Talk:Ivermectin

Treatments for COVID-19: Current consensus

A note on WP:MEDRS: Per this Wikipedia policy, we must rely on the highest quality secondary sources and the recommendations of professional organizations and government bodies when determining the scientific consensus about medical treatments.

1. Ivermectin: The highest quality sources (1 2 3 4) suggest Ivermectin is not an effective treatment for COVID-19. In all likelihood, ivermectin does not reduce all-cause mortality (moderate certainty) or improve quality of life (high certainty) when used to treat COVID-19 in the outpatient setting (4). Recommendations from relevant organizations can be summarized as: Evidence of efficacy for ivermectin is inconclusive. It should not be used outside of clinical trials. (May 2021, June 2021, June 2021, July 2021, July 2021) (WHO, FDA, IDSA, ASHP, CDC, NIH)
2. Chloroquine & hydroxychloroquine: The highest quality sources (1 2 3 4) demonstrate that neither is effective for treating COVID-19. These analyses accounted for use both alone and in combination with azithromycin. Some data suggest their usage may worsen outcomes. Recommendations from relevant organizations can be summarized: Neither hydroxychloroquine nor chloroquine should be used, either alone or in combination with azithromycin, in inpatient or outpatient settings. (July 2020, Aug 2020, Sep 2020, May 2021) (WHO, FDA, IDSA, ASHP, NIH)
3. Ivmmeta.com, c19ivermectin.com, c19hcq.com, hcqmeta.com, trialsitenews.com, etc: These sites are not reliable. The authors are pseudonymous. The findings have not been subject to peer review. We must rely on expert opinion, which describes these sites as unreliable. From published criticisms (1 2 3 4 5), it is clear that these analyses violate basic methodological norms which are known to cause spurious or false conclusions. These analyses include studies which have very small sample sizes, widely different dosages of treatment, open-label designs, different incompatible outcome measures, poor-quality control groups, and ad-hoc un-published trials which themselves did not undergo peer-review. (Dec 2020, Jan 2021, Feb 2021)

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Last updated (diff) on 27 February 2023 by Sumanuil (t · c)

Misinformation

"During the COVID-19 pandemic, misinformation has been widely spread claiming that ivermectin is beneficial for treating and preventing COVID-19.[18][19] Such claims are not backed by credible scientific evidence.[20][21]

Not true. There's over 40 credible scientific papers by top research scientists stating it is beneficial, including a Monash University study revealing Ivermectin kills COVID within 48 hrs, paper snippet here and National Library of Medicine here which indicates a five day treatment is effective. The media is lying and trying to make Ivermectin look like a controversial medicine when it is even on the WHO list of essential medicines and is considered safe for human use. † Encyclopædius 08:06, 7 September 2021 (UTC)

That is a lot of ifs buts and maybes. When you have a source that says it is beneficial we can change the wording.Slatersteven (talk) 12:07, 7 September 2021 (UTC)

What about this article from the American Journal of Therapeutics? It is a reputable, peer-reviewed journal. (Justus R. Hope mentioned this same article, but it was subsequently removed from this Wikipedia page.) Sdekk (talk) 18:32, 20 September 2021 (UTC)

Buts and maybes? How do you get "a lot of buts and maybes" from the citation of multiple scientific papers demonstrating the claim that the conclusion of those studies is "not backed by credible scientific evidence"? This makes absolutely no sense. — Preceding unsigned comment added by 2601:280:c081:9220:f570:6e02:44a7:32e4 (talk) 22:38, 19 October 2021 (UTC)

You can check https://osf.io/preprints/socarxiv/r93g4/ and https://osf.io/9egh4 among others for scientific published evidence of the EFFECTIVENESS of Ivermectin against covid19. The statement is not true.

Due to the wave of reporting that ivermectin is only used to treat heart worms in horses, often from sources or in the same articles correctly identifying that ivermectin is not approved for covid treatment, I think this section should have it noted that it is erroneous that ivermectin is not suitable for any human application. — Preceding unsigned comment added by 75.164.76.179 (talk) 14:14, 12 September 2021 (UTC)

We require higher quality sources for medical claims on wikipedia. These preprints do not apply. — Shibbolethink ^{(♔ ♕)} 14:20, 12 September 2021 (UTC)

I have a question about this: does the article in the American Journal of Therapeutics not comply with the criteria of "Higher Quality Resources for medical claims"? The article appears to be a peer reviewed secondary source within the Wikipedia definition of secondary sources. It appears to be a review article and meta analysis of peer reviewed primary sources. Please can somebody explain. Robscovell (talk) 01:47, 4 October 2021 (UTC)

See WP:REDFLAG and past discussion on this topic in the archives. Firefangledfeathers (talk) 02:08, 4 October 2021 (UTC)

I think it would be educational to explain why the article in the American Journal of Therapeutics meets the "Red Flag" criteria listed in WP:REDFLAG. On the face of it it appears to be a valid meta-analysis in a reputable peer-reviewed medical journal. I have reviewed the past discussion on the topic in the archives and I haven't found a detailed critique of the article yet. It would help me, and others, if there could be a detailed explanation of the inadequacy of the article.Robscovell (talk) 00:32, 10 October 2021 (UTC)

