Friday, June 04, 2021

Why Has Ivermectin Been Suppressed?

ivmmeta | 97% of 37 early treatment and prophylaxis studies report positive effects (95% of all 57 studies). 26 studies show statistically significant improvements in isolation.

Random effects meta-analysis with pooled effects using the most serious outcome reported shows 78% and 85% improvement for early treatment and prophylaxis (RR 0.22 [0.12-0.39] and 0.15 [0.09-0.25]). Results are similar after exclusion based sensitivity analysis: 80% and 87% (RR 0.20 [0.14-0.28] and 0.13 [0.07-0.25]), and after restriction to 32 peer-reviewed studies: 80% and 88% (RR 0.20 [0.12-0.34] 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 17 Randomized Controlled Trials (RCTs) for early treatment and prophylaxis report positive effects, with an estimated improvement of 73% and 83% respectively (RR 0.27 [0.18-0.41] and 0.17 [0.05-0.61]), and 93% of all 29 RCTs. 
 
The probability that an ineffective treatment generated results as positive as the 57 studies to date is estimated to be 1 in 5 trillion (p = 0.00000000000021). 
 
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 28% 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, Hill, Kory, Lawrie, Nardelli] for other meta analyses, all with similar results confirming effectiveness.
Resources: FLCCC, BIRD
Analyses: WHO, Merck

ImprovementStudies AuthorsPatients
Early treatment 78% [61‑88%] 232363,227
Late treatment 45% [27‑59%] 201656,595
Prophylaxis 85% [75‑91%] 141088,789
Mortality 72% [54‑83%] 211957,525
RCTs only 65% [49‑75%] 293105,161
All studies 72% [63‑78%] 5750918,611
Evidence base used for other COVID-19 approvals
MedicationStudiesPatientsImprovement
Budesonide (UK)11,77917%
Remdesivir (USA)11,06331%
Casiri/imdevimab (USA)179966%
Ivermectin evidence5718,611 72% [63‑78%]

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