Ivermectin does not work against Covid, new study from Brazil shows

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Ivermectin does not work against Covid. This is the result of a large Brazilian gold standard study of the drug. The results show that the antiparasitic does not reduce the risk of hospitalization, does not increase the speed of recovery, does not reduce time in hospital or risk of death.

The survey was carried out in partnership with public health authorities from 12 cities in Brazil and involved more than 3,000 people. It was published in the NEJM (The New England Journal of Medicine) on Wednesday (30).

Patients at high risk for developing severe Covid, with confirmed disease and with less than seven days since the onset of symptoms were recruited. The study lasted from March 23 to August 6, 2021 and even those who had already been vaccinated were able to participate.

679 patients were given ivermectin for three days at considerably higher doses (400 micrograms per kilogram) than those used in previous studies. The drug’s indication for its proven uses is a single dose of 200 micrograms per kilogram.

The authors of the research, from PUC-MG, the Federal University of Ouro Preto, the University of Minnesota and other institutions, say they made sure that the participants had not previously used the drug – something relevant to avoid elements of confusion. in the results, especially when considering all the fake news that mention the drug in Brazil.

In the country, this and other drugs were distributed and their use was encouraged by the Ministry of Health and President Jair Bolsonaro (PL).

Another 679 participants took a placebo and thus served as a control group. Still another 2,157 underwent another type of intervention.

As in other studies with a more robust methodology, no benefits were found in the use of the drug against Covid in the overall analysis.

The scientists also analyzed participating subgroups, after all, looking at a large sample like this, some degree of benefit could perhaps be found within some age group, with preexisting diseases or even in people who contracted Covid less time ago (that is, , an “early treatment”, something much commented in circles that defend the drug). But, again, the result was the same: no benefit from ivermectin.

David Boulware, a researcher at the University of Minnesota and one of the authors of the study, highlighted that his social networks were an important fact when considering a drug that was widely associated in Brazil with the idea of ​​”early treatment”.

“Among the most notable findings, those who started taking ivermectin earlier (from 0 to 3 days after the onset of Covid symptoms) did not do better. In fact, they did worse than those who took a placebo,” he said. “To me, sooner should be better for effective therapy.”

Gilmar Reis, one of the authors of the research and professor in the department of medicine at PUC-MG, says he would like the medication to work. “But it doesn’t work, patience. Let’s use the resources in something more useful”, he says. “Planning a study to go wrong is unthinkable. Wasting money, resources, heads.”

The researcher from PUC-MG points out that an independent and also “blind” committee that analyzed the data determined, at a certain point, that the study was interrupted and that no more people were recruited, due to how blunt the negative data were in relation to ivermectin. .

The study was supported by FastGrants and the Rainwater Charitable Foundation.

Before population studies, in vitro research pointed out that ivermectin could be useful against Covid. The studies that found positive results used very high doses to have an effect – which was already a bad sign for human trials.

Small research in humans also came to show results of the drug against the coronavirus. The problem is that small studies, in general, have a much lower capacity to draw robust conclusions, precisely because of the small sample size.

Studies without a control group (that is, without participants receiving a placebo) and without blinding the participants (patients do not know whether they are receiving the drug or the placebo and scientists do not know who they are giving one or the other to) are subject to biases that harm the conclusions.

Several of the studies on ivermectin have suffered from this. Several of them were even “unpublished” due to concerns about credibility.

The WHO (World Health Organization) does not recommend ivermectin outside of clinical trials, precisely because of the generally poor quality of the available data.

In the new work, however, the number of events observed (hospitalizations, deaths, etc.) — the more abundant, the better for evaluating the results — was greater than in the sum of all studies that previously participated in meta-analyses on ivermectin and Covid, say the authors.

Do the new results then end the discussion and false information that circulates so much about the use of the antiparasitic ivermectin for Covid? It is difficult to say, but the authors themselves seem not to believe this.

“We suspect that there will be more criticism that our administration regimen was inadequate,” the researchers write.

Reis says he already sees on social media some people distorting the study data. That’s because the raw numbers show a percentage difference of fewer events in the group that took ivermectin.

But that doesn’t mean the drug actually had an effect. Therefore, statistical analysis of the data is important to see if a result could have been achieved by chance or if the difference is of statistical significance.

This is the normal and indicated pattern of good research methodologies. Depending on the percentage found, it will mean mere chance — that is, it points out that, if the study were redone, the percentage difference could, this time, go to the group that took the placebo.

The researcher from PUC-MG says that clinging to this small percentage found is “statistical incompetence”.

“The person who knows how to read statistics sees that the data is very strong and shows that it really doesn’t work”, says Reis. “I could do with 30,000 people and the result would be more or less the same.”

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