The specific REDFLAG criterion for me is "Claims that are contradicted by the prevailing view within the relevant community or that would significantly alter mainstream assumptions—especially in science, medicine, history, politics, and biographies of living and recently dead people. This is especially true when proponents say there is a conspiracy to silence them." Firefangledfeathers (talk) 00:41, 10 October 2021 (UTC)

I still think it would be highly instructive, from a science education point of view, to provide a critique of the article in the American Journal of Therapeutics by members of the relevant community (who are they?) and in the context of mainstream assumptions (what are the relevant assumptions?). That would help reader to understand the AMA's decision and would also help provide clarity as to the dangers of Ivermectin. Of course, there is a meta-question here: who decides what is the 'relevant community' and what the 'mainstream assumptions' are? Robscovell (talk) 01:19, 10 October 2021 (UTC)

WP:REDFLAG applies to claims, not (merely) to sources. If one article in a minor journal makes claims which contradict what every major medical organization is saying, and has been criticized for its undisclosed conflicts of interest by reliable sources, then it's safe to say it is suspect and does not reflect accepted knowledge. As to "who decides", Wikipedia operates according to consensus, as rooted in the WP:PAGs. As it's turned out, Wikipedia has been entirely right to take this stance as the pro-ivermectin/COVID research has all turned out to be dodgy and the ivermectin boosters, quacks. Alexbrn (talk) 01:28, 10 October 2021 (UTC)

In that case, this leads naturally to questions about whether or not Wikipedia's approach is valid or not, which is obviously a much broader topic beyond the limit of this discussion, so I won't pursue it here. It is true that the consensus opinion of major medical organisations is that pro-Ivermectin/COVID research is flawed, so I will leave it there, because that is the highest claim that Wikipedia is constitutionally able to make. Robscovell (talk) 03:21, 10 October 2021 (UTC)

The research fraud and quackery is just the reality (something the pro-ivermectin crank-o-sphere has trouble with) and Wikipedia likes to contextualize WP:FRINGE views properly: historically WP:QUACKS have disliked this but, as an encyclopedia, Wikipedia is only meant to offer a handy summary of accepted knowledge as published in high-quality sources. Alexbrn (talk) 03:33, 10 October 2021 (UTC)

• Justus Wilby Dunn wishes to comment on Desert Tosh being deleted in five minutes – what took you so long? Haven't managed to find mention in the archives, but he's been at it again, in case you didn't notice. Hat tip to Sjoerd Verweij at Ars, with some pointed comments. . . dave souza, talk 20:02, 15 October 2021 (UTC)

Missing anti-viral properties as primary description. Ivermectin has known anti-viral properties as well as anti-parasitic properties. Failing to mention it's anti-viral properties in the first paragraph is noteworthy, and is obviously due to the controversy about it's efficacy with the coronavirus that causes COVID-19. Regardless of whether this article cites the potential of Ivermectin to treat COVID, the anti-viral properties of Ivermectin are well-established and obvious, as the vast majority of the citations in this article testify to. The first sentence should read "Ivermectin is a medication used to treat parasitic and viral infections". To do otherwise violates Nuetrality. — Preceding unsigned comment added by 2601:280:C081:9220:F570:6E02:44A7:32E4 (talk) 22:35, 19 October 2021 (UTC)

@AlexBrn reverted my edit to the Ivermectin article which provided three references, available from NIH, on the ability of Ivermectin to bind to the COVID-19 spike protein, indicating that it may be useful for treatment of the disease. Clinical trials are ongoing, and it is certainly not yet approved by the various agencies, but I think this information is useful. I think peer-reviewed articles from respectable journals, available at the National Institute of Health website do not qualify as "unreliable/misinformation". Here are the articles: Please let me know if this changes your opinion. PAR (talk) 20:47, 11 November 2021 (UTC)

It's actually more an issue of WP:MEDPRIMARY and WP:MEDASSESS. What you are making is a medical claim: "it may be useful for treatment of the disease." But what you have brought are not WP:MEDRS sources. They are A) primary sources (not secondary narrative review articles), B) from pretty low impact and not well regarded journals, and C) extremely low on the totem pole of evidence around here. This is also an example of WP:OR given that these are primary sources, we would need high quality secondary sources to say this even if it wasn't a medical claim. The fact that it's a medical claim raises the bar even higher. — Shibbolethink ^{(♔ ♕)} 03:56, 12 November 2021 (UTC)

Is ivermectin diverse?

A few weeks ago I inserted an edit that said: It is considered a very diverse biopharmaceutical product.. Another editor reverted it with this summary: undue without explaining this is an oldish piece by Ivermectin's inventor, in the context of a parasitology journal which is not reliable for exceptional claims of general use. During a quick review of the literature I have found a few different and significant mentions of ivermectin being "diverse". For instance, some sources say that it is "broad spectrum", "versatile", or "an old drug with new tricks".

