Bayesian Hypothesis Testing and Hierarchical Modeling of Ivermectin Effectiveness
et al., American Journal of Therapeutics, doi:10.1097/MJT.0000000000001450 (meta analysis)
, Bayesian Hypothesis Testing and Hierarchical Modeling of Ivermectin Effectiveness, American Journal of Therapeutics, doi:10.1097/MJT.0000000000001450 (meta analysis)
Updated Bayesian analysis of a subset of ivermectin trials showing that there is strong evidence to support a causal link between ivermectin and COVID-19 severity and mortality, and that the result is robust in sensitivity analysis, including exclusion of Elgazzar et al.Currently there are 95 ivermectin studies and meta analysis shows:
| Outcome | Improvement |
|---|---|
| Mortality | 51% lower [37‑62%] |
| Ventilation | 29% lower [13‑42%] |
| ICU admission | 41% lower [16‑58%] |
| Hospitalization | 34% lower [20‑45%] |
| Cases | 78% fewer [67‑85%] |
Neil et al., 2 Sep 2021, peer-reviewed, 2 authors.
Abstract: e576
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2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372. doi: 10.1136/bmj.n71.
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7. Scheim D, Hibberd JA, Chamie-Quintero J. Protocol violations in López-Medina et al.: 38 switched Ivermectin
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Bayesian Hypothesis Testing and Hierarchical Modeling of
Ivermectin Effectiveness
To the Editor:
A recent meta-analysis of the trials evaluating ivermectin that was published in AJT1 (referred to here as
Bryant) was widely welcomed by those who argue
that this antiparasitic drug is a cheap and effective
treatment for COVID-19 infections. The study
concluded:
“Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin.
Using ivermectin early in the clinical course may reduce
numbers progressing to severe disease. The apparent
safety and low cost suggest that ivermectin is likely to
have a significant impact on the severe acute respiratory
syndrome coronavirus 2 pandemic globally.”
These conclusions stand in stark contrast to those of
a later meta-analysis2 (referred to here as Roman) that
looked at a subset of the trials. Roman concluded:
“In comparison to standard of care or placebo, ivermectin
(IVM) did not reduce all-cause mortality, length of stay, or
viral clearance in randomized controlled trials in COVID19 patients with mostly mild disease. IVM did not have
effect on adverse events or severe adverse events. IVM is
not a viable option to treat COVID-19 patients.”
Irrespective of the errors in the data and the analysis
performed by Roman that were already highlighted by
American Journal of Therapeutics (2021) 28(5)
Crawford,3 we believe that this conclusion is not..
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