Which 18 studies?


The National COVID-19 Clinical Evidence Taskforce (NCCET) very recently updated its Ivermectin guidance (h/t: Muddy on the OOT).  Apart from the standard mention of the ‘dangers’ of ivermectin, they write: 

The certainty of the current evidence base varies from low to very low depending which on outcome is being measured, as a result of serious risk of bias and serious imprecision in the 18 included studies.

But they don’t actually mention which studies they’ve included. However, they do throw some shade on Bryant et al meta-analysis: 

Despite some early suggestions that  that ivermectin may provide both prophylactic and therapeutic benefit, the available research evidence does not yet provide reasonable certainty to recommend for or against the use of ivermectin.  More robust, well-designed randomised controlled trials are needed to demonstrate whether or not ivermectin is effective. 

Some widely discussed meta-analyses of ivermectin studies (e.g. The British Ivermectin Research Development (BIRD) Group [they mean Bryant et al; that this is still uncorrected is staggering] meta analysis) have significant weaknesses, for example  they  include a large trial which has been discredited and retracted (Elgazzar et al.).  Even in these reviews, when patient populations are separated by severity and comparisons to active treatments removed, no meaningful effect is found.

Two things pop-out to me here. Firstly, why haven’t NCCET themselves organized and sponsored an RCT here in Australia? If you look at the list of Taskforce members, partners and funders, it beggars belief that they would simply wait for the Oxford PRINCIPLE Trial to report the results of their RCT in the next year or so rather than completing one here themselves under their own guidance. Secondly, the removal of Elgazzar paper from Bryant et al, which the authors removed immediately, still yields a meaningful effect for ivermectin both as prophylaxis (88% improvement) and mortality (49% reduction in), which is why the NCCET felt it necessary to follow up with some guff about “patient populations are separated by severity and comparisons to active treatments removed”, the analysis of which we are not privy to anyway. In fact, researching this led me to a magnificent piece in Quadrant were two of the co-authors of Bryant et al, Tess Lawrie and Edmund Fordham, respond to the NCCET statement on ivermectin, particularly in relation to the NCCET’s criticism of Bryant et al but also more broadly to their decision to exclude OCTs and clinical success of independent clinicians around the world among another things. 

Which returns me to my principle question. Which 18 RCTs did the NCCET use in its advice? This would be interesting to know as the  Ivermectin for COVID-19: real-time meta analysis of 63 studies includes 30 RCTs that indicate the efficacy of ivermectin as prophylaxis is in the order of 84%, in early treatment, 62%, and in late treatment 20%. It is simply unacceptable that we are not informed of this, and why the other 12 studies were excluded. It is also unacceptable that they ignore all of the OCTs on ivermectin as well as the experience of clinicians treating COVID at various stages of the illness around the world. Given the apparent urgency of a pandemic, the reticence to consider ivermectin, given its widespread usage as a anti-parasitic and its excellent safety record, is simply inexplicable.

Well, it isn’t. But that may be a story for another day.  


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bemused
bemused
October 18, 2021 5:53 pm

Tell this to all the Indians who now have Ivermectin at home in their medicine cupboards should symptoms arise. India virtually eliminated COVID deaths because of Ivermectin, but apparently the WHO put pressure on the Indian government not to promote it. I wish I could find the link again.

Chris M
Chris M
October 18, 2021 6:09 pm

Indonesia is doing way better than Australia now despite 10x the population.

This useless dangerous and illegal horse medicine they started used end of July really seems to have done a number on delta but the loathsome skidmarks at ATAGI have determined it only works in developing countries and would not be beneficial to their shareholdings here.

bemused
bemused
October 18, 2021 6:47 pm

dover0beach says:
October 18, 2021 at 6:11 pm

I saw the Quadrant article earlier, but I also watched a very good YouTube presentation that gave a clear explanation of what India has done and how it’s worked for them. The video also mentioned the WHO involvement.

What gets me is that if our government can lie about these thing and prevent the use of medicines that have been in use for decades, yet are OK with vaccines that have had no rigorous clinical trials, what else will they be capable of doing in future?

Muddy
Muddy
October 18, 2021 8:41 pm

I don’t know if any of the following will provide information not already known:
University of Oxford’s COVID-19 vaccine trials
The following seems like old news:
The Oxford Vaccine Centre COVID-19 Phase I Clinical Trial Explained

Outputs & Publications

Muddy
Muddy
October 18, 2021 8:50 pm
Muddy
Muddy
October 18, 2021 8:57 pm

Eh?

175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials.


Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Apologies for robo-spamming. I’ll stop now. (Only because I’ve realised I don’t understand any of this).