I propose we discuss here the precise meaning of this diversity. Is it:

1. Diverse among antiparasitic medications (i.e. it combats a more-diverse than usual range of parasitic diseases)
2. Diverse because it is both an antiparasitic and a drug "studied as a potential antiviral agent against chikungunya"
3. Diverse because it has a tradition of off-label prescriptions by physicians to treat not only parasites, but a diverse range of diseases

There is a danger in numerals 2 and 3 above. They can imply that it is normalized to consider ivermectin for treatment of diseases other than parasites. This implication can open the door for POV and fringy views that ivermectin is effective as a prophylactic for COVID-19. So, although the diversity deserves a mention, wording has to be extra careful here to keep things NPOV. Forich (talk) 03:39, 18 October 2021 (UTC)

Or does "diverse" mean it is used for lots of different animals? Or that it can be a oral medication, a sheep dip, or an ointment? Having "It is considered a very diverse biopharmaceutical product" was not good. Alexbrn (talk) 04:30, 18 October 2021 (UTC)

I requested help from the guys at Wikiproject Pharmacology, this is too technical for me. I suspect that it being used in lots of different animals is not the connotative meaning, though. Forich (talk) 04:41, 18 October 2021 (UTC)

Here is another synonym used: "multifaceted". It is so notable that they use it in the title.Forich (talk) 04:44, 18 October 2021 (UTC)

That is drivel. It's about as meaningful as saying the drug is "enigmatic". Alexbrn (talk) 04:50, 18 October 2021 (UTC)

Yeah... Wikipedia is written for the lay public, and any use of language which is technically correct but confusing is misunderstanding the purpose here. This sentence adds very little to popular understanding of the drug. — Shibbolethink ^{(♔ ♕)} 09:33, 18 October 2021 (UTC)

Let's go with the best MEDRS out there for a second. If we follow Heidari and Gharebaghi (2020), their first description of ivermectin in the introduction, which is the most appropiate place to find an NPOV summary of the drug, reads: Ivermectin has been used for several years to treat many infectious diseases in mammals.. (By the way, the section that opens the introduction is titled: "Ivermectin: a multifaceted medication" keep that in mind for my point below). This description is very different from the current one we are using, which says Ivermectin is a medication used to treat parasite infestations..

To make my case clearer, let me use an analogy. Suppose we were dicussing the description in the lead for Mark Allen (triathlete). The fact that Allen is a thriatlete, that is, an athlete that competes in many diverse sports is the equivalent of the multifaceted property of ivermectin that I am trying to include as an edit. Our current entry in Ivermectin omits this fact, which is the equivalent of saying of Mark Allen: "Mark Allen is a swimmer." coupled with information in the body of the article saying that he also does biking and running.

The analogy is not perfect, because in our current political climate it is risky to say that ivermectin is multifaceted. However, we can repeat Heidari and Gharebhaghi (2020) wording, because the "many diseases" implies multifacets, and the mammals implies (humans, livestock, horses, dogs, and many other animals), (CNN just misinformed saying that it is a horse dewormer, an error we should not repeat).

So, to sum up my recommendation: i) Open with the same wording as in the best MEDRS we have Ivermectin has been used to treat many infectious diseases in mammals. and ii) Inmediately make the distinction between FDA approved uses in humans (this part is not multifaceted) vs the medication's "properties", which pertain to inhibiting diseases in vitro, and include:

1. anti-parasitic
2. anti-viral (in vitro)
3. inhibiting the proliferation of cancer cells (in vitro)
4. regulating glucose and cholesterol in animals (in vitro and in vivo)

I disagree with Shibbolethink and Alexbrn's position to continue omiting the multifaceting property. Alex says it is nonsense (wrong, as proved by the MEDRS I showed) and Shibbolethink says it is too confusing for a lay reader. Perhaps after reading this longer explanation my point of introducing implicitly the multifaceted property by opening with "many diseases"+ inmediate distinction of FDA-approved uses and experimental properties may change your mind. Please comment, the article state is not optimal, as if would be the case if the entry on Mark Allen said that he was a swimmer instead of a thriatlete, in my opinion. Forich (talk) 03:02, 19 October 2021 (UTC)

The "MEDRS" also says ivermectin is "enigmatic". Scientists do write some crap sometimes. What you seem to want to do is cherry-pick the most imprecise and meaningless wording out of sources to water-down the meaningful knowledge that we precisely convey already, while also introducing a misleading slant about ivermectin somehow being a "drug" for cancer and so on. Writing a Wikipedia article means understanding and summarizing sources, not creating a collage of words from them. Alexbrn (talk) 03:44, 19 October 2021 (UTC)

To take your analogy to its logical extent... Mark Allen would only be a triathlete if he competed professionally with sponsorships in all 3 sports. Not if he competed professionally only as a runner, and then did some practice small-town bike and swim races on his off-weekends. Ivermectin is not approved or used widely in any evidence-based sense to treat these other things. So for our purposes, it's mainly an anti-parasitic, and then some people think it might be useful for other stuff, despite mostly negative clinical evidence.

It's still confusing and unnecessarily detailed for the purposes of this article. There's a reason we don't often go into the minutiae of in vitro vs in vivo uses, and it's because it runs afoul of WP:MEDRS sourcing for what counts as a "treatment." If anti-parasitic is the only indication for which it is actually clinically used in any meaningful evidence-based sense per our sources, then the most accurate and policy-compliant interpretation of "treatment of many diseases" is "treatment of many different parasites." See WP:MEDANIMAL and weigh the overall clinical evidence for the drug in these contexts vs this one review. It just isn't there, and we accurately describe the level of evidence already.

