Ivermectin doesn’t treat COVID or keep people out of hospital, study finds

[lindamy]

综述：Ivermectin for Prevention and Treatment of COVID-19 Infection​

来源: fuz 于 2021-08-01 15:50:28

介绍两篇综述性分析文章，让大家对印度防疫“神药”有所了解。

Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines​

Ivermectin for Prevention and Treatment of COVID-19... : American Journal of Therapeutics
Conclusions:
Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.


另一篇回朔性分析文章，则有着不同的结论
Ivermectin for preventing and treating COVID-19 - PubMed
Authors' conclusions: Based on the current very low- to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID-19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use ivermectin for treatment or prevention of COVID-19 outside of well-designed randomized trials.

还有一篇综述也不推荐使用
Systematic review explores the effects of ivermectin in preventing and treating COVID-19
"The lack of good quality evidence on efficacy and safety of ivermectin arises from a study pool that consists mainly of small, insufficiently powered RCTs with overall limited quality regarding study design, conduct and reporting. Current evidence does not support using ivermectin for treating or preventing of COVID-19 unless they are part of well-designed randomized trials."

真正值得推敲的是这篇在二月份发表的临床研究。吃两次药，在之后的一个月里能减少近3/4的感染。很神奇啊。

Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study​

Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study

Results​

Ivermectin prophylaxis was taken by 76 controls and 41 cases. Two-dose ivermectin prophylaxis (AOR 0.27, 95% CI, 0.15–0.51) was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month. Those involved in physical activity (AOR 3.06 95% CI, 1.18–7.93) for more than an hour/day were more likely to contract SARS-CoV-2 infection. Type of household, COVID duty, single-dose ivermectin prophylaxis, vitamin-C prophylaxis and hydroxychloroquine prophylaxis were not associated with SARS-CoV-2 infection.

Conclusion​

Two-dose ivermectin prophylaxis at a dose of 300 μg/kg with a gap of 72 hours was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month. Chemoprophylaxis has relevance in the containment of pandemic.

接下来，印度疫情失控。无奈之下，一地方政府在五月十号决定发给居民“神药”。
Goa prescribes Ivermectin for all above 18 to fight COVID-19 even as experts flag concern: All you need to know-Health News , Firstpost

二周后，当地政府声称病死例数真的降下来了。很神奇哟。
‘Lower mortality...’: Goa govt defends Ivermectin’s efficacy against Covid-19
In defence of its decision to administer Ivermectin, an anti-parasitic medicine for the use as prophylaxis, to Covid-19 patients, the Goa government, in a statement, has claimed that the mortality rate is much lower in patients who take the medicine than those who don’t.




FDA这样说的
Why You Should Not Use Ivermectin to Treat or Prevent COVID-19

Here’s What You Need to Know about Ivermectin​

• FDA has not approved ivermectin for use in treating or preventing COVID-19 in humans. Ivermectin tablets are approved at very specific doses for some parasitic worms, and there are topical (on the skin) formulations for head lice and skin conditions like rosacea. Ivermectin is not an anti-viral (a drug for treating viruses).
• Taking large doses of this drug is dangerous and can cause serious harm.
• If you have a prescription for ivermectin for an FDA-approved use, get it from a legitimate source and take it exactly as prescribed.
• Never use medications intended for animals on yourself. Ivermectin preparations for animals are very different from those approved for humans.

（EMA)欧盟也不赞同使用

EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials​

EMA advises against use of ivermectin for the prevention or treatment COVID-19 outside randomised clinical trials - European Medicines Agency，

综述：Ivermectin for Prevention and Treatment of COVID-19 Infection - fuz发表于 健康养生 - 论坛 | 文学城

bbs.wenxuecity.com

 

[cable4sale]

 

[lindamy]

这里有一篇综述

 

[lindamy]

再谈谈伊维菌素 - 伊维霉素的问题不是能否在体外抗病毒，而是服了后在体内根本达不到抗病毒的浓度。​

来源: Fanreninus 于 2022-01-31 08:18:46

再谈谈伊维菌素

在前一篇文(伊维菌素和新冠)里，我提到了伊维菌素为何会被一些人推崇，最初的原因是有人发现它和羟基氯喹一样，在体外有抗病毒作用。

对于药物发现和开发来讲，这只是第一步，在体外有抗病毒作用的化合物估计有成百上千，但并不是所有的都能用来作为抗病毒药物的。

要成为抗病毒药，必须经过很多实验来证明它在体内也安全有效，其中最关键的就是在病人身上进行测试的三期临床双盲对照试验。

伊维菌素不仅没有这样的资料，甚至连进行三期临床测试的条件都达不到。原因就是用现有的剂型和量，在体内根本就达不到期望浓度。

要想知道是否达到期望浓度，要有两个参数。

第一个就是人体内的浓度，由于血液比较容易采样，通常以血浆里的浓度来代表人体内的浓度。

第二个在什么浓度下，药物能够发挥其活性或者效力（potency）。 譬如说药物抑制其靶物或相关细胞活动的50%（IC50）或者90%（IC90）的浓度是多少。

血浆浓度如果高于IC90的话，药物就有可能发生效果，就达到了期望浓度。如果达不到的话，就很难产生作用。
那么使用现有剂型的ivermectin后体内能否达到期望浓度呢？

