passfailboat | 18 points | Jan 14 2021 21:26:31

[UPDATED NIH] Statement on Ivermectin | COVID-19 Treatment Guidelines

https://www.covid19treatmentguidelines.nih.gov/statement-on-ivermectin/

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[-] bikes4paul | 13 points | Jan 15 2021 05:07:00

Whiteboard Doctor just posted a video review on what these NIH guidelines actually mean. It's a big win since it removes the handcuffs from doctors who are forced to follow guidelines.

https://youtu.be/bB_ueASTR9g

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[-] stereomatch | 1 points | Jan 15 2021 07:55:50

I have added a rough transcript of Whiteboard Doctor's comments on that (it includes a critique by Dr Been of one of those 4 studies as well):

https://www.reddit.com/r/ivermectin/comments/kxf75t/updated_nih_statement_on_ivermectin_covid19/gjboe1a/

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[-] passfailboat | 12 points | Jan 14 2021 21:30:27

#Recommendation The COVID-19 Treatment Guidelines Panel (the Panel) has determined that currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin for the treatment of COVID-19.

...

#Clinical Data Since the last revision of the Ivermectin section of the Guidelines, the results of several randomized trials and retrospective cohort studies of ivermectin use in patients with COVID-19 have been published in peer-reviewed journals or made available as preliminary, non-peer-reviewed reports. Some clinical studies showed no benefits or worsening of disease after ivermectin use, whereas others reported shorter time to resolution of disease manifestations attributed to COVID-19, greater reduction in inflammatory markers, shorter time to viral clearance, or lower mortality rates in patients who received ivermectin than in patients who received comparator drugs or placebo.

...

Because of these limitations, the Panel cannot draw definitive conclusions about the clinical efficacy or safety of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin for the treatment of COVID-19.

So it's progress. The big key is that they have removed the recommendation against using ivermectin. So this will potentially free up some physicians to be able to prescribe it who were previously sticking to the NIH guidelines. This won't mean widespread use, but hopefully this makes it easier for patients to go to their physicians with study data and work with them. Baby steps.

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[-] ED_Rx | 4 points | Jan 14 2021 22:04:28

Yes

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[-] TheAfricaBug | 2 points | Jan 15 2021 16:36:17

Some clinical studies showed no benefits or worsening of disease after ivermectin use,

Que?
Can somebody point me to ONE study where IVM showed negative results??

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[-] sufivibration88 | 4 points | Jan 16 2021 03:14:51

Yea that’s BS, I have seen one yet.

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[-] dogrescuersometimes | 4 points | Jan 16 2021 05:16:28

It's a lie.

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[-] 1002eep | 1 points | Jan 19 2021 20:07:03

Pulmonologist Dr Kory testified to congress that there's overwhelming evidence on ivermectin's efficacy and anymore placebo trials should be considered malpractice. He also showed how countries that couldn't afford novel, patented agents had better covid-19 outcomes AND their mortality rates have dropped back to pre-pandemic levels. His testimony is videotaped on this link (scroll down page) https://covid19criticalcare.com/

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[-] ecraft23 | 2 points | Jan 15 2021 16:39:30

I’ll Take it at this point!

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[-] passfailboat | 2 points | Jan 15 2021 17:12:01

That's exactly how I feel. At least now, diligent people will not be handcuffed and have to resort to veterinary or foreign meds.

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[-] ecraft23 | 3 points | Jan 15 2021 17:29:39

🤣 I’ve got a Lot of veterinary Grade Ivermectin to get through now, though. I think I bought enough to treat my entire neighborhood! 😊

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[-] passfailboat | 1 points | Jan 15 2021 19:22:39

I've got a fair amount as well. I will probably just keep taking that. The only thing that I couldn't get is Prednisone or Dexamethasone ahead of time. It needs to be taken day 8 and I don't have that on hand. But that should be quite a bit easier to get if I get sick.

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[-] ecraft23 | 2 points | Jan 15 2021 19:25:44

👍🏽

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[-] Ok-Film-9049 | 8 points | Jan 15 2021 00:21:52

Where are the studies showing worseening of symptoms? If there aren't any that this just sounds like a statement to stall things. Nothing on a major scale can start before the vaccines rescue the day. It is so sad that we will never know how many lives could have been saved over the pandemic.

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[-] cuibono2 | 5 points | Jan 15 2021 00:35:45

Some clinical studies showed no benefits or worsening of disease after ivermectin use,

can anyone point to studies showing worsening?

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[-] retro_future_2021 | 3 points | Jan 15 2021 03:54:27

From the document it indicates the studies were in footnote 11-14:

"Some clinical studies showed no benefits or worsening of disease after ivermectin use,11-14

  1. Ahmed S, Karim MM, Ross AG, et al. A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness. Int J Infect Dis. 2020;103:214-216. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33278625.

  2. Chachar AZK, Khan KA, Asif M, Tanveer K, Khaqan A, Basri R. Effectiveness of ivermectin in SARS-COV-2/COVID-19 Patients. Int J of Sci. 2020;9:31-35. Available at: https://www.ijsciences.com/pub/article/2378.