BTW, ivermectin really is a medication used to treat worms in horses.

Including: Red flukes (small strongyles) [1][2], Hairworms [3], Blood flukes (large strongyles) [4], Botworms/Botflies [5]. Intestinal Roundworms (Ascarids) [6], Intestinal threadworms [7], Pinworms (Oxyuris) [8], Lungworms (Dictyocaulus) [9], and Stomach worms (Habronema) [10].

It is literally a dewormer used in horses. That is not misinformation in any sense of the word. — Shibbolethink ^{(♔ ♕)} 03:58, 19 October 2021 (UTC)

@Alexbrn:, you said What you seem to want to do is cherry-pick the most imprecise and meaningless wording out of sources. To be clear and transparent, if one uses as a google-scholar-search-strategy the terms "allintitle: ivermectin review" and pick the first three results that come up, which the algorithm tends to show the one with most cites, we get these results:

1. Navarro et al (2020), describe ivermectin as: Anthelmintics available through drug donations are being used according to manufacturer recommendations and a large body of experience and knowledge has been gained through their use in millions of individuals. Ivermectin is probably the most remarkable anthelmintic drug owing to its impact on onchocerciasis and LF, with an efficacy and safety that have made it the most relevant tool for the control of those diseases..
2. Gonzalez et al (2008), use this wording on their first description of ivermectin in the introduction: Ivermectin is a semisynthetic derivative of avermectin B1 and consists of an 80:20 mixture of the equipotent homologous dehydro B1a and B1b. This antiparasitic agent, developed by Merck & Co., is frequently used in veterinary medicine, due to its broad spectrum of activity, high efficacy and wide margin of safety.
3. Heidari and Gharebhaghi (2020), describe ivermectin as: Ivermectin has been used for several years to treat many infectious diseases in mammals. It has a good safety profile with low adverse effects when orally prescribed. Ivermectin was identified in late 1970s and first approved for animal use in 1981. Its potential use in humans was confirmed a few years later. Subsequently, William C. Campbell and Satoshi Ōmura who discovered and developed this medication received the 2015 Nobel Prize in Physiology or Medicine. Studies revealed that ivermectin as a broad-spectrum drug with high lipid solubility possesses numerous effects on parasites, nematodes, arthropods, flavivirus, mycobacteria, and mammals through a variety of mechanisms. In addition to having antiparasitic and antiviral effects, this drug also causes immunomodulation in the host. Studies have shown its effect on inhibiting the proliferation of cancer cells, as well as regulating glucose and cholesterol in animals. Despite diverse effects of this medication, many of its underlying mechanisms are not yet known. Of note, some of these effects may be secondary to toxic effects on cells.

I purposefully quoted whole paragraphs from these papers to avoid the accusation of cherry-picking, so please aknowledge that I'm putting the effort to avoid selective editing. Let's keep this discussion productive. Forich (talk) 05:14, 19 October 2021 (UTC)

@Shibbolethink:, you said So for our purposes, it's mainly an anti-parasitic. Are you aware that our wording does not include the word "mainly"? I can compromise to including it, seems a fair description. Forich (talk) 05:17, 19 October 2021 (UTC)

To be honest I don't understand what you're doing, but it seems you somehow think the connotations of general words override specific meanings in texts. Is there a language problem maybe - are you a native English speaker? Alexbrn (talk) 05:20, 19 October 2021 (UTC)

@Alexbrn:, you said it seems you somehow think the connotations of general words override specific meanings in texts. I made this proposed wording for the lead: "Ivermectin has been used to treat many infectious diseases in mammals." I apologize if it wasn't clear that this is what I am recommending to include in the article. If you think I am pushing for a general word (I did mention "multifaceted", but not in the proposed text), let me make clear that I understand that including the word "multifaceted" or a similar term in the lead is too general and imprecise and, for that reason, it was not in my proposed text. So to answer directly your comment, I do not think that the connotation of general words should override specific meaning in texts, as my proposal to use the specific meaning "Ivermectin has been used to treat many infectious diseases in mammals." shows. My wording says many infectious diseases, the current text says "parasite infestations" so in this instance mine is more precise. My text says "in mammals" whereas the current words do not specify subjects of treatment, which to me seems like my proposal is more precise. I am not an english native speaker, perhaps that is influencing your perception of me being unclear. You do seem to speak english very well but I don´t mind collaborating with you even if you are not a native speaker. If that becomes a problem I can always ask a native speaker to proof-read my texts, just let me know. Forich (talk) 05:43, 19 October 2021 (UTC)

I suspected from your approach to language you might not be a native English speaker. Saying in the lede that ivermectin "has been used to treat many infectious diseases" would be misleading, ironically for exactly the same reason that calling ivermectin simply a "horse dewormer" would be. Such statements omit necessary precision and offer a technically correct but vague general statement that implies false things. Ivermectin can apparently be used to de-worm (some) reptiles, as well as mammals. Alexbrn (talk) 05:59, 19 October 2021 (UTC)