下面是服用各种剂型和剂量后在血液中达到的最高浓度，其中最高的是每毫升80纳克。把这个用分子量（875）一除即可换算成每升多少个摩尔的摩尔浓度，结果是0.09微摩尔。

这个浓度远远低于该药抑制病毒的IC90或者（~6微摩尔）IC50（2.8微摩尔），血浆最高浓度比IC90低30倍。这说明服用后，该药根本达不到抑制病毒所需的浓度。

下面这个链接里的一文也得出同样的结论。

https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/cpt.1889

文中说：空腹服用批准剂量的伊维菌素后能达到的最大血浆浓度 (Cmax)比 50%抑制的浓度 (IC50; 2 µM) 低35倍，即使多给十倍的药，血液和肺部的药物也不可能达到期望的浓度。

如果是临床一期得到这样的结论的话，就不会对被测试的药继续进行第二期（小规模的安全性和效果观察）和第三期（大规模的效果和安全性观察）了，不然不仅浪费人力物力财力，还有违医学伦理。

所以说用伊维菌素治疗或者预防新冠是没有足够科学证据的，不仅没有临床试验得到的科学证据，就连理论上也经不起推敲。为了自己和他人的身体健康，不要一味媚俗。

再谈谈伊维菌素 - 伊维霉素的问题不是能否在体外抗病毒，而是服了后在体内根本达不到抗病毒的浓度。 - Fanreninus发表于 健康养生 - 论坛 | 文学城

bbs.wenxuecity.com

 

[何 不]

江湖骗子极力推崇的

 

[lindamy]

Ivermectin Doesn't Prevent Severe COVID-19, New Study Finds (upi.com)​

Posted by EditorDavid on Saturday February 19, 2022 @10:34AM from the randomized-control-trial dept.

UPI reports on the results of a new randomized-controlled trial of ivermectin, the "gold standard" of medical research.

UPI reports that treatment with ivermectin "failed to prevent patients with mild to moderate COVID-19 from progressing to serious illness, a study published Friday by JAMA Internal Medicine found."Of 241 patients in the study with mild to moderate symptoms treated with the veterinary medication, 52, or 22% developed severe COVID-19, the data showed. Meanwhile, 43 of 249 patients, or 17%, who received "standard" treatment, including corticosteroids and, in a handful of cases, other experimental drugs, progressed to serious illness from the virus, the researchers said.

"Essentially, our study findings have dismissed the notion of ivermectin being a 'miracle drug' against COVID-19," study co-author Dr. Steven Chee Loon Lim told UPI in an email.... In addition, study participants treated with ivermectin reported more side effects than those given other drugs, Lim said. This "raises concerns about the widespread use of this drug," he said.... 14 of the ivermectin patients developed severe diarrhea and four suffered potentially life-threatening kidney damage, the researchers said.

The new study also examined whether patients had to go on a ventilator, needed intensive care or died from their infections — and discovered "there were no significant differences between groups."

And the researchers' study also points out that two additional randomized clinical trials conducted in 2021 also "found no significant effect of ivermectin on symptom resolution and hospitalization rates." UPI now quotes Dr. Lim as saying Friday that despite early hopes for ivermectin, "large and well-designed randomized clinical trials, including ours, have consistently shown that ivermectin offered little or no significant clinical benefits.

"I believe the findings in our study will likely 'close the door' on the use of ivermectin as a treatment for COVID-19."

