[-] Ivermectin4all | 8 points | Apr 14 2021 11:31:41

My first 3 observations

a vaccinologist
turned off comments to public
included the López-Medina JAMA study

WHO has proven itself rotten to the core. Cochrane too?

Can't wait to read the paper.

[-] Haitchpeasauce | 1 points | Apr 14 2021 13:36:29

If mixed population is a flaw then what benefit is a homogenous population? Opponents would then simply say that results from one ethnicity is not relevant to another. All that matters is that a study's groups are well matched.

[-] Haitchpeasauce | 3 points | Apr 14 2021 12:46:17

Slide 1: "Meta analysis" using one single study with 60 severe patients. The slide states 66 patients, but if you go look at the study results 6 in the Ivermectin arm had a mutation that disrupts Ivermectin and did not complete the trial. Does this person know how to read results?

Slide 2: WHO progression score level 7 or above D28, in studies with mostly mild and some moderate patients. Score 7 = Intubation and mechanical ventilation, pO2/FiO2 ≥150 or SpO2/FiO2 ≥200 (see Page 4 of this document from the WHO). That is an extremely high threshold for studies of mild/moderate cases.

Slide 3: Clinical improvement D28 in mild patients. Once again, majority are mild patients, endpoint is meaningless at 28 days. The real goal here is reduced hospital stays, faster recovery, fewer deaths, less spread, lower morbidity.

Slide 4: All cause mortality D28 in mild patients. Trend is towards favouring Ivermectin but not significant confidence interval (CI).

What he deems as "NO EFFECT":

Validates Ivermectin does not harm
Uses parameters designed to hide clinical benefit
Confirms the chosen studies largely have low risk of bias

Only followers can reply to the Tweet? Maybe he's worried people might point out his meta analysis was not very good. Does Dr Melvin Sanicas honestly believe he knows more about meta analysis than Dr Lawrie, Dr Kory or even Dr Hill?

Let's look more closely at the results of the Okumus study which gave Ivermectin to severe patients**.

Note: Have we neglected to post the results to this sub? If so we (myself included) are falling behind on the game here.

https://clinicaltrials.gov/ct2/show/results/NCT04646109

The endpoints and results are actually interesting and detailed, something a single line on a meta analysis completely removes.

There were some endpoints that did not return statistically significant results.

For instance, Ivermectin group had fewer deaths (6/30) versus control (9/30), but this had a p-value of 0.37. This was over a period of 3 months. Where did the above Tweet get D60 from? I suppose that is captured in the "or above" words.
Ivermectin had a higher rate of clinical response (22/30) versus control (16/30) on days 6-10 but a p-value of 0.10
Lymphocyte counts from days 6-10 were higher in the Ivermectin group but a p-value of 0.24.

In other words, the study was not powered to return a result with sufficient confidence, but the trend to benefit was there.

But there were some endpoints which did return a statistically result:

Ivermectin had lower serum D-dimer levels from on days 6-10 with a p-value of 0.03
Ivermectin had a lower change of serum ferritin levels on days 6-10 with a p-value of 0.005
Ivermectin had a higher rate of PCR negativity at day 10 (14/16; 87.5%), compared to the control (3/8; 37.5%) with a p-value of 0.01
There were zero incidents of nausea or vomiting in the Ivermectin group versus 2 in the control group, zero treatment-related adverse events on days 6-10 for both Ivermectin and control groups.

Although the study has a low sample size, the results are in favour of Ivermectin.

Patients are showing better figures in the Ivermectin arm versus the control arm, the patients are in better health. At a glance, the patients in the Ivermectin had more clinical symptoms at the start of the study.

Both the Ivermectin arm and the control arm received Hydroxychloroquine, Favipiravir and Azithromycin. Both arms showed no significant treatment-related adverse events.

Remember that these results are from patients with severe symptoms**. Both Ivermectin and HCQ were demonstrated to be safe in patients with severe COVID-19.

** The trial inclusion criteria was for patients with SpO2 < 90% in room air, tachypnea = 30/minute, and mechanical ventilation requirement.

[-] bitregister | 1 points | Apr 14 2021 10:56:38

So now we have this? Legit?

[-] Director_Quirky | 1 points | Apr 14 2021 16:27:31

DISCalert

[-] machinelearny | 1 points | Apr 14 2021 17:24:22

ok.... so not really clear what made him choose the studies he did but anyways.

So his all cause mortality RR = 0.38, I think I will just go and TAKE that No Effect, and call on your stay and home and wait to die! Because personally, I like those odds! If that's the worst these guys can do, it's pretty good.