@Shibbolethink:, this also deserves quick response: Ivermectin is not approved or used widely in any evidence-based sense to treat these other things. Can you comment what part of my interventions led you to think that I want to edit the article to conform to Ivermectin being approved or used widely in other things than parasites? My request to have a secondary sentence following the opening description in which we make an explicit distinction between the FDA approved uses and the other properties seems to fail to make across the point that I understand the distinction exists and should be clear. I believe this back and forth is revealing where is our main point of miscommunication, please bear with me and you'll see where I'm going, we are getting closer I think. Forich (talk) 06:05, 19 October 2021 (UTC)

I feel an overall lesson of this discussion is that the three of us value the FDA approved uses to come across as the most important message to convey in Wikipedia. I would go as far to say that I do not mind to comply to a wikipolicy that enforces us to use in the first sentence of a drug entry exclusively the FDA approved uses of the drug in the United States. But we should be honest and admit that is the goal guiding us. If I get some time I will look at the articles for other drugs with notable off-label prescriptions to see what do their lead sections look like, maybe it is a de facto pattern to include the FDA-approved uses as the main descriptor and I have missed it. Forich (talk) 06:15, 19 October 2021 (UTC)

No, I think any text which says “many infectious diseases” or “many uses” or “diverse uses” is unnecessarily vague and imprecise. For our purposes, the most important thing is that we do not reference its unapproved uses in the same breath as its approved ones. Ever. That’s how we create a false equivalence. Even if we explain it immediately after, it still makes the article worse by unnecessary generalization. I have no interest in changing the current wording to one that changes “anti parasitic” or “treat parasitic diseases” to something that is not parasite specific. The difference in depth of use and context between A) its actual efficacious uses in veterinary medicine and human allopathic medicine versus B) its off label uses and infant research ideas means we should not use generalizing language to refer to both together… — Shibbolethink ^{(♔ ♕)} 10:02, 19 October 2021 (UTC)

Further, the review sources support this. All 3 of those sources you cited put its parasitic uses first. One, the last one, uses vague language which is the result of writing a review about its in vitro data as well. Unlike us, this review is for content experts, so they can get away with this sleight of hand. We cannot. — Shibbolethink ^{(♔ ♕)} 10:05, 19 October 2021 (UTC)

I can see where you are coming from. I'll think about it more through. Two of the three top MEDRS indeed prioritize the anti parasitic use in their decription. I disagree in discarding the 3rd MEDRS which doesn't, as you do, but I am not willing to die on a hill of expanding the MEDRS to top 5 or top 10 and counting how many of them use a broader-than-anti-parasitic description. Forich (talk) 21:30, 27 October 2021 (UTC)

Sources redux

Take a look at the 4 links posted as "proof against ivmmeta.com", they are complete jokes. Vice news interviewing some unqualified idiot? No, the way science works is by using meta analysis/scientific reviews not opinion pieces, which there are many of ivermectin's dozens of trials, and they almost all show it is highly effective. The stupidity in suggesting that the scientific review of ivermectin is "flawed" and then linking a garbage vice article as proof of "consensus" just shows that the editors here are nowhere near following wikipedia's own policy. Only one single study has been widely criticized by El Gazzar, which in the context of a meta analysis doesn't remotely matter as the results are the same. There are 60+ other trials that still make the prophylactic, early and late treatment effect signal clearly effective against covid 19. From the early in vitro study which showed a 5000 fold reduction in covid 19 within 48 hours, to the dozens of trials, many peer reviewed and published, many double blind rcts, to the population wide studies to the thousands of testimonies of people on deaths door suddenly making a full turnaround, ivermectin is unequivocally proven and anyone saying otherwise is either: a) stupid or b) paid to lie. Reading some random shill who has no credentials vs hundreds of studies from people with zero potential for conflict of interest, gee which is more likely to be true?