Ivermectin Doesn't Prevent Severe COVID-19, New Study Finds - Slashdot

UPI reports on the results of a new randomized-controlled trial of ivermectin, the "gold standard" of medical research. UPI reports that treatment with ivermectin "failed to prevent patients with mild to moderate COVID-19 from progressing to serious illness, a study published Friday by JAMA...

science.slashdot.org

 

[lindamy]

New study finds ivermectin ineffective against COVID-19

New research shows ivermectin doesn’t appear to be a strong tool in the fight against COVID-19.

www.kptv.com

Ivermectin doesn't prevent severe disease from Covid-19, new study finds | CNN

The antiparasitic drug ivermectin doesn't prevent severe disease from Covid-19 any more effectively than symptom management and close observation by medical professionals, according to a study published Friday in the journal JAMA Internal Medicine.

www.cnn.com

 

[lindamy]

前天CBC报道，BC 医生 Charles Hoffe 关于IVM 和疫苗的虚假宣传受到十几位医生联名起诉。相关医疗协会对Hoffe医生发出传票，指控理由是“在社交媒体和其他媒体平台上发布有关 COVID-19 疫苗接种、治疗和公共措施的误导、不正确或煽动性声明。”

这些医生的指控认为，Hoffe医生的虚假宣传，将公众至于危险之中。IVM作为一种冠状病毒的治疗方法在抗疫苗界很受欢迎，但最近的研究表明它无效，并且使用这种用于动物的制剂，可能会产生严重的副作用。

他还宣传疫苗比感染新冠病毒更危险，包括“公开表示 COVID-19 疫苗会导致微观血栓，从而导致严重的神经损伤、女性不育和大量死亡，这是公共卫生不承认。”

B.C. doctor to face disciplinary panel over 'misleading, incorrect or inflammatory' claims about COVID-19​

Dr. Charles Hoffe told patients to buy veterinary ivermectin, made false claims about vaccines, college says​

Bethany Lindsay · CBC News · Posted: Feb 23, 2022 10:50 AM PT | Last Updated: February 23

Dr. Charles Hoffe is shown during the Doctors on Tour stop in Terrace, B.C., on Jan. 26. (Georgie Smyth/CBC)

A B.C. doctor who's been touring the province and giving public speeches that include false claims about the COVID-19 vaccine is facing a hearing over allegations of professional misconduct.

The College of Physicians and Surgeons of B.C. has posted a notice online saying a citation has been issued for family physician Dr. Charles Hoffe of Lytton for "publishing statements on social media and other digital platforms that were misleading, incorrect or inflammatory about vaccinations, treatments and public measures relating to COVID-19."

Vancouver pediatrician Dr. Alastair McAlpine, one of more than a dozen doctors who've filed complaints against Hoffe with the college, said he has mixed feelings about the news.

"[I'm] grateful on the one hand that something is being done, but also just disappointment because it honestly feels like it's too little too late … and there's no indication that his licence has been limited in any way, which means he can continue to spread the misinformation that he's been spreading," McAlpine told CBC News.

A college disciplinary panel will consider evidence that includes Hoffe's recommendation for patients to use the anti parasitic medication ivermectin to treat COVID-19, and suggesting they visit animal feed stores to buy the veterinary version of the treatment, according to the notice.

• 2 B.C. doctors went on a COVID-19 speaking tour. Colleagues say their misinformation put public at risk

Ivermectin has become popular in anti-vaccine circles as a treatment for the coronavirus, but the most recent research suggests it is not effective and consuming a formulation meant for animals can have serious side-effects.

The notice also points to Hoffe's false claims that COVID-19 vaccines are more dangerous than the disease, including "publicly expressing that the COVID-19 vaccinations cause microscopic blood clots that cause serious neurological harm, female infertility and a high number of deaths that is not recognized by public health."

His incorrect suggestions that vaccinated people can cause harm to unvaccinated people will be under consideration, as well.

CBC News has contacted Hoffe for comment, but he has yet to reply.

Letter posted on anti-vaccine website​

The allegations against Hoffe concern statements he's published online beginning in April 2021, according to the college's notice.

That's when Hoffe suddenly rose to prominence in the anti-COVID vaccine movement after publishing a letter to Provincial Health Officer Dr. Bonnie Henry on the website of the anti-vaccine group Vaccine Choice Canada.

Hoffe claimed in his letter that after administering the Moderna shot to community members, he believed "this vaccine is quite clearly more dangerous than COVID-19."

• B.C. doctor disciplined for 'harmful' COVID-19 misinformation claims free speech violations

His letter also echoed a common but thoroughly debunked talking point that suggests mRNA vaccines are actually a form of "experimental gene modification therapy."

More recently, Hoffe has been one of the main speakers in a series of events called "Doctors on Tour" that stopped in more than a dozen communities across the province in December and January.

When a CBC reporter approached Hoffe during a stop in Terrace, B.C., earlier this year, he declined to comment on any college investigations into his activities.