Baba
Baba
October 18, 2021 9:35 pm

I have little faith in the Oxford PRINCIPAL Trial of ivermectin. I haven’t been able to find any details of the trial other than ivermectin will be administered for 3 days which is just over half the minimum period recommended in the Front Line Covid-19 Critical Care (FLCCC) Alliance protocol. I haven’t found anything about dosage or the usage of supplementary therapeutics.

There was a widely touted study a few months ago which allegedly debunked ivermectin. Participants were given half the FLCCC recommended dosage for half the recommended time without any of the recommended supplements. Not surprisingly results were inconclusive.

Why can’t Oxford simply subject the FLCCC recommended protocols or the Uttar Pradesh kit (or preferably both) to clinical trial?

Jorge
Jorge
October 18, 2021 9:51 pm

I have 5l of ivermectin (sheep drench sold as Ausmectin) which I will use as and when necessary. I won’t be discussing this with any medical professional. They have zero credibility on the topic.

Maniac
Maniac
October 19, 2021 1:03 am

A pre-filled oral syringe of the Mr. Ed gel arrived in the mail recently. Just in case.

HD
HD
October 19, 2021 1:58 am

I wonder if the TGA will grow some balls and admit smoking may very well be beneficial to your health. So this trial seeks to evaluate the magnitude thereof by giving nicotine patches to non-smokers.

“Daily active smokers are infrequent among outpatients or hospitalized patients with COVID-19.”

https://clinicaltrials.gov/ct2/show/NCT04583410

bemused
bemused
October 19, 2021 7:16 am

“Daily active smokers are infrequent among outpatients or hospitalized patients with COVID-19.”

I remember that being written about very early in the days of the COVID panic; that smokers represented a very small portion of those seriously affected by COVID. That sort of news disappeared rather quickly.

Mother Lode
Mother Lode
October 19, 2021 8:20 am

I have noticed that there is in fact a distinct intellectual faculty available to progressives but not to the rest of us.

For us studies are part of a dialogue. Their value derives from their content and a study based on faulty premises becomes faulty itself. Everything asserted in the study has its own truth value: If the study contains a chemical process that process is as true when used in the study or anywhere else.

If it contains a logical fallacy that logic is as fallacious in the study as without. If there is a passage that says “20% of patients had this outcome” referring to 20% of a group which satisfies conditions a, b, and c specified in the study then we would expect the same results for that same (a, b, c) group outside the study.

A possible image is to imagine all the possible statements of chemistry, logic, statistics (etc) are set out, and a study is like drawing lines linking them together to produce the argument, and another, closed line grouping them together. The lines are incidental. Nothing becomes more or less true merely by being included in the lines.

So, for us, a study is to be evaluated by examining its contents: Their truth is the only thing that governs the study’s truth so that is where you have to look.

But for progressives there is this additional tool, in words like ‘discredited’ and ‘debunked’. Here the words are not related to processes. Nothing has been done to discredit or debunk them. Instead the words are used to flag what studies are to be ignored, and give license to progressives to not only dismiss their contents, but to smear anyone who does not agree. It is the opposite of science and thought.

It is like someone hanging a sign across a path reading ‘Danger!’. If there is no apparent danger then a normal person will investigate, looking around for threats, stepping gingerly to find anything unsound, and afterward deciding the sign was wrong. Progressives won’t cross. They congratulate themselves on having so adroitly saved themselves from being eaten by sharks, bitten by snakes, slashed to ribbons by rogue threshing machines, and fried to a crisp by intergalactic gamma radiation (or ‘Delta’ in this case). These progs despise the reckless ones who checked and who put everyone, including these very progs themselves, in danger even though they obeyed the sign.

It is why Warmies were able to insist the world should slit its own throat on a study based on seven trees in Yalta, Russia, but dismiss historical records across the planet and across centuries that showed the current warming trend is entirely consistent with an ongoing cycle.

And they will insist they are the smart, the nuanced, ones.

bemused
bemused
October 19, 2021 8:41 am

And they will insist they are the smart, the nuanced, ones.

Modern society has created less independent people and independently thinking people; they are much more prone to herd mentality. The media and the tech giants are pretty much to blame, as they are often the sole source of information that people access. The vast majority of people have become the ultimate ‘flat earthers’.

OldOzzie
OldOzzie
October 19, 2021 8:48 am

Now, let us continue.

Powell died on Monday at age 84 from complications related to COVID-19, said his family in a statement. While Powell was fully vaccinated, he also had multiple myeloma, a cancer that suppresses the body’s immune response, as noted by U.S. News & World Report.

Roger W
Roger W
October 19, 2021 9:42 am

“More robust, well-designed randomised controlled trials are needed to demonstrate whether or not ivermectin is effective. “

Are these the same robust, well-designed randomized controlled trials that they have insisted are not needed for the “vaccinations” being forced on people now – the “vaccines” that are only given provisional emergency approval because no other treatment is supposedly available – which treatment cannot be considered or given (and is in fact illegal in states like Queensland) because “more robust, well-designed randomized controlled trials” have not been started, let alone completed?

