Better Data on Ivermectin Is Finally on Its Way Studies have been small and often not great. The best info so far says don’t use it, get vaccinated, and hang in there for the more promising meds being tested https://www.wired.com/story/better-data-on-ivermectin-is-finally-on-its-way/ EDWARD MILLS CAMEto the meeting last month with very good data. A clinical trials expert at McMaster University, Mills was presenting new results from a trial that is looking at how well half a dozen different drugs treat Covid-19—not for the people so sick they’re in the emergency room or the hospital, but in people whose symptoms haven’t gotten that bad yet. People sick at home, in other words. At his online talk, put on by the National Institutes of Health, Mills’ slides told the tale: A relatively safe, familiar, cheap drug reduced the relative risk of mild Covid getting worse by nearly 30 percent. The drug is fluvoxamine, a selective serotonin reuptake inhibitor—an antidepressant. (It’s also an anti-inflammatory, and inflammation and an overreacting immune system are hallmarks of serious Covid infection, so that might be why it seems to help). Get a bunch of people with Covid and randomize them into two groups; 739 get fluvoxamine and 733 get a placebo. Only 77 of the fluvoxamine-takers end up in the hospital; 109 of the placebo group do. This is exciting. “This is the first time these results have been presented in a public forum?” asked the moderator, Adrian Hernandez, director of the Duke Clinical Research Institute. “Yeah,” Mills answered. “You are hearing it for the first time.” “Well, simply, wow,” Hernandez said. If the data bears out, it’ll be only the second repurposed drug that works for outpatient Covid-19. (The other is a steroid called budesonide; other drugs you might have heard of, like remdesivir or dexamethasone, are for people who are severely ill and hospitalized.) The team’s results haven’t been peer-reviewed or officially published yet, but the Together trial, on which Mills is co-principal investigator, is well-designed and respected. Now, to be clear, fluvoxamine is still a ways off from becoming part of the standard of care for people with Covid-19. Once the Together trial’s results get published, guideline-setting organizations like the US Food and Drug Administration and the World Health Organization will have to take a look. But the Together trial data, if it holds up, seems positive for the SSRI. But wait! There’s more! In the very same presentation, the very same trial that showed this antidepressant might lessen the symptoms of Covid-19also showed that the antiparasitic drug ivermectin—you’ve heard about that one, right?—doesn’t help at all. In the Together trial, that drug, commonly used against things like river blindness and intestinal roundworms, didn’t keep anyone with Covid out of the hospital any better than a placebo. Of 677 people with Covid who got 400 micrograms per kilogram of weight per day for three days, 86 ended up in the ER or hospital; of the 678 people who got a placebo, 95 went. That’s not a significant difference, and Mills’ team dropped it from the study. (Vaccination, I should add, is still the most effective, safest, cheapest, and easiest way to avoid getting sick.) Ivermectin had some promising early results against the virus in petri dishes and in smaller and observational studies, but it still hasn’t aced a trial. Of two apparent large-scale confirmations of its effects, one (a preprint from researchers in Egypt) got retracted over concerns about plagiarism and fake data. Scientists and journalists at BuzzFeed have found irregularitie sin the data from another. A separate, positive review of all the data on ivermectin was rejected from a journal after provisional acceptance for concerns about research integrity and conflicts of interest, while a strict meta-analysis of all the randomized, controlled trials of ivermectin against Covid found no positive effect for the drug. The FDA says people shouldn’t take it. The American Medical Association and two pharmacist associations have issued a statement recommending that none of their members prescribe ivermectin for Covid-19 outside of a clinical trial. (Oh, and a physician in Arkansas gave the drug to unknowing, unconsenting prison inmates, which generally is not the side of history you want to be on.) Yet ivermectin is still a big deal in the US. Prescriptions spiked to nearly 100,000 in August, 20 times their pre-pandemic level. Talk show hosts, right-wing propagandists, and some physicians are still claiming that the drug is miraculously effective. Shortages and lack of access to prescriptions have led some people to turn to the more readily available veterinary formulations of the drug—horse and cow deworming agents. That’s dangerous, to be sure, though perhaps not enough peopleactuallydid it to warrant an unusual amount of snark from a federal agency warning against interspecies self-medication. All this confusion and misinformation filled what has been an information vacuum. No one had rock-solid data on cheap, workhorse drugs to fight “mild” outpatient Covid. The need for them became apparent early in the pandemic, and it hasn’t gone away. Vaccines are powerful armor against the virus, but money, policy, and logistics mean most of the world can’t get them, and pockets of political opposition and structural obstacles remain in wealthier countries like the United States. Combine that real need with snake-oil grifterism and political opportunism and you get crazes like this one for ivermectin or last year’s for hydroxychloroquine (which mostly faded when big randomized trials like Recovery in England and another at the University of Minnesota found that it had no effect, and doctors stopped prescribing it). Maybe hydroxychloroquine’s journey will be a template. “There was noise on both sides in terms of, is it a cure-all or does it have safety issues? But when the Recovery trial came out with a rigorous, definitive answer of ‘No, it doesn’t work,’ everything quieted down,” says Hernandez. “That’s the crisis. We haven’t had a national system that can rigorously evaluate these in a rapid fashion. That’s kind of what we need now to address the ivermectin question, a definitive answer to ‘does it work or not?’” In North America, trials to get those answers have begun. The Together trial is an adaptive, multi-arm trial—which means it enrolls people on an ongoing basis and uses statistical techniques to swap drugs in and out as they either succeed or fail. Besides helping dispatch hydroxychloroquine, the Together trial has now similarly shown that the antidiabetes (and sometimes anti-aging) drug metformin doesn’t make much of a difference, either.
Interesting, actually very, escatalopram also has significant anti-inflammatory effects. There are times I have taken this ad-hoc over the years due to hospice helping stuff getting depressing and I know from experience it helps my bad knee. If Trumpers take an antidepressant and the things they are told to worry about seem unimportant? Well it's an all out Conservative war on antidepressants, "depression is God's will".
Please don't modify anyone's quotes like that. Rumor has it that it's a ban-able offense; not to mention that a message forum is rendered useless if everyone is modifying everyone else's quotes. Besides, I'm sure you're more creative than that. For example: Isn't really impressive, is it?
People have been banned in the past for altering people sentences and then reposting it as a quote. Usually, if you report someone for doing such, they'll get a warning. Then if they do it again, they then get banned even if they did such here in the Political threads. wrbtrader
Thanks for clarifying ... I wasn't sure. His recent posts made him seem ignorant in other matters, so I assumed he was also ignorant of how we do things 'round here. So I didn't report it.
People that alter other member sentences as quotes are immature and you'll then see them say they've been doing it as "a joke"...just kidding around sort'uv speak. wrbtrader
Maybe you're right. In context I thought it was clear I was making my own edit, especially with the 'fixed' thing. I definitely did not mean to imply YOU said that. Only that I was correcting what I found was a mistaken statement. I thought my addition would show up properly, but you're right: it didn't really look that way. Apologies.
Glad you get it, just wanted to respond: Everything in a quote book is automatically implied/inferred to be a quote. I understood your intent--easy for me to do since I know what I wrote. Thing is ... not everyone that reads it, will 'get it' and make the correct distinction. Not everyone will even have read the original quote, to know that the second quote was altered. Thanks for the proper response ... now let's get back to insulting each other.