Another bogus analysis of ivermectin with a shady background, coming from Peru and from US pharma consultants

While it is very hard to create a study showing that a  successful drug does not work, it can be done, with the right people and funding. This appears to have happened in a paper published June 28 by a group of latin american and US authors.

Ivermectin studies were cherrypicked to yield a poor outcome.  This is no easy task, since virtually all of the 60 studies in existence show positive benefits.

Here is the new study that was designed to sink ivermectin treatment of Covid. It was published by Oxford University Press, for the IDSA (the organization that has covered up chronic Lyme disease for over 30 years):

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab591/6310839

Among the authors are people who you would not expect to be studying ivermectin.

The authors include an employee of Cello Health, the Centro de Investigación, Instituto Peruano de Oncología y Radioterapia (IPOR), and the Unidad de revisiones sistemáticas y meta-análisis, guías de práctica clínica y evaluaciones de tecnologías sanitarias (URSIGET).  The last 2 are in Peru.

Cello Health is a high end consulting company, mostly to Pharma.  It claims to work with 24 of the top 25 pharma companies in the world.  Its website brags about "Competitor Planning and Response." One of its consulting jobs is "supporting the Scottish Government in the creation of a series of compelling public health campaigns to drive social distancing and self-isolation..."  

IPOR is a cancer treatment center in Lima, Peru.  Its long list of partners includes the NIH and many large pharmaceutical companies.  When you open the website you see a pop-up offering vaccinations. 

URSIGET, as best I can tell, is a Peruvian organization designed to help train scientists how to write papers and get research grants.

All 3 of these organizations have a focus on consulting and making money.  The authors are not academics.  Yet the paper claims:

Funding: No funding was received for this study. 

Acknowledgment: None. 

Conflict of Interest: The authors declare that there is no conflict of interest.

Do you believe it?  I don't. This looks like another form of paid hit job, grossly similar to the Colombian paper dissing ivermectin I wrote about 4 months ago. It was probably farmed out to a foreign country to make its financial trail harder to identify.

It has been criticized by Tess Lawrie and Pierre Kory's groups.  Here is a compilation of 60 ivermectin studies so you can compare the overall results with those of this paper.  

Here is a June 17 meticulous meta-analysis of ivermectin studies for Covid by the UK BIRD group. And here is their criticism of the Roman paper.

Here is the Roman/Peruvian paper's abstract:

Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials 

Yuani M Roman, MD, MPH, Paula Alejandra Burela, BSc, Vinay Pasupuleti, MD, PhD, Alejandro Piscoya, MD, Jose E Vidal, MD, PhD, Adrian V Hernandez, MD, PhD

Clinical Infectious Diseases, ciab591, https://doi.org/10.1093/cid/ciab591

Published:

 

28 June 2021

 Article history

Abstract

Background

We systematically assessed benefits and harms of the use of ivermectin (IVM) in COVID-19 patients.

Methods

Published and preprint randomized controlled trials (RCTs) assessing IVM effects on COVID-19 adult patients were searched until March 22, 2021 in five engines. Primary outcomes were all-cause mortality, length of stay (LOS), and adverse events (AE). Secondary outcomes included viral clearance and severe AEs. Risk of bias (RoB) was evaluated using Cochrane RoB 2·0 tool. Inverse variance random effect meta-analyses were performed. with quality of evidence (QoE) evaluated using GRADE methodology.

Results

Ten RCTs (n=1173) were included. Controls were standard of care [SOC] in five RCTs and placebo in five RCTs. COVID-19 disease severity was mild in 8 RCTs, moderate in one RCT, and mild and moderate in one RCT. IVM did not reduce all-cause mortality vs. controls (RR 0.37, 95%CI 0.12 to 1.13, very low QoE) or LOS vs. controls (MD 0.72 days, 95%CI −0.86 to 2.29, very low QoE). AEs, severe AE and viral clearance were similar between IVM and controls (all outcomes: low QoE). Subgroups by severity of COVID-19 or RoB were mostly consistent with main analyses; all-cause mortality in three RCTs at high RoB was reduced with IVM.

Conclusions

In comparison to SOC or placebo, IVM did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease. IVM did not have an effect on AEs or severe AEs. IVM is not a viable option to treat COVID-19 patients.