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Another Ivermectin Study Shows Benefit
Reduced chances of hospitalization and death by 27%
Warning: this article is BORING and discusses confusing scientific studies lacking statistical power, with poorly defined outcomes, whose conclusions lack statistical significance. If you are looking for a viral shareable article with incredibly exciting and well-founded conclusions, this one is not of that kind and you can stop reading right now.
For those brave enough to continue, I will include a bonus personal tidbit about Ivermectin working against Ba.5 last week, at the end. So let’s go.
Another study of Ivermectin is out.
In this study, scientists tried THREE repurposed drugs — ivermectin, metformin, and fluvoxamine — to see if they reduce the chances of severe outcomes (such as hospitalization, death, ER visit, or low blood oxygen). The results were mixed: they found that metformin and ivermectin reduced the chances of hospitalization or death, while fluvoxamine slightly increased the chances.
Unfortunately, due to the small size of the trial, all three outcomes were not statistically significantly different from zero. This is a problem that plagues all repurposed drug trials: they are not well financed and therefore small and underpowered. As a result of a small number of participants, the outcomes lack statistical power to prove the statistical significance of an outcome. Nevertheless, the outcomes do show the same trend as most other studies: the fact that Ivermectin-treated groups have better outcomes when it comes to severe events like hospitalization and death.
The design of the study was extremely confusing: they gave patients different combinations of drugs, not just one drug like ivermectin:
The groups received the trial drugs according to the following doses: immediate-release metformin administered with an increase in dose over 6 days to 1500 mg per day for 14 days, ivermectin at a dose of 390 to 470 μg per kilogram per day for 3 days, and fluvoxamine at a dose of 50 mg twice daily for 14 days. For the analysis, the metformin group included the patients who had received metformin alone or metformin in combination with either fluvoxamine or ivermectin. The metformin control group included the patients who had received placebo, fluvoxamine alone, or ivermectin alone. The ivermectin group included the patients who had received ivermectin alone or ivermectin in combination with metformin. Patients in the ivermectin control group were randomly assigned to receive either placebo or metformin alone. The fluvoxamine and fluvoxamine control groups were constructed similarly. The control groups that were used in the comparisons with the active-drug groups included only concurrently randomly assigned patients.
Did you understand the above from the first reading? I did not.
The dose of Ivermectin was along the lines of FLCCC recommendations (390 to 470 μg per kg), but the duration was shorter, only 3 days of Ivermectin as opposed to FLCCC’s recommended 5.
So we have a confusing study design, with possible “low blood oxygen readings” being one of the primary outcomes. This is what the authors have to say about oxygen readings:
The FDA later issued a safety communication on the accuracy of pulse oximeters after the trial began. In addition, numerous patients recorded apparently spurious readings.
They also made part of the ivermectin group affected by the previously-unexplored interaction of ivermectin and metformin.
So all of this gives us a very complicated statistical picture, muddled by drug interactions, “spurious oxygen readings” causing ER visits, numerous subgroups, one drug being a control for another, and so on.
Nevertheless, the Ivermectin-treated group had 27% lower chance of hospitalization or death, compared to the control group.
The adjusted odds ratio for hospitalization or death was 0.47 (95% CI, 0.20 to 1.11) with metformin, 0.73 (95% CI, 0.19 to 2.77) with ivermectin, and 1.11 (95% CI, 0.33 to 3.76) with fluvoxamine.
If emergency department visits were included in the picture (some were caused by “spurious oxygen readings”), the results change:
In prespecified secondary analyses, the adjusted odds ratio for emergency department visit, hospitalization, or death was 0.58 (95% CI, 0.35 to 0.94) with metformin, 1.39 (95% CI, 0.72 to 2.69) with ivermectin, and 1.17 (95% CI, 0.57 to 2.40) with fluvoxamine.
None of the above results is statistically significant because of a small number of participants and a small number of outcomes.
Overall, this is a study with
Small number of participants and outcomes
Very confusing factorial design of mixing drugs and control groups
“Spurious readings” of blood oxygen likely affecting counts of predefined “low blood oxygen outcomes” that likely made people make trips to ER for nothing but spurious oximeter readings
Does not conclusively prove that Ivermectin reduces hospitalization and death, even though there is a 27% reduction, because of the lack of statistical significance
I am not a scientist, but in my own mind, I would prefer that studies such as this one were designed with simplicity in mind and without outcomes affected by “spurious readings”.
The takeaway is: this strangely designed study shows 27% reduction of hospitalization or death with Ivermectin, with the reduction NOT rising to the level of statistical significance.
Small and Confusing Studies are the Bane of “COVID Research”
Remember my recent article about reinfections occurring more frequently in vaccinated people?
Unfortunately, the Iceland study that I reported, had the same exact problems as the Ivermectin study above: it had a confusing selection of participants (vaccinated with “two or more doses” vs “one or zero doses”), study conclusions that flip depending on what adjustments to apply, short study period, etc. What it did have, however, was a statistically significant difference favoring the unvaccinated.
Two important people weighed in. El Gato Malo looked at it also and found the study to be relatively lacking in quality, but providing a conclusion that is in line with other sources of information about greater reinfections in vaccinated vs unvaccinated people:
Modern Discontent also looked at this same study and his conclusion was that the study was so bad that it should be totally disregarded. I do not personally agree with him about that; the Iceland study still provides useful, although limited evidence, and has statistical significance. Nevertheless, his opinion deserves the light of day and I feel that we should welcome robust discussion, so here’s his article:
Recent Personal Experience with Ivermectin
A family of a friend had two young adult persons with Covid that started on Thursday last week; both given 0.3 mg/kg for 5 days, one starting Thursday and another Friday. Both fully recovered on Monday with negative tests. Did Ivermectin help these two specific individuals? I obviously cannot know that. All I know is that their previous infection in January was worse than this one. Make of this what you want.
Because this article is boring, I am not including a SHARE button. Share it if you want, but it is clearly not a viral bombshell.