Wednesday, October 27

Fraudulent ivermectin studies open a new battlefield between science and misinformation | Health


Dr Carlos Chaccour had difficulties when he and his colleagues began recruiting patients in Peru for its study to determine the effect of a daily dose of the antiparasitic drug ivermectin in people infected with Covid-19.

“We would call the patient and say, ‘You have just been diagnosed with Covid and are eligible for this study. Are you taking ivermectin? ‘”, He says.

“And they would say, ‘Of course.’

The former Minister of Health of Peru and leader of the study, Patricia García, told nature: “Of about 10 people who come [to the hospital]I would say that eight have taken ivermectin and cannot participate in the study. “

Ivermectin has never been proven as an effective Covid treatment, and the studies that said it was have been poorly conducted, too small for their findings to apply more broadly, or totally falsified. However, the popularity of the drug has exploded.

One of the first fraudulent studies of ivermectin was revealed just a few months after the pandemic, before it was even widely used or promoted to treat the virus. That study found that ivermectin was improving and reducing mortality in hospitalized Covid-19 patients around the world. The article was eventually withdrawn by the medical journal that published it after it was discovered that the data had been falsified and that the patients did not exist.

But the damage is already done. Before the retraction, the Peruvian government included ivermectin in its national Covid-19 therapeutic guidelines, its advice informed in part by the article on ivermectin.

Other studies found Ivermectin does not have a significant impact on the viral load of Covid-19 patients., and that furthermore, larger studies are needed to properly assess any impact of ivermectin on Covid-19. Despite all this, the drug has taken off beyond Peru and is now being used around the world, promoted by politicians, celebrities, and even some doctors and scientists as a credible treatment for Covid-19.

Chaccour, who has been researching ivermectin for its ability to control tropical diseases for more than 15 years, says the hope and use of ivermectin is almost understandable when people die in waiting rooms and there is a lack of supply. of Covid-19 vaccines.

Countries with widely available vaccines, such as the UK, the US, and Australia, have also been hit by the ivermectin hype, with people trying to obtain the drug and even turning to formulations used to treat parasites in animals. . General practitioners, in some cases, gladly prescribe it. Influential politicians and controversial researchers frequently tweet studies claiming to support its use.

But more of those studies are proving problematic.

In July, Guardian Australia revealed that the results of a randomized control trial from Egypt had been withdrawn after serious ethical concerns were raised, along with questions about the data.

In September, Buzzfeed News reported that an influential study from Argentina Claiming that ivermectin prevented Covid-19 100% of the time contained suspicious data and was based on flawed methodology.

Questioning the investigation

In research, a control group is the group of study participants who do not receive the intervention, in this case ivermectin, and is an essential part of a reliable study. If most people are already taking the drug you want to test, you can’t do a proper clinical trial.

The control group and the experimental group should be similar in all other respects, such as gender division, age ranges, Covid severity, and overall health, to increase the likelihood that any effects observed in the group experimental is the result of the intervention.

These studies are known as randomized controlled trials (RCTs) and the strongest are also “double blind”: neither the researchers nor the participants know which patients are receiving the intervention or treatment with placebo, which is usually a sugar pill or, in vaccine trials, a saline solution.

Due to the strength of RCTs, they are critical in the fight against Covid-19. The more participants enrolled in an RCT, the stronger the findings and the more likely the findings will be ‘replicated’ in future studies and when the intervention is delivered to the general population. Governments and drug regulators rely heavily on the findings of RCTs to make recommendations on which drugs to approve.

On Thursday, the prestigious medical journal Nature Medicine published an article written by interested epidemiologists and researchers who questioned studies on ivermectin.

“Many hundreds of thousands of patients have been administered ivermectin, based on an evidence base that has substantially evaporated under close scrutiny,” the authors wrote.

“Several … studies claiming a clinical benefit for ivermectin are equally tense and contain impossible numbers in their results, inexplicable mismatches between trial registry updates and published patient demographics, assumed time frames that are not consistent with the veracity of the data collection and methodological weaknesses “.

Chris kenny
Chris Kenny of Sky News is among those who have promoted the use of ivermectin as a Covid-19 treatment, despite studies refuting the drug’s efficacy for this purpose.

Gideon Meyerowitz-Katz, an epidemiologist at the University of Wollongong in New South Wales and a co-author of the Nature Medicine paper, says that he and his colleagues examined more than a dozen studies that claim that ivermectin is beneficial either as a preventive or as a treatment for COVID-19.

“Of those studies, we have serious concerns about four that have been made public and several more that we are still investigating,” he says.

Some of the authors have been unable to share data from their research, which Meyerowitz-Katz says “is a very worrying sign at this time.”

“So far there has only been one retraction, but I suspect more will come,” he says.

Disinformation fuels conspiracy theories

When asked why researchers make so many mistakes or worse, deliberately mislead, misrepresent and falsify data, he says: “The real question is why none of the groups promoting ivermectin as a mass treatment for Covid-19 did their due. basic diligence, because much of the fraud is not that difficult to identify. “

Chaccour believes that pressure on academics plays a role.

“A lot of people are working entry-level and PhDs, putting in 120 hours a week for less than minimum wage,” he says. “The more you publish and the bigger the article, the more recognition the magazine that publishes it gets, the closer you are to a more stable lifestyle and professional recognition.”

In the case of ivermectin, the recognition comes from researchers who cite articles, pushing articles up in academic rankings, and giving prominence to journals or websites where they are published. But politicians, celebrities and journalists are also promoting the findings.

Nifty websites have emerged that post “treatment protocols” for ivermectin. Some even sell merchandise, including T-shirts with the slogan “Covid kills, ivermectin saves lives.”

Chaccour says he has watched in despair as journalists began to attribute a reduction in Covid-19 in Peru to ivermectin rather than the strict lockdown measures that were introduced before disease rates fell. This misinformation was helping fuel conspiracy theories that the medical establishment was deliberately hiding ivermectin because the drug has been around for decades, is cheap to produce, and therefore not profitable.

In fact, says Chaccour, the chemical companies that make the ingredients for ivermectin have seen their profits skyrocket. Meyerowitz-Katz says that even though ivermectin is off-patent, meaning rival drug companies can produce cheap generic versions of the drug, the Share prices of two companies that make patented ivermectin products have skyrocketed.

Chaccour makes it clear that he doesn’t think these companies are behind the ivermectin push, but says it’s wrong for those promoting ivermectin to say the drug is being downplayed because it wasn’t as profitable as the new proprietary drugs.

“I think for those who promote ivermectin, there is a level of ignorance and lack of education … there is a level of mistrust in government and mistrust in science, and there is a level of ‘I do my own research’ and pride that comes with that. ,” he says.

In Australia, the National Covid-19 Clinical Evidence Working Group develops Covid-19 recommendations for clinicians based on the most recent and robust available evidence. The group does not recommend the use of ivermectin outside of randomized controlled trials and does the methodology behind your public recommendations.

Despite this, the chair of the task force, Associate Professor Tari Turner, says that she and other members of the task force are frequently approached and criticized for not supporting the findings of certain ivermectin studies in their recommendations.

Turner said she wasn’t sure why, despite all the big-name organizations explaining the lack of evidence for ivermectin in treating Covid-19, people still saw it as a wonder drug.

“The task force’s job is to find evidence that allows us to determine the effectiveness of ivermectin and other treatments,” she says. “While it seems to me that many of the proponents of ivermectin, and hydroxychloroquine previously, are only looking for evidence to show that it is effective.”




www.theguardian.com

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