Collapse list of weak sources

Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study https://pubmed.ncbi.nlm.nih.gov/33592050/ Effects of Ivermectin in Patients With COVID-19: A Multicenter, Double-Blind, Randomized, Controlled Clinical Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101859/ https://naturalselections.substack.com/p/on-driving-sars-cov2-extinct Favorable outcome on viral load and culture viability using Ivermectin in early treatment of non-hospitalized patients with mild COVID-19 – A double-blind, randomized placebo-controlled trial https://www.medrxiv.org/content/10.1101/2021.05.31.21258081v1 Effects of Ivermectin in Patients With COVID-19: A Multicenter, Double-Blind, Randomized, Controlled Clinical Trial https://www.sciencedirect.com/science/article/pii/S0149291821002010 Real-World Evidence: The Case of Peru. Causality between Ivermectin and COVID-19 Infection Fatality Rate https://www.researchgate.net/publication/344469305_Real-World_Evidence_The_Case_of_Peru_Causality_between_Ivermectin_and_COVID-19_Infection_Fatality_Rate Sharp Reductions in COVID-19 Case Fatalities and Excess Deaths in Peru in Close Time Conjunction, State-By-State, with Ivermectin Treatments https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3765018 Use of Ivermectin Is Associated With Lower Mortality in Hospitalized Patients With Coronavirus Disease 2019 The Ivermectin in COVID Nineteen Study https://journal.chestnet.org/article/S0012-3692(20)34898-4/fulltext A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness Note: this study was funded by https://pubmed.ncbi.nlm.nih.gov/33278625/ https://www.jcdr.net/articles/PDF/14529/46795_CE[Ra]_F(Sh)_PF1(SY_OM)_PFA_(OM)_PN(KM).pdf Use of Ivermectin as a Potential Chemoprophylaxis for COVID-19 in Egypt: A Randomised Clinical Trial Antiviral effect of high-dose ivermectin in adults with COVID-19: A proof-of-concept randomized trial https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00239-X/fulltext Crying wolf in time of Corona: the strange case of ivermectin and hydroxychloroquine. Is the fear of failure withholding potential life-saving treatment from clinical use? https://www.signavitae.com/articles/10.22514/sv.2021.043 Global trends in clinical studies of ivermectin in COVID-19 Morimasa Yagisawa, Ph.D.1,2, Patrick J. Foster, M.D.2 Hideaki Hanaki, Ph.D.1 and Satoshi Ōmura, Ph.D.1 https://kitasato-infection-control.info/swfu/d/ivermectin_20210330_e.pdf Ivermectin: a multifaceted drug of Nobel prize-honoured distinction with indicated efficacy against a new global scourge, COVID-19 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383101/ Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection Andrew Hill, Anna Garratt, Jacob Levi, Jonathan Falconer, Leah Ellis, Kaitlyn McCann, Victoria Pilkington, Ambar Qavi, Junzheng Wang, Hannah Wentzel https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab358/6316214#.YOSvFH94xL0.twitter Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19 Pierre Kory, MD,1,* Gianfranco Umberto Meduri, MD,2 Joseph Varon, MD,3 Jose Iglesias, DO,4 and Paul E. Marik, MD5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088823/ Ivermectin for Prevention and Treatment of COVID-19 Infection A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines (peer reviewed & published June 12, 2021) Bryant, Andrew MSc1,*; Lawrie, Theresa A. MBBCh, PhD2; Dowswell, Therese PhD2; Fordham, Edmund J. PhD2; Mitchell, Scott MBChB, MRCS3; Hill, Sarah R. PhD1; Tham, Tony C. MD, FRCP4 https://journals.lww.com/americantherapeutics/Abstract/9000/Ivermectin_for_Prevention_and_Treatment_of.98040.aspx https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/ Ivermectin works on all variants: https://www.globenewswire.com/en/news-release/2021/05/18/2231755/0/en/Mountain-Valley-MD-Receives-Successful-Results-From-BSL-4-COVID-19-Clearance-Trial-on-Three-Variants-Tested-With-Ivectosol.html "Ivermectin was able to reduce virus replication by a factor of 1,000 even at low concentrations" https://twitter.com/Covid19Crusher/status/1390288935729905670 Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen Fatemeh Heidary & Reza Gharebaghi https://www.nature.com/articles/s41429-020-0336-z The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro https://www.sciencedirect.com/science/article/pii/S0166354220302011 https://c19ivermectin.com/caly.html "Rajter et al. summarize the author, noting that “the antiviral activities of ivermectin have been derived from laboratory experiments that largely involve high, generally non physiologic, multiplicities of infection, and cell mono layer cultures, often of cell lines such as Vero cells that are not clinically relevant. The EC50 values should not be interpreted beyond the fact that they reveal robust, dose dependent antiviral activity in the cell model system used, and it would be naive to strive for μM concentrations of ivermectin in the clinic based on them.” [4]." The broad spectrum host-directed agent ivermectin as an antiviral for SARS-CoV-2 ? https://www.sciencedirect.com/science/article/abs/pii/S0006291X20319598?via%3Dihub Ivermectin Docks to the SARS-CoV-2 Spike Receptor-binding Domain Attached to ACE2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652439/ Zimbabwee “The secretary for health and child care has authorized the MCAZ to authorize the importation and use of ivermectin for COVID-19. MCAZ will issue bulk section 75 approval for importation of human formulations of ivermectin manufactured by compliant facilities.” India(some states, with more switching to ivermectin as evidence is overwhelming enough to combat propaganda) https://joannenova.com.au/2021/05/cases-down-in-the-parts-of-india-that-approved-ivermectin-use/ Peru https://joannenova.com.au/2021/02/in-peru-ivermectin-cut-covid-deaths-by-75-in-6-weeks-cheap-safe-and-quite-ignored/

Many of these are systemic reviews, they are far higher quality secondary sources than some random opinion pieces which the corrupt mods here put as "consensus". No, the consensus is the meta analysis and it shows unequivocally that ivermectin works in thousands of different examples. There is almost no evidence that it doesnt. Every study that showed poor results used the drug at 7-14 days after symptoms, clearly well past the viral replication stage of covid. Using horrible quality sources as a heading in this section over the actual quality scientific reviews just exposes how many people here need to be removed from power. Asailum (talk) 05:38, 23 October 2021 (UTC)

Kindly refer to the consensus template at the head of this page to find what the WP:BESTSOURCES say. We shall not be using tweets from "Covidcrusher", primary sources, fraudulent research or discredited reviews to propagate quackery and misinformation, but instead shall be using reliable, mainstream sources to call it out, while carefully presenting the accepted scholarship of the wider world. Be aware this topic area is under WP:AC/DS. Alexbrn (talk) 05:50, 23 October 2021 (UTC)

Patience, patience..

