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)

Which pages use this template?

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

“[S]uch claims are not backed by sound evidence.”

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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“During the COVID-19 pandemic, misinformation was widely spread claiming that ivermectin was beneficial for treating and preventing COVID-19.[14] Such claims are not backed by sound evidence.[15][16][17][18][19]”

This passage assumes that the only evidence of medical efficacy is the conduct of large scale, double-blind trials. This is incorrect. Clinically practicing doctors can detect the efficacy of treatments, and routinely do so. As an extreme example, surgeons generally do not conduct large scale, double-blind trials…people would die if they did. Yet we routinely consider the life-saving surgical practices of surgeons as “sound evidence”, because they demonstrably change the survival rates of patients with certain conditions or injuries. Let’s change this passage to be more accurate…there may not be large-scale double-blind trials, but I do hear compelling evidence that there are practicing physicians who are detecting a beneficial effect. Ivermectin is not known to have serious side-effects, therefore it seems a low-risk alternative that does no harm, and may do some good. We’re at vaccine saturation in the US…why not make a safe treatment acceptable for consideration by doctors, especially since it might pull in a portion of the vaccine skeptical public? Can we tone this down so it highlights that there is one very specific form of evidence that is lacking, while leaving open the question of emerging evidence from clinical practice? BleedingKansas (talk) 05:27, 7 July 2021 (UTC)

 Not done You are espousing a fringe view. Wikipedia's policy is to align to reliable, mainstream sources. Alexbrn (talk) 06:27, 7 July 2021 (UTC)

There is no evidence that BleedingKansas has espoused a "fringe" view. As a rule, wikipedia editors should refrain from base rhetoric such as labelling viewpoints by other editors "fringe". Rather, BleedingKansas has espoused a common sense viewpoint. Where a common sense viewpoint diverges with alleged mainstream sources, giving room for the common sense viewpoint should be considered. In this instance, the alleged mainstream sources have given no rationale for excluding ivermectin from the medical practitioner's toolbox insofar as it is considered a safe drug by the same sources. The line of thinking that the editor collective should rigidly parrot perceived "mainstream sources" would preclude us to inform readers in a Semmelweis moment, and is therefore false. Esperion (talk) 12:11, 14 August 2021 (UTC)

This page is in desperate need of correction. There is sound research demonstrating the efficacy of ivermectin in inhibiting viral replication in COVID-19[2], as well as in several other viruses[1]. It could be more correctly described as an anti-parsitic and selective antiviral. Note the last reference here is a double blinded randomised control trial[3]. Please make use of research search engines DevnullNZ (talk) 09:57, 9 August 2021 (UTC)

I would like to add my voice to the chorus of voices that have been asking for this paragraph to be toned down, at the very least. Does the new meta-analysis by Andrew Hill meet the standards for inclusion here? Hill is a researcher for the WHO. The peer-reviewed analysis is published by the Open Forum of Infectious Diseases, which has a journal impact factor of 3.835. The editorial accompanying the analysis (Mark J. Siedner MD MPH, Harvard Medical School), states the following: "The results are compelling. They identify a clinically significant benefit in pooled estimates for most of their selected outcomes. For example, they estimate a mean reduction in time to viral clearance of 3 days (95%CI 1-5), a reduction in time to clinical recovery of 1.5 days (95%CI 0.4-2.8), a reduction in duration of hospitalization of 4.3 days (95%CI 0.0-8.6) and 56% reduced risk of mortality. Notably, their estimates remain largely similar after excluding studies at high risk of bias. And, although the included studies do not overlap, their results are largely consistent with many (but not all 20) other meta-analytic evaluations of ivermectin conduct by other groups. Even the most ardent skeptic should be given pause by this data."

Clearly, this can no longer be considered only a fringe view, nor can we characterize it as misinformation that is not backed by sound evidence. Meta-analysis is here: https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab358/6316214 Editorial is here: https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab318/6298585

WP:CLEARLY? It's the same issue as the others: an ivermectin advocate publishing a review of low quality data that oddly comes out different to all the reputable medical organisations considering it. WP:REDFLAG applies. Alexbrn (talk) 20:53, 11 July 2021 (UTC)

So, a well regarded researcher who comes in unbiased and with no apparent conflict of interest, but forms a positive opinion after reviewing good evidence gets labeled "an ivermectin advocate," and is therefore eliminated from consideration when he presents the evidence in a respected peer reviewed journal from Oxford University Press? Are the journal editor and those doing the peer review now denigrated as well to "ivermectin advocate" status? This reasoning does not make sense. It's not just presenting an opinion (like the numerous links allowed, written by authors of questionable expertise), but rather is sharing results from "24 randomized clinical trials (3328 patients) identified through systematic searches of PUBMED, EMBASE, MedRxiv and trial registries."

Perhaps you can read the study and tell us where it goes wrong, and what the peer reviewers and the editor from Harvard missed? Then you can write a letter and inform them why they should retract the study. — Preceding unsigned comment added by DavidM58 (talk • contribs) 23:13, 11 July 2021 (UTC)

Please learn how to WP:SIGN and how to WP:INDENT.

This is an encyclopedia, not a science-journal monitoring center. When we judge a source not good enough for inclusion in an article, there is no compulsion to inform the publisher of the source of our decision. And if all studies which are not strong enough to overturn a consensus were retracted, all research would screech to a halt. --Hob Gadling (talk) 07:25, 12 July 2021 (UTC)

Quite. If we were going just by normal rules of thumb, the new piece is in a non-MEDLINE-indexed journal, which would rule it out for non-mundane claims. But since we're in a highly problematic field with sourced expressