What is the evidence for Ivermectin's use in Covid?
Fact check: Despite compelling evidence as to the efficacy of Ivermectin in the treatment of Covid-19, the WHO only recommends its use in clinical trials, the NIH neither recommends nor not- recommends it and the FDA recommends against its use, citing no evidence.
Hotly contested debates amongst scientists continue. However, given the amount of evidence in its favour, definitive statements that Ivermectin has zero efficacy are at best, disingenuous and misleading.
Yes, Ivermectin is also registered to treat livestock. This statement on the meme is misleading as it implies the drug is not registered for use in humans. Ivermectin has been registered for use in humans since the 1980s, won a nobel prize and is widely recognised as having an excellent safety profile.
No application has been received by the FDA to register Ivermectin for use in Covid. Its use is classed as "off-label" and is legal.
Social media meme used commonly to oppose the use of Ivermectin in Covid-19.
Those silly social media memes about Ivermectin being in horse paste are true: horse paste does contain Ivermectin.
That is about where the honesty starts and finishes. As with all effective memes, tiny attention spans combined with a desire to have a patronising laugh at others doesn't even scratch the surface of the full story.
Ivermectin is registered for use in humans, although its use in new diseases such as Covid are an "unapproved indication". That means the drug is not licensed for that particular purpose. However, it is still legal for a doctor to prescribe for off label use so long as the patient is made aware it is not licensed for the purpose being taken for and sign a disclaimer as such.
Its use for Covid is contentious because despite strong evidence of its efficacy and safety, authorities around the world continue to actively advise against its use. All the while, independent evidence to the contrary continues to mount up.
This has been resoundingly counter-intuitive to the doctors who have studied and reported positive patient outcomes.
One comprehensive, independent compilation of studies on Ivermectin can be found at ivmmeta.com. It used meta-analysis, which means lots of individual studies were pooled in order to increase sample size. Meta-analysis are a gold standard for scientific studies. For IVMmeta, the sample size was over 26,000 patients.
Their results showed an improvement in Covid symptoms of 86% when used as a prophylaxis (preventative) treatment, 69% in early treatment and a 40% improvement when used in late treatment.
Specific to New Zealand, Medsafe and the Ministry of Health strongly recommend Ivermectin is not used for treating Covid, while the Director General of Health slams the use of Ivermectin and the NZ College of GPs advise that there is literally zero evidence of any benefit using Ivermectin and strongly recommend against its use.
The answer to why NZ takes this position can be found on Medsafe’s website where they appear to rely on the Cochrane Organisation's examination of the evidence.
Cochrane conducted a meta-analysis on Ivermectin and concluded there was "no evidence to support the use of Ivermectin, but that the evidence base is limited".
Cochrane says of IVMmeta.com that “... (IVMmeta's) analyses are misleading and have several limitations. As described for the other reviews, several ineligible interventions and comparators were pooled”
Cochrane used a tighter selection criteria for the studies in their meta-analysis, using a "Risk of Bias" tool - a certainty of evidence system called GRADE. In doing so their sample size was limited to 1,678 participants and excluded many of the studies that were used in the much larger ivermectin trials. This explains why their conclusion was qualified with the statement that "the evidence base is limited”
IVMmeta says of Cochrane's findings that, "we believe (our study) can be more valuable than checklist-based approaches such as Cochrane GRADE, which may under emphasise serious issues not captured in the checklists, and over emphasise issues unlikely to alter outcomes in specific cases"
Other criticisms of Cochrane by one of the participants include "... (the) Cochrane review surprisingly doesn’t take a pragmatic approach comparing ivermectin versus no ivermectin, like in the majority of other existing reviews. It uses a granular approach (...) splitting studies up and thereby diluting effects. Consequently, the uncertain conclusions add nothing to the evidence base. A further obfuscation of the evidence on ivermectin and an example of research waste. Funding conflicts of interests of the authors and of the journal concerned should be examined."
IVMmeta also go on to comment of Cochrane, that “Cochrane was reputable in the past, but is now controlled by pharmaceutical interests. For example, see the news related to the expulsion of founder Dr. Gotzsche and the associated mass resignation of board members in protest which has been held out by some as a symptom of a wider malaise at the heart of the international network. Cochrane, they say, has lost its way, its members increasingly disenfranchised from a corporate centre focused on income generation and “message control.”
Further, we also have real world data, where Ivermectin has been widely distributed amongst populations, the incidence of Covid has plummeted. In Uttar Pradesh, where Covid is nearly eliminated, the WHO reports that those who tested positive were quickly isolated and given a medicine kit. The WHO does not state that Ivermectin was amongst the items in the kit.
The position of the World Health Organisation is that the use of Ivermectin is inconclusive and more data is needed.
In fact, all authorities recommend against its use.
The FLCCC is one of several groups researching the use of ivermectin in COVID-19, and along with many such groups, we have become increasingly concerned regarding unprecedented, highly irregular, and poorly defended public health agency (PHA) decisions regarding multiple therapeutic agents including that of ivermectin. Many providers, patients, and citizens now openly speculate that these behaviours are consistent with suppression and distortion of the scientific data in order to meet non-scientific (financial and other) objectives.
Whatever one's take is on the highly contentious issue, it is disingenuous to state that there is literally “no evidence” of effectiveness of Ivermectin for treatment of Covid.
Those denying the efficacy of treatments such as Ivermectin share responsibility for the increased risk of COVID-19 becoming endemic; and the increased mortality, morbidity, and collateral damage.
Note: Although no application to the FDA has been made for the use of Ivermectin in Covid, new drugs that work by the same mechanism are being developed by drug companies.
Is Ivermectin really unsafe?
We’re told by Dr Bloomfield that Ivermectin is not safe and the self appointed medical journalists at Stuff, go so far as to say it is dangerous.
Immunosafe commissioned a review by Dr Jacques Descotes MD, PharmD, Phd, professor emeritus, and toxicologist, to conduct an expert review report on the safety of Ivermectin.
The conclusion of the review was that the present analysis of the available medical data concludes that "the safety profile of ivermectin has so far been excellent in the majority of treated human patients so that ivermectin human toxicity cannot be claimed to be a serious cause for concern."
Nobody is suggesting to take Ivermectin in doses suitable for a horse. Those Americans who got confused about dose rates would not have done so if the human version of the drug was more readily available on prescription.
The Ivermectin issue is ongoing and more data and studies are available all the time. So when you see people making silly horse drench jokes, you know that the joke is on them. And when you see the authorities discounting any evidence at all for Ivermectin, you know that their basis for doing so is becoming more and more tenuous.
As a result of the above, we have a message for Dr Bloomfield: We implore you to look at the evidence for Ivermectin outside the Cochrane Institute and to look at real world data. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. All practical, effective, and safe means should be used. Those denying the efficacy of treatments share responsibility for the increased risk of COVID-19 becoming endemic; and the increased mortality, morbidity, and collateral damage.