  3. Chowdhury ATMM, Shahbaz M, Karim MR, Islam J, Guo D, He S. A randomized trial of ivermectin-doxycycline and hydroxychloroquine-azithromycin therapy on COVID19 patients. Research Square. 2020;Preprint. Available at: https://assets.researchsquare.com/files/rs-38896/v1/3ee350c3-9d3f-4253-85f9-1f17f3af9551.pdf.

  4. Soto-Becerra P, Culquichicón C, Hurtado-Roca Y, Araujo-Castillo RV. Real-world effectiveness of hydroxychloroquine, azithromycin, and ivermectin among hospitalized COVID-19 patients: results of a target trial emulation using observational data from a nationwide healthcare system in Peru. medRxiv. 2020;Preprint. Available at: https://www.medrxiv.org/content/10.1101/2020.10.06.20208066v3."

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[-] stereomatch | 2 points | Jan 15 2021 07:56:55

I have added a rough transcript of Whiteboard Doctor's comments on that (it includes a critique by Dr Been of one of those 4 studies as well):

https://www.reddit.com/r/ivermectin/comments/kxf75t/updated_nih_statement_on_ivermectin_covid19/gjboe1a/

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[-] TrumpLyftAlles | 2 points | Jan 15 2021 18:34:53

  1. Ahmed:

Virological clearance was earlier in the 5-day ivermectin treatment arm when compared to the placebo group (9.7 days vs 12.7 days; p = 0.02), but this was not the case for the ivermectin + doxycycline arm (11.5 days; p = 0.27).

  1. Chachar

Statistically there was no significant difference between case group who were given ivermectin along with symptomatic treatment and control group who were only given symptomatic treatment without ivermectin, being asymptomatic on day 7 at follow up. p-value (0.500)

  1. Chowdhury

All subjects in the Ivermectin-Doxycycline group (group A) reached a negative PCR for SARS-CoV2, at a mean of 8.93days, and all reached symptomatic recovery, at a mean of 5.93days, with 55.10% symptom-free by the 5th day. In the Hydroxychloroquine-Azithromcyin group (group B), 96.36% reached a negative PCR at a mean of 6.99days and were symptoms-free at 9.33days. Group A patients had symptoms that could have been caused by the medication in 31.67% of patients, including lethargy in 14(23.3%), nausea in 11(18.3%), and occasional vertigo in 7(11.66%) of patients. In Group B, 46.43% had symptoms that could have been caused by the medication, including 13(23.21%) mild blurring of vision and headache; 22(39.2%) increased lethargy and dizziness, 10(17.85%) occasional palpitation, and 9(16.07%) nausea and vomiting.

  1. Soto-Becerra

Results Among 5683 patients, 200 received HCT, 203 IVM, 1600 AZIT, 692 HCQ+AZIT, 358 IVM+AZIT, and 2630 standard of care. HCQ+AZIT was associated with 84% higher all-cause death hazard compared to standard care (wHR=1.84, 95%CI 1.12-3.02). Consistently, HCQ+AZIT was also associated with higher death and/or ICU transfer (wHR=1.49, 95%CI 1.01-2.19), and death and/or oxygen prescription (wHR=1.70, 95%CI 1.07-2.69). HCQ only showed higher death and/or oxygen prescription hazard. No effect was found for AZIT or IVM+AZIT.

I read those as works, doesn't work, works, and doesn't work, respectively.

I didn't see any harm done, except for (3) which described lethargy, nausea and occasional vertigo -- hardly significant in the context of covid.

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[-] medicalpublishing | 7 points | Jan 15 2021 13:05:45

Thank you NIH for not getting in the way. Thank you EVMS for Math+ including ivermectin.

We started ordering Ivermectin in December for the second wave of Covid sweeping through the nursing homes. Most of the patients are doing very well — they test positive, they get isolated, they get the cocktail — vitamin D, vitamin C, aspirin, famotidine, melatonin, zinc and two doses of ivermectin. 10 days later, it’s back to their old rooms. (This is against a background of 40% hospitalization and 20-30 % deaths at most US nursing facilities testing positive).

No fever. No cough. Some patients do become increasingly frail after infection and are at increased risk of hospitalization or dying in the following weeks.

We are ordering Ivermectin 3 mg 4 tablets every two days for 2 doses. Ivermectin is ordered by weight and if it’s a small person, they get 3 tablets every two days.

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[-] TrumpLyftAlles | 2 points | Jan 15 2021 18:25:14

That sounds excellent, MP! You're saving lives!

Have you considered giving ivermectin prophylactically? Maybe ask the residents if they agree to take IVM, then giving a random half of those who agree IVM and give the other half sugar pills?

This isn't meant as a challenge, just an observation: if it's ethical to not give ivermectin prophylactically, then it's at least as ethical to give it prophylactically to a random half. I'm not sure that logic is valid, but there it is.

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[-] dogrescuersometimes | 2 points | Jan 16 2021 05:18:05

THANK YOU.

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[-] Haitchpeasauce | 2 points | Jan 17 2021 12:24:36

Fantastic update. Expectedly they become more frail which hopefully reverses, but this is still far better than the mortality seen without treatment.

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[-] [deleted] | 1 points | Jan 15 2021 08:39:47

[deleted]

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