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Ivermectin meta   Meta Analysis
7/28 Meta
Popp et al., Cochrane Database of Systematic Reviews, doi:10.1002/14651858.CD015017.pub2 (Preprint) (meta analysis)
Ivermectin for preventing and treating COVID‐19
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This is a very biased meta analysis designed to exclude almost all studies. Authors select a small subset of studies, with a majority of results based on only 1 or 2 studies, showing positive (non-statistically significant) results for 10 of 11 primary outcomes across a total of 13 studies.
This analysis splits up studies in order to dilute the effects and avoid statistical significance. However, we can consider the probability of 10 of 11 positive effects occurring due to chance for an ineffective treatment, which is very unlikely (0.006).
The study is entirely retrospective in the current version. The protocol is dated April 20, 2021, and the most recent study included is from March 9, 2021. The protocol was modified after publication in order to include a close to null result (Gonzalez et al. "patients discharged without respiratory deterioration or death at 28 days"), so the current protocol is dated July 28, 2021.
Authors excluded many studies by requiring results at a specific time, for example mortality, ventilation, etc. required results at exactly 28 days. Authors excluded all prophylaxis studies by requiring results at exactly 14 days.
Studies comparing with other medications were excluded, however these studies confirm efficacy of ivermectin. The only case where they could overstate the efficacy of ivermectin is if the other medication was harmful. There is some evidence of this for excessive dosage/very late stage use, however that does not apply to any of the studies here.
Studies using combined treatment were excluded, even when it is known that the other components have minimal or no effect. 3 of 4 RCTs with combined treatment use doxycycline in addition [sciencedirect.com]. Other studies were excluded by requiring PCR confirmation.
Authors are inconsistent regarding active comparators. They state that hydroxychloroquine “does not work”, yet excluded trials comparing ivermectin to a drug they hold to be inactive. On the other hand, remdesivir was an acceptable comparator, although it is considered to be effective standard of care in some locations [osf.io].
Authors fail to recognize that Risk of Bias (RoB) domains such as blinding are far less important for the objective outcome of mortality.
Bryant et al. note several other issues [osf.io].
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. Gøtzsche and the associated mass resignation of board members in protest [blogs.bmj.com, bmj.com, en.x-mol.com]. For another example of bias see [ebm.bmj.com].
The BiRD group gave the following early comment: "Yesterday’s 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 similar to WHO’s and the flawed Roman et al paper, 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."
Authors report funding from the German Federal Ministry of Education and Research, which may be influenced by [gcgh.grandchallenges.org].
Bias due to funding is ignored for both analyzed studies and Cochrane. For Cochrane funders see [cochrane.org, cochrane.org (B)].
Popp et al., 7/28/2021, preprint, 8 authors.
All 116 studies   Meta Analysis
Please send us corrections, updates, or comments. Vaccines and treatments are both extremely valuable and complementary. All practical, effective, and safe means should be used. Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. Treatment protocols for physicians are available from the FLCCC.
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