Ivermectin

From the National Institute of Health library:

Ivermectin: a multifaceted drug of Nobel prize-honoured distinction with indicated efficacy against a new global scourge, COVID-19

Bring on the horse de-wormer!

Curiously, FDA approved an RCT of 28 days in April of 2021.  Either it failed (in which case the above study is wrong) or it worked and FDA kept it quiet.  If they stomped on it, hundreds of thousands died without reason. The conspiracy theories (give unlimited control to the fascists who run the Blue States, kill off old people who tend to vote for conservatives) seem increasingly plausible.

August 2001 American Journal of Therapeutics:

Meta-analysis of 15 trials found that ivermectin reduced risk of death compared with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73; n = 2438; I² = 49%; moderate-certainty evidence).

May/June American Journal of Therapeutics:

Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.

This study concluded opposite:

RESULTS: Ten RCTs (n=1173) were included. Controls were standard of care [SOC] in five RCTs and placebo in five RCTs. COVID-19 disease severity was mild in 8 RCTs, moderate in one RCT, and mild and moderate in one RCT. IVM did not reduce all-cause mortality vs. controls (RR 0.37, 95%CI 0.12 to 1.13, very low QoE) or LOS vs. controls (MD 0.72 days, 95%CI -0.86 to 2.29, very low QoE). AEs, severe AE and viral clearance were similar between IVM and controls (all outcomes: low QoE). Subgroups by severity of COVID-19 or RoB were mostly consistent with main analyses; all-cause mortality in three RCTs at high RoB was reduced with IVM.

From a peer-reviewed journal Cureus:

Results: Of the 223,128 citizens of Itajaí considered for the study, a total of 159,561 subjects were included in the analysis: 113,845 (71.3%) regular ivermectin users and 45,716 (23.3%) non-users. Of these, 4,311 ivermectin users were infected, among which 4,197 were from the city of Itajaí (3.7% infection rate), and 3,034 non-users (from Itajaí) were infected (6.6% infection rate), with a 44% reduction in COVID-19 infection rate (risk ratio [RR], 0.56; 95% confidence interval (95% CI), 0.53-0.58; p < 0.0001). Using PSM, two cohorts of 3,034 subjects suffering from COVID-19 infection were compared. The regular use of ivermectin led to a 68% reduction in COVID-19 mortality (25 [0.8%] versus 79 [2.6%] among ivermectin non-users; RR, 0.32; 95% CI, 0.20-0.49; p < 0.0001). When adjusted for residual variables, reduction in mortality rate was 70% (RR, 0.30; 95% CI, 0.19-0.46; p < 0.0001). There was a 56% reduction in hospitalization rate (44 versus 99 hospitalizations among ivermectin users and non-users, respectively; RR, 0.44; 95% CI, 0.31-0.63; p < 0.0001). After adjustment for residual variables, reduction in hospitalization rate was 67% (RR, 0.33; 95% CI, 023-0.66; p < 0.0001).

Conclusion: In this large PSM study, regular use of ivermectin as a prophylactic agent was associated with significantly reduced COVID-19 infection, hospitalization, and mortality rates.

Does ivermectin work?  Heck if I know, but it seems hard to argue against doctors at least trying.  The sheer scale of snarky articles by non-experts rejecting the claim is curious:

Here’s some of the latest “say-whatever-you-want-without-real-evidence” news. There have been claims online that ivermectin somehow helped Japan conquer the Covid-19 coronavirus pandemic. For example, Pierre Kory, MD, MPA, a critical care physician who has been pushing for the use of ivermectin to prevent and treat Covid-19, recently tweeted out that “Tokyo in particular is kicking Covid’s [word that means butt] with IVM- fewest hospitalized since before pandemic:...

First of all, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) doesn’t have a butt that can be kicked. Instead, the virus is shaped like a round ball with many spikes. So perhaps you could say that you want to kick Covid’s balls.

Secondly, what evidence did Kory provide that Tokyo has been using IVM to do the said kicking? Here IVM presumably stands for “ivermectin” rather than “I varnish mangos” or “I value muskrats.”