Dr. Stephen Malthouse and Dr. Charles Hoffe are the subject of complaints from fellow physicians about spreading COVID-19 misinformation. The pair are both practicing physicians and both have active licenses. (Georgie Smyth/CBC)

McAlpine said he was disappointed that the notice from the college doesn't mention Hoffe's public statements on tour or during other public appearances.
"They haven't mentioned anything about the fact that since the initial complaint he's appeared at multiple schools spreading misinformation, telling patients not to take the vaccine, calling it the 'death shot' and the 'clot shot,' standing in front of effigies of [Heath Minister] Adrian Dix with a noose around his neck," McAlpine said, referring to a protest outside the B.C. legislature in December.

He also noted there has been no update from the college on its investigation into Dr. Stephen Malthouse, who has also been a part of the tour and has been the subject of numerous complaints from fellow doctors related to COVID-19 misinformation.

Malthouse filed a petition in B.C. Supreme Court last year claiming that the college is violating his right to free speech by investigating him and proposing disciplinary measures. The college has yet to file a response.

A hearing date for Hoffe has yet to be scheduled. He remains a fully licensed doctor in B.C., with no conditions on his practice.

https://www.cbc.ca/news/canada/british-columbia/charles-hoffe-doctor-discipline-panel-covid19-1.6361624

 

[lindamy]

Ivermectin doesn’t treat COVID or keep people out of hospital, study finds​

By Michelle Butterfield Global News
Posted March 31, 2022 2:36 pm

View image in full screen
File Photo / The Associated Press

Ivermectin, the anti-parasitic drug touted by some as an alternative COVID-19 treatment, doesn’t do much — if anything — in terms of alleviating symptoms or keeping people out of the hospital, a new study has found.

The clinical trial, which looked at more than 1,300 people who became infected with the coronavirus in Brazil, effectively ruled out the drug as a treatment for COVID-19.

The results were first shared in a presentation by the National Institutes of Health, and the full data was released Wednesday in The New England Journal of Medicine.

In the double-blind randomized study, researchers in Brazil compared patients — some given ivermectin while others received a placebo — and found no difference between the groups.

“There’s really no sign of any benefit,” Dr. David Boulware, an infectious-disease expert at the University of Minnesota and one of the study’s authors, told the New York Times.

“Now that people can dive into the details and the data, hopefully that will steer the majority of doctors away from ivermectin towards other therapies,” he continued.

Early in the pandemic, several small-scale studies found ivermectin to be effective on cells, but this latest research says studies involving humans failed to back up those findings.

Several studies cited by ivermectin advocates have been retracted for flawed or fabricated data and analysis, while many randomized trials have shown no benefits.

Health Canada, The Centers for Disease Control (CDC) and the World Health Organization (WHO) all warned against using the drug to prevent or treat COVID-19, but that didn’t stop some people from spreading the message that ivermectin is an acceptable tool in the coronavirus treatment arsenal.

1:39Podcast star Joe Rogan tests positive for COVID-19, says he feels ‘good’ after ‘throwing kitchen sink at it’

• 
  
  Podcast star Joe Rogan tests positive for COVID-19, says he feels ‘good’ after ‘throwing kitchen sink at it’
• 
  
  Demand for livestock dewormer as COVID-19 cure forces Calgary-area store to hide it
• 
  
  Despite health warnings, horse medicine being purchased to treat COVID-19

Ivermectin’s popularity really exploded in the second year of the pandemic, when several high-profile people, like podcaster Joe Rogan, used their huge platforms and media presence to support the product.

Rogan hosted Bret Weinstein, a former biology professor at Evergreen State College in Washington state, on his podcast several times. Weinstein, along with his wife Heather Heying, was one of the first people in the medical arena to tout the drug as a treatment, and he also talked with Tucker Carlson on Fox News and Bill Maher on HBO to promote the drug.

However, according to Portland’s Williamette Week, Weinstein and Heying have backed away from ivermectin recently. The newspaper reports that Weinstein has deleted all mention of the drug from his Twitter feed.

Ivermectin is sometimes prescribed to treat worm infections in humans, but veterinary clinics sounded the alarm last year that poison calls were up after people were taking a formulation intended for livestock.

2:14Ontario doctor banned from prescribing ivermectin now director of company offering drug

• 
  
  Ontario doctor banned from prescribing ivermectin now director of company offering drug
• 
  
  COVID-19: Dr. Moore comments on doctor banned from prescribing ivermectin
• 
  
  Saskatoon pharmacist warning about use of Ivermectin to treat COVID-19
• 
  
  U.S. FDA warns Americans not to use livestock drug as COVID-19 remedy

In September, B.C.’s Drug and Poison Information Centre told Global News it had nine cases related to people taking veterinary-grade ivermectin to prevent or treat COVID-19 in the last six months, when it had received zero calls about the drug in the prior two years. None of these calls ended in a serious adverse outcome, the agency said.

