Peter G. Lurie writes:

In striking testimony before the U.S. Senate Homeland Security and Governmental Affairs Committee in December 2020, Pierre Kory, a critical care physician who formerly worked for the University of Wisconsin Health University Hospital, described the “immense potency” of ivermectin, characterizing it as effectively a “miracle drug.” “All studies are positive,” he testified, “with considerable magnitude benefits, with the vast majority reaching strong statistical significance.”

Unfortunately, and not for the first time in the Covid-19 pandemic, the hype exceeded the evidence.

The gold standard in drug development is the randomized controlled trial. These maximize the chance that the group receiving a treatment and the control group not receiving it are alike in all other respects. But even such trials must be properly conducted with adequate sample sizes, investigators and participants blinded to who is getting what, and rigorous data collection and analysis. But Kory cited several non-randomized observational studies, in which patients can receive non-standardized treatments, as well as many poor-quality controlled trials.

One of these was a trial by Ahmed Elgazzar from Benha University in Egypt. In this trial of patients with severe Covid-19, one group received ivermectin while the other, the control group, received hydroxychloroquine (people in this group should have received a placebo). According to the researchers, there was a 90% reduction in deaths in the ivermectin group, a degree of effectiveness strikingly at odds with most other studies of ivermectin and considerably better than even FDA-approved therapies for Covid-19.

A British medical student, Jack Lawrence, was assigned to evaluate the Elgazzar paper for a course and encountered a potpourri of apparent plagiarism and data fabrication. The Elgazzar paper had not been formally published in a medical journal, but had appeared instead on a preprint website called Research Square. Upon learning of Lawrence’s analysis, Research Square promptly retracted the paper.

Gideon Meyerowitz-Katz, an Australian chronic disease epidemiologist who also reviewed the Elgazzar data, found faults similar to Lawrence. Researchers often summarize large bodies of literature by statistically synthesizing trials in what are called meta-analyses. “If you remove this one study from the scientific literature,” he told The Guardian “most meta-analyses that have found positive results would have their conclusions entirely reversed.” [Continue reading…]

Time reports:

Mike says he was struggling with COVID-19 when he felt his breathing getting worse. He did not want to go to the Veterans Affairs hospital near his home, where he believed doctors might put him on a ventilator. And he knew they would not prescribe the treatment he really wanted: a drug called ivermectin.

So in late July, Mike, who says he is a 48-year-old teacher and disabled veteran from New York state, contacted America’s Frontline Doctors (AFLD), a group he had been following on social media. AFLD has been a leading promoter of ivermectin, a medication typically used to treat parasitic worms in livestock, as a “safe and effective treatment” for COVID-19. Through its website, Mike says, he paid the group $90 for a telemedicine appointment with a doctor willing to prescribe the drug.

A week later, he was still anxiously waiting for the consultation. Calls and emails to AFLD went unreturned, he says. Finally, he called his bank to report a fraudulent charge. “Not even an apology,” Mike, whom TIME is referring to using a pseudonym because of his concerns about his job, told TIME in an interview. “This is absolutely nuts. This organization is not helping anyone but their pocketbooks.”

Similar stories have flooded anti-vaccine forums and messaging apps in recent weeks as some customers and donors raise doubts about AFLD. The group describes itself as a “non-partisan” group of medical professionals. But it originated as a right-wing political organization, and since its founding has consistently spread medical misinformation. Its name implies the group consists of physicians on the frontlines of the pandemic, but it’s not clear how many of its members have spent any time treating patients with COVID-19. [Continue reading…]