and the cost/benefit analysis would still be positive, as compared to the virus that virtually everyone will eventually get.

Also that particular virus also caused narcolepsy, rarely, by a similar immunological mechanism.


The recent Ivermectin poison statistics are more than a little at odds with your "markedly safe" categorization.


It'd be useful if you linked to them.

Here's a human study referring to their safety. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043740/


Those are likely related to people consuming the animal grade ivermectin, not the prescription based for humans.

More than 700 million people have taken ivermectin as an anti parasitic medicine. Something like 4B doses have been given. The WHO lists Ivermectin as an essential medicine.


"Essential" and "safe" doesn't mean it doesn't have side-effects. Both at the recommended dosing and above. Some people react to Ivermectin more than others.

That's why you should not be using it unless there is a clear benefit. For the 700 million people taking it as anti parasitic medicine it does have a clear benefit, but some of them still experience side effects, some of them even might have died.


no.


Joe Rogan (who has COVID right now btw, for what it’s worth, but not part of the point here) had on his show an ICU specialist who has developed some of the key protocols for treating COVID including with the use of Ivermectin:

https://open.spotify.com/episode/7uVXKgE6eLJKMXkETwcw0D?si=p...

If you do open the podcast, know that it is very possible in Spotify to skip forward 15 seconds at a time to get past the many ads at the beginning.

Also on the show was evolutionary biologist Brett Weinstein. Long story short, the guests suggest that some of the (allegedly compromised by money) authoritative medical bodies have been captured, and have helped industry by cherry picking studies to highlight the low quality ones, while the high quality studies and, more importantly, country wide actual results in practice in several large countries, they are downplaying. Again this is done by authorities who, it is claimed, may have a vested (direct or indirect) interest in suppressing a low cost drug that is bad for business.

The episode also covers the remarkable censorship around this.

They also mention that US hospitals are prescribing Remdesivir (sp?) even though the WHO does not recommend it. According to the doctor on the podcast Remdesivir costs $3,000 a dose.


Caleb Wallace, famous Texas Anti-vaxxer died from covid even though he took ivermectin.

Anecdotal evidence, but a powerful one to be sure.


Aussie guy overdoses on Ivermectin - https://www.abc.net.au/news/2021-09-02/warning-over-backdoor...

but pretty sure the excuse here is going to be a no true scotsman thing


So the existence of the no true scotsman construct is, to you, proof positive that any home grown, DIY abuse of a horse dosage of a medicine for which there are proper protocols for treatment of humans with human doses, automatically invalidates any and all uses of the drug even when properly administered? Who can possibly crack the wall you have constructed here? Nobody. Good job, I guess. Let me know if you ever think of anything that could change your mind.


Poison control centers in the US are experiencing high call volumes related to Ivermectin poisonings.


DIY administered without following proper protocols, in my understanding. I’m not an expert on this but DIY drugs sounds like a bad idea.


nobody should take anything on the rogan show at face value.


Stop the tin-foil hat nonsense. Joe Rogan is not an expert. He refused the vaccine. There is no one out to get you. Hundreds of anti-vax, pro-horse-dewormer patients are dying due to COVID.


Joe Rogan is (indeed) a self-professed moron, an assessment I agree with.

However, setting that aside, please bear with me here, he does sometimes have very intelligent and well informed people on his show. I think that is the case with this particular episode. It would behoove you or anyone to keep an open mind.


Yes, Joe Rogan is a moron. And those guests he has on? Chosen by a moron. It's morons all the way down.


Keeping an open mind that an unproven (for Covid) drug might eventually be proven effective is one thing; relying on an unproven drug or spreading unproven claims is another.




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