“Ivermectin toxicity can lead to abdominal pain, nausea, vomiting, diarrhea, headache, dizziness, low blood pressure, seizures, coma, respiratory failure, and death,” the agency wrote in a statement.

The College of Physicians and Surgeons of Ontario (CPSO) announced earlier this year that they are investigating multiple telehealth doctors who were found offering ivermectin to patients and were alleged to have issued false medical exemptions.

© 2022 Global News, a division of Corus Entertainment Inc.

Ivermectin doesn’t treat COVID or keep people out of hospital, study finds - National | Globalnews.ca

Ivermectin showed some promise in treating COVID-19 in the lab, but studies have failed to replicate the response in humans.

globalnews.ca

 

[So what]

这驱虫药够顽强的，难怪成为了一些人的精神支柱

 

[lindamy]

 

[lindamy]

Effect of Early Treatment with Ivermectin among Patients with Covid-19​

Abstract​

BACKGROUND​

The efficacy of ivermectin in preventing hospitalization or extended observation in an emergency setting among outpatients with acutely symptomatic coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is unclear.

METHODS​

We conducted a double-blind, randomized, placebo-controlled, adaptive platform trial involving symptomatic SARS-CoV-2–positive adults recruited from 12 public health clinics in Brazil. Patients who had had symptoms of Covid-19 for up to 7 days and had at least one risk factor for disease progression were randomly assigned to receive ivermectin (400 μg per kilogram of body weight) once daily for 3 days or placebo. (The trial also involved other interventions that are not reported here.) The primary composite outcome was hospitalization due to Covid-19 within 28 days after randomization or an emergency department visit due to clinical worsening of Covid-19 (defined as the participant remaining under observation for >6 hours) within 28 days after randomization.

RESULTS​

A total of 3515 patients were randomly assigned to receive ivermectin (679 patients), placebo (679), or another intervention (2157). Overall, 100 patients (14.7%) in the ivermectin group had a primary-outcome event, as compared with 111 (16.3%) in the placebo group (relative risk, 0.90; 95% Bayesian credible interval, 0.70 to 1.16). Of the 211 primary-outcome events, 171 (81.0%) were hospital admissions. Findings were similar to the primary analysis in a modified intention-to-treat analysis that included only patients who received at least one dose of ivermectin or placebo (relative risk, 0.89; 95% Bayesian credible interval, 0.69 to 1.15) and in a per-protocol analysis that included only patients who reported 100% adherence to the assigned regimen (relative risk, 0.94; 95% Bayesian credible interval, 0.67 to 1.35). There were no significant effects of ivermectin use on secondary outcomes or adverse events.

CONCLUSIONS​

Treatment with ivermectin did not result in a lower incidence of medical admission to a hospital due to progression of Covid-19 or of prolonged emergency department observation among outpatients with an early diagnosis of Covid-19. (Funded by FastGrants and the Rainwater Charitable Foundation; TOGETHER ClinicalTrials.gov number, NCT04727424. opens in new tab.)

Figure 1.Randomization and Follow-up of the Patients.

Outpatients with symptoms of coronavirus disease 2019 (Covid-19) were assessed for eligibility. The intention-to-treat population included all the patients who had undergone randomization. The modified intention-to-treat population included all the patients who received ivermectin or placebo for at least 24 hours before a primary-outcome event (hospitalization due to Covid-19 within 28 days after randomization or an emergency department visit due to clinical worsening of Covid-19, defined as the participant remaining under observation for >6 hours); if the event occurred before 24 hours after randomization, the patient was not included in this population. The per-protocol population included only patients who reported 100% adherence to the assigned regimen. Only the results in the 3-day ivermectin group as compared with the concurrent placebo group are reported in this article. Participants in the placebo group received placebo for 1, 3, 10, or 14 days, comparable to the active-treatment groups in the trial. Although all the participants who had been assigned to receive any placebo were included in the intention-to-treat population, only those in the 3-day placebo groups were included in the per-protocol population.

Figure 2.Subgroup Analyses of Ivermectin as Compared with Placebo for the Prevention of Covid-19–Related Hospitalization or Prolonged Observation in an Emergency Setting.

The primary composite outcome was hospitalization due to Covid-19 within 28 days after randomization or an emergency department visit due to clinical worsening of Covid-19 (defined as the participant remaining under observation for >6 hours) within 28 days after randomization. Arrows indicate that the 95% Bayesian credible interval extends outside the graphed range.

https://www.nejm.org/doi/full/10.1056/NEJMoa2115869