foggynotion | 11 points
New England Journal of Medicine (NEJM JWatch blog) - "Ivermectin for COVID-19 - Breakthrough Treatment or Hydroxychloroquine Redux?" (US 2020-01-04)Really nice writeup! Seems like if the RCTs coming out this month are supportive of using ivermectin, then ivermectin has a great chance of being accepted as treatment soon.
Of course, the downside is that the Colombian study seems to be heading to not supportive side. The big question is if it's more on the "no conclusive results" side, or if it's actually showing ivermectin did nothing. As the hospitalisation rate was really low in both groups, and even lower in IVM group hopefully it's on the no conclusive results side.
Since ivermectin has been shown to have anti-inflammatory effects (at least in mice), one plausible possibility is that its apparent effectiveness in hospitalized COVID patients is due to those effects, while at the early stages of the disease there is not yet much inflammation.
[-] foggynotion | 6 points | Jan 05 2021 09:32:48
Great analysis, and conclusion here:
My take-home view? The clinical trials data for ivermectin look stronger than they ever did for hydroxychloroquine, but we’re not quite yet at the “practice changing” level. Results from at least 5 randomized clinical trials are expected soon that might further inform the decision. NIH treatment guidelines still recommend against use of ivermectin for treatment of COVID-19, a recommendation I support pending further data — we shouldn’t have to wait long.
But we have to guard against two important biases here. First, that because we were burned by hydroxychloroquine means that all other repurposed antiparasitic drugs will fail too.
Second, that studies done in low- and middle-income countries must be discounted because, well, they weren’t done in the right places.
That’s not just bias, it’s also snobbery.
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