A lot of more pro-Ivermectin studies will fall, eventually. garbage in, garbage out. --Julius Senegal (talk) 12:19, 23 October 2021 (UTC)

Or, at the very least, those purporting to show a miraculous effect, though it might not happen soon. Szmenderowiecki (talk) 00:26, 26 October 2021 (UTC)

At least the fraudulent Niaee et al. paper has now a warning. So much garbage with those pro-IVM "papers". --Julius Senegal (talk) 06:46, 26 October 2021 (UTC)

edit request

There is nothing in the chemistry section about its total synthesis. I propose to add the following text:

"The total synthesis of ivermectin and related avermectins have been reported by various groups."

@142.157.199.66: It is already mentioned that once avermectin homologues are produced that they separately undergo hydrogenation to give ivermectin. Obama gaming (talk) 02:35, 27 October 2021 (UTC)

@Obama gaming: yes but there is no discussion on the total synthesis of the avermectins, which is worth a brief discussion at least. 142.157.199.66 (talk) 02:55, 27 October 2021 (UTC)

@142.157.199.66: I see where you're getting at, although I think if you gave it a bit more context (i.e. date, whether useful or not etc) it would be great. I'd be more than happy to add it in for you Obama gaming (talk) 05:50, 27 October 2021 (UTC)

References

I have closed this request as answered due to the above conversation. Z1720 (talk) 20:50, 24 November 2021 (UTC)

Trichinosis and ivermectin

The current version of the article does not mention Trichinosis. According to MEDRS Ashour (2019), ivermectin has five "clinical uses", with number four being Trichinosis. It also says Although not yet approved, experimental studies with IVM have shown promising effects.. Given these fact shown in high quality sources, how should we proceed to mention Trichinosis:

1. Do not mention it because it is currently not approved
2. Mention it in the body of the article, but not in the lead, AND use the words "clinical use" to describe its relation to ivermectin
3. Mention it in the body of the article, but not in the lead, AND do not use the words "clinical use" to describe its relation to ivermectin. Try instead, 'experimental', 'potential', 'promising', 'off-label', or some other variation as long as a reader do not get confused that it received approved use
4. Mention it in the body and the lead, but abstain from "clinical use" wordings
5. Mention it in the body and the lead, and use the words "clinical use" regarding ivermectin and Trichinosis

Please discuss. Forich (talk) 03:05, 13 November 2021 (UTC)

The source does not mention any clinical use ivermectin (only animal studies) and such a use does not appear in its table listing clinical usages (Table 2). So it would appear the article has got its content messed-up in the wrong sections. At most, we can say ivermectin has been researched for treatment of Trichinosis. Alexbrn (talk) 06:10, 13 November 2021 (UTC)

My general feeling is that we should reserve the "Medical uses" section for diseases that the drug is being widely used to treat (typically following recommendation of some major health body). The source you link above suggests ivermectin and trichinosis is a topic of current research, but not clinically used. So I'd suggest mentioning it in the research section here. I don't think that merits mention in the lead. Ajpolino (talk) 23:33, 14 November 2021 (UTC)

Section Veterinary use

I noticed that the section Veterinary use is far down in the article, even though this is an important use. I would suggest merging it into the section Medical uses. --Leyo 16:27, 17 November 2021 (UTC)

Per WP:MEDSECTIONS vet stuff is usually last. Alexbrn (talk) 16:38, 17 November 2021 (UTC)

This does not seem to be a thoughtful sequence, especially for drugs that only have a veterinary use. --Leyo 17:29, 17 November 2021 (UTC)

It's not clear if you meant to imply this, but ivermectin does not only have veterinary uses. Firefangledfeathers 17:32, 17 November 2021 (UTC)

@Leyo: As I understand it, purely veterinary drugs would not fall under WP:MEDRS/WP:MEDMOS, and guidance for such topics could be sought at WP:VET. Alexbrn (talk) 17:34, 17 November 2021 (UTC)

I am aware that ivermectin has other uses, but its veterinary use is quite important. The information on different uses should be kept together for the ease of reading IMHO. --Leyo 17:40, 17 November 2021 (UTC)

Since ivermectin is a massive blockbuster drug in veterinary medicine I tend to agree that it should be mentioned higher up, probably after the "medical uses" section. I'd oppose merging the two sections as I think that'd become unwieldy to the reader. WP:MEDSECTIONS is clear that its section order is just a suggestion and we needn't be overrigid in applying it. I'll take a look for sources to improve the veterinary section sometime this week; my impression is that ivermectin is among the bestselling veterinary drugs of all time (possibly the bestselling?), though it's always easier to find sources for human medicine than veterinary... Ajpolino (talk) 17:54, 17 November 2021 (UTC)

Separate sections in a modified order is fine with me. Firefangledfeathers 19:06, 17 November 2021 (UTC)

Sounds like a good solution. --Leyo 21:44, 17 November 2021 (UTC)

Semi-protected edit request on 17 November 2021

Change "COVID-19 Misinformation" section to "Treatment of COVID-19" while adding information that supports successful treatment of COVID-19 with ivermectin.

