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All Studies   Meta Analysis   Recent: 
Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials
Roman et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab591 (date from earlier preprint) (meta analysis)
28 Jun 2021    Source   PDF   Share   Tweet
This is a severely flawed meta analysis. An open letter signed by 40 physicians detailing errors and flaws, and requesting retraction, can be found at [trialsitenews.com]. See also [bird-group.org].
Authors cherry-pick to include only 4 studies reporting non-zero mortality and they initially claimed a mortality RR of 1.11 [0.16-7.65]. However, they reported incorrect values for Niaee et al., claiming an RR of 6.51 [2.18-19.45], when the correct RR for Niaee et al. is 0.18 [0.06-0.55]. After correction, their cherry-picked studies show >60% mortality reduction, however authors did not correct the conclusion.
Similarly, for viral clearance and NCT04392713 (history), they report 20/41 treatment, 18/45 control, whereas the correct day 7 clearance numbers are 37/41 and 20/45 (sum of clearance @72hrs and @7 days), or 17/41 and 2/45 @72 hrs.
The duration of hospital stay for Niaee et al. is also incorrectly reported, showing a lower duration for the control group.
All of the errors are in one direction - incorrectly reporting lower than actual efficacy for ivermectin. Authors claim to include all RCTs excluding prophylaxis, however they only include 10 of the 24 non-prophylaxis RCTs (28 including prophylaxis at the time of publication). Authors actually reference meta analyses that do include the missing RCTs, so they should be aware of the missing RCTs.
The PubMed search strategy provided is syntactically incorrect. For additional errors, see [pubpeer.com]. Also see [roundingtheearth.substack.com].
The authors state that they have no conflicts of interest on medRxiv, however Dr. Pasupuleti’s affiliation is Cello Health, whose website [cellohealth.com] notes that they provide services such as “brand and portfolio commercial strategy for biotech and pharma”, and that their clients are "24 of the top 25 pharmaceutical companies”.
Only one of these errors has been partially fixed as of 5/29 - the Niaee RR was corrected, but the associated conclusion was not. Other errors have not been corrected. Comments on this article appear to be censored, with zero comments posted as of July 5.
Currently there are 93 ivermectin studies and meta analysis shows:
OutcomeImprovement
Mortality51% lower [37‑62%]
Ventilation29% lower [13‑42%]
ICU admission42% lower [18‑59%]
Hospitalization34% lower [20‑45%]
Cases78% fewer [67‑86%]
Roman et al., 28 Jun 2021, peer-reviewed, 6 authors.
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