My friend John - going strictly by anecdotal evidence- who was lucky(apparently) enough to get some Ivermectin by way of his ER doc nephew, would I think agree with this: why the heck not try it?
https://covid19criticalcare.com/wp-content/uploads/2020/12/juan-chamie-real-world-evidence-the-case-of-peru.pdfhttps://www.acsh.org/news/2021/05/04/who%e2%80%99s-afraid-ivermectin-15529" By Dan Stein, M.D. — May 4, 2021
In a pandemic, will physicians, who determine that the potential benefit of Ivermectin outweighs its well-documented risks for their patients, finally once again be given free rein to practice medicine?
Why can’t a drug approved and used in humans for 35 years, with excellent safety margins, and 3.7 billion doses administered worldwide, and with almost uniformly demonstrated benefit in all stages of COVID-19 infection, get a decent day in court?
The most recent updated meta-analysis of worldwide ivermectin use in COVID-19 disease shows risk reductions
85 % for prophylaxis (n=8,789)
81% early disease (n=1,937 subjects)
43%hospitalized patients (n=6,831 subjects)
76% overall reduction in mortality (n = 7,267 subjects)
In aggregate, this data far outstrips the results felt sufficient to recommend Remdesivir, Casiri/imdevimab, dexamethasone, and budesonide to treat symptomatic COVID-19.
In January 2021, NIH upgraded its ivermectin stance from ‘not recommended’ to ‘neither recommended nor not recommended’ based upon a limited set of randomized controlled trials (RCT). If only considering RCTs, the ongoing meta-analysis found a 64% observed improvement in 27 studies involving 4,489 subjects.
Why the hesitancy to endorse? The NIH determined that several of the RCTs could be subject to bias, thus reducing overall confidence in a proven beneficial effect.
A recent RCT, published in JAMA, is a perfect case of potential bias, ironically, in the opposite direction. This RCT in young mildly symptomatic COVID found a two-day non-statistically significantly shorter time to symptom resolution with ivermectin vs. placebo.
Seventy-five consecutive subjects were dropped from the analyses when it was discovered they all received ivermectin rather than being randomized, raising questions about
the rigor of study procedures.
Placebo subjects had so few symptoms that the prespecified primary outcome had to be changed.
At the time of the study, ivermectin was freely distributed to that city’s population with widespread acceptance and adoption. Subjects who took ivermectin for five days before the study were excluded, but ivermectin’s active metabolites have a 72-hour half-life, and significant biological effects can be seen up to one month after a single dose.
Placebo subjects may have been “unblinded” to their grouping. During the initial study period, the taste of the placebo was clearly distinguishable, and no validation of taste equivalency is reported in the second period. Given the availability of information on social media and that multiple family members could be recruited from the same household during period 2, how hard would it be for a subject to conclude whether they received active drug
In other words, could the placebo group have been exposed to clinically relevant quantities of ivermectin? Maybe. Scheim noted that the side effects specific for high doses of ivermectin and not shared with COVID-19 symptomatology were identical between ivermectin and placebo groups. Unfortunately, no serum samples were collected to test ivermectin exposure............................".
But here is the most important part for this drug (or IV C for that matter) when I ask, in frustration, "why not try it":
"A word about
safety
There were no serious ivermectin-related adverse events. Reports of dizziness (40.0%), blurred vision (10.7%), and nausea (24%) were high but resolved within a median of 2 days or less, all consistent with the drug’s label. A cumulative incidence of one serious adverse event per million was reported over the first 11 years of use during mass global administration. .". Considering the drug is dirt cheap, and considering how long it has been given with quite a high safety profile compared to most prescript
ion drugs, if there is even a reasonable chance (even if anecdotal evidence only) it might keep me from dying, why can't I get it?
Sometimes, if it is all you have, anecdotes (or clinical case reports) are a lot better than nothing. Particularly if evidence of safety is quite high.
Post Edited (BillyBob@388) : 7/14/2021 9:50:58 AM (GMT-6)