The current article only speak to a very one-sided view on the subject with very dubious support from media references rather than published research. It also maintains that "misinformation" is spread by right-wing politician rather than medical and scientific community. On contrary, there is substantial body of evidence that ivermectin is a medication uniquely suited to treat COVID-19 given its now well-described, potent anti-viral and anti-inflammatory properties. The efficacy of ivermectin is supported by results from 64 controlled trials, 32 of them randomized, and 16 of those were double-blinded, the gold standard of research design.

If there is controversy in the use of ivermectin for COVID-19 treatment, such controversy should be reflected in the article based on the very spirit of Wikipedia and must not be blocked from editing. "Wikipedia is an online free content encyclopedia project helping create a world in which everyone can freely share in the sum of all knowledge. It is supported by the Wikimedia Foundation and based on a model of freely editable content."

A list of research articles can be found here:

• https://covid19criticalcare.com/wp-content/uploads/2021/09/FLCCC-Summary-of-the-evidence-of-ivermectin-in-COVID-19.pdf

Here's an extract:

• https://oce.ovid.com/article/00078401-202005000-00007
• https://oce.ovid.com/article/00078401-201811000-00006
• https://oce.ovid.com/article/00004548-201208000-00014
• https://oce.ovid.com/article/00078401-201309000-00013
• https://pubmed.ncbi.nlm.nih.gov/32641484/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762688/
• https://www.jcdr.net/articles/PDF/14529/46795_CE%5bRa%5d_F(Sh)_PF1(SY_OM)_PFA_(OM)_PN(KM).pdf
• https://www.medrxiv.org/content/10.1101/2021.03.26.21254398v1
• https://www.ijidonline.com/article/S1201-9712(21)00345-3/fulltext#secsect0090
• https://media.marinomed.com/8b/7a/c7/nota-journal-of-biomedical-research-safety-adn-efficacy-iota-carrageenan-and-ivermectin.pdf
• https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247163
• https://www.sciencedirect.com/science/article/abs/pii/S015196382030627X
• https://ejmed.org/index.php/ejmed/article/view/599
• https://c19ivermectin.com/vallejos.html
• https://www.cureus.com/articles/64807-prophylactic-role-of-ivermectin-in-severe-acute-respiratory-syndrome-coronavirus-2-infection-among-healthcare-workers
• https://c19ivermectin.com/mondal.html
• https://www.cureus.com/articles/63131-ivermectin-as-a-sars-cov-2-pre-exposure-prophylaxis-method-in-healthcare-workers-a-propensity-score-matched-retrospective-cohort-study

Glebl1 (talk) 18:48, 17 November 2021 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. covid19criticalcarecom is not a WP:MEDRS compliant source. Also, we don't get any of your donation money, so we don't really care about donations. ScottishFinnishRadish (talk) 18:54, 17 November 2021 (UTC)

Nobody cares if you threated to withdraw your donations to Wikipedia, we don't get paid for our work, and there are many other people who donate to Wikipedia so your total contribution to the funds is miniscule and irrelevant. Hemiauchenia (talk) 21:13, 17 November 2021 (UTC)

@Glebl1: Comment The first 4 research articles you linked don't even mention coronavirus, CoV2, or COVID-19. EvergreenFir (talk) 22:54, 17 November 2021 (UTC)

PLOS ONE is not a reliable source? "We conclude that two-dose ivermectin prophylaxis at a dose of 300 μg/kg body weight with a gap of 72 hours was associated with a 73% reduction of SARS-CoV-2 infection among HCWs in the following one month." Please get updated.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247163 Otaku00 (talk) 05:35, 25 November 2021 (UTC)

Case studies are not reliable sources (see WP:MEDASSESS). Alexbrn (talk) 06:39, 25 November 2021 (UTC)

If you need a meta analysis, Hill et al. was corrected (70 percent reduction in mild cases): https://academic.oup.com/ofid/article/8/11/ofab358/6316214 Otaku00 (talk) 12:59, 25 November 2021 (UTC)

Low-quality journal - see the statement at the top of this page for the WP:BESTSOURCES which Wikipedia uses. Bottom like: Wikipedia is not getting suckered in by the ivermectin BS, but reflects accepted mainstream knowledge as it is bound to do. Alexbrn (talk) 14:47, 25 November 2021 (UTC)

Words like "suckered in"and "misinformation" like in the article only show that a neutral viewpoint is not given anymore. Your link does not say who decided that this source is "low quality". Was it you? I would therefore be good to explicitly name ALL the only sources that are considered high quality here because otherwise there will always be the same rhetoric answers. Otaku00 (talk) 15:09, 25 November 2021 (UTC)

And by the way, you got yourself trapped here because number 2 of those given sources on the top of this page is the same as the one I gave. Otaku00 (talk) 15:15, 25 November 2021 (UTC)

Which says "Compared with the standard of care or placebo, IVM did not reduce all-cause mortality, LOS, or viral clearance in RCTs in patients with mostly mild COVID-19. IVM did not have an effect on AEs or SAEs and is not a viable option to treat patients with COVID-19.", So I am unsure how you think this is saying its a viable trweatment.Slatersteven (talk) 15:21, 25 November 2021 (UTC)