Alice in Wonderland is no longer fiction.

areff
areff
October 19, 2021 10:21 am

“Daily active smokers are infrequent among outpatients or hospitalized patients with COVID-19.”

Knew was doing myself some good.

Old bloke
Old bloke
October 19, 2021 11:19 am

The sad part of this story is that we could have rid ourselves of Covid-19 and the deaths and injuries from the “vaccines” in August last year. There has to be an accounting at some future time.

Australian develops effective Triple Therapy to treat COVID-19

There would have been no lockdowns, no curfews, no mask mandates, no forced injections, no economic damage, no societal divisions, no travel restrictions. Those in authority must pay for what they have done to us.

Rorschach
Rorschach
October 19, 2021 11:29 am

While Powell was fully vaccinated, he also had multiple myeloma, a cancer that suppresses the body’s immune response,

One of the persistent comments / questions on the vaXXines relates to the process where the RNA snippet enters the bodies own cells to change them and create the spike protein, [Which then stimulates the body’s immune response…]

The question then is: if someone is immunosuppressed why in hell would you be injecting that someone with something that the body can’t respond to? I just saw Dr Chant say something of the same?

Isn’t this illogical? Wouldn’t the response to the vaXXine overwhelm the immune system and be ineffective at best and at worst allow something else (bacterial etc) to do damage?

Miss Anthropist
Miss Anthropist
October 19, 2021 12:28 pm

So I can politely tell the rabid slavering moon eyed anti smokers that I am protecting myself from COVID.
Far more polite and nuanced from my normal response.

Simon
Simon
October 19, 2021 2:53 pm

This is on item I would want to appear in any Royal Commission on our handling of this pandemic.

The idea that the TGA and this NCCET are perfectly happy to promote new vaccines (authorised for emergency use with the manufacturer’s fully indemnified), and new oral medications released only this month by Pfizer, and still point blank refuse to consider IVM & HCQ treatments is not just weird – it’s downright criminal.

Oh come on
Oh come on
October 19, 2021 5:08 pm

The Oxford ivermectin RCT has been rigged to discredit ivermectin as an effective treatment – or, at the very least, heavily water down its efficacy. Trial participants are eligible to join up to 14 days after a positive Covid test. 14 days! Ivermectin is most effective as an early intervention treatment, according to the medical practitioners who are using it to treat patients with enormous success. What is the point of giving ivermectin to someone who has had a positive Covid diagnosis for 14 days, 10 days or even a week? It’s not going to do much for these people. We already know this.

If the overwhelming evidence of IVM’s effectiveness isn’t enough for you – the collapses in spread almost immediately after IVM began to be broadly dispensed, those isolated aged care facilities entirely untouched by Covid (because a resident had a case of scabies, causing all residents to be treated with IVM as a prophylaxis which is standard practice), whilst others surrounding them were ravaged by the virus – if evidence like this (and there is so much more) isn’t good enough for you and you still need your precious RCT…then at LEAST limit eligibility to participants that obtained a positive Covid result no more than three days’ prior. And data needs to be collected regarding when the participant first experienced symptoms.

Kneel
Kneel
October 21, 2021 1:50 pm

“And they will insist they are the smart, the nuanced, ones.”

As per Dan Bongino: they are stupid smart people.
Stupid stupid people know they are stupid and take care to get things right, seek advise and so on.
Smart smart people know their limitations and take care to get things right, because they know they don’t know everything.
Stupid smart people think they know the answer and never doubt the “conventional wisdom” as spouted by their favoured “expert”, refuse to acknowledge any contra-indications, and generally believe everything those they perceive have authority tell them to believe.

Stupid smart people are the biggest danger to all of us, and they are in positions of power right now throughout the entire “west” – have been for the last 20 years at least. And you seem surprised by the outcomes this creates.
Yes, they really are that dumb – they NEVER ask “And then what?”

“We should be the mine and farm of the world – it’s what we do best” – “And then what?”
“We should get rid of fossil fuels and use renewables” – “And then what?”
“We should let people decide for themselves what their gender is” – “And then what?”
“We can print money to pay for things” – “And then what?”
“We should all get vaxxed without any long term data on the vax” – “And then what?”

They never ask. And when you do, they don’t have an answer, so flounder around for a few seconds, then call you a “Science denier”, “Xenophobe”, “homophobe” or whatever.
Fine. If you want to believe that, you can. It hardly makes the question unreasonable to ask, does it? So why don’t you answer the question – I’ll even stipulate that I really am a xenophibic, transaphobic, homophobic, phobaphobe if you it’ll make you answer the question. But more likely, it’ll just make you think I’m not even worth talking to, and you won’t consider the question worthy of answering.

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