Letter to the Editor: A recent study shows ivermectin is not an effective COVID-19 treatment
Two recent articles clarify Bruce Menzel’s late April letter asserting that use of ivermectin in COVID-19 infections is foolhardy. In toxicology, any medicine can be a poison when used inappropriately, but is ivermectin really that dangerous? It is a generic affordable medication on the list of the World Health Organization’s essential medicines for its success in combatting parasitic infections in underdeveloped countries.
The first article in the Spring edition of Regulation, from the libertarian Cato Institute, emphasizes the incredible safety of ivermectin. It has been used for over four decades. It has been dosed over four billion times in humans. Plus, it has been found to attack single stranded RNA viruses like COVID-19 in lab experiments. Early in the pandemic when no vaccine or proven treatment was available, off label prescribing of proper doses of ivermectin seemed reasonable to many health care providers.
Not helping was the fact that many early studies of ivermectin were poorly designed and lacked statistical significance, meaning that a study’s conclusion is not due to chance alone. When many small, well done study results were pooled, use of ivermectin seemed promising but politicization of the issue quickly overwhelmed any rationale for its use.
Finally, in its May 5, 2022 edition, the trusted New England Journal of Medicine published a well-done, double blind study from Brazil that used strict criteria for enrollment and involved enough patients to reach statistical significance. The authors found that ivermectin use did not decrease hospital admissions or prolonged stays in the emergency department.
Medicine is notorious for its failure to replicate important studies but at this point in time, there is no support for use of ivermectin in COVID-19 unless it is in a controlled study environment. A combination of regulatory humility and better early studies might have given us this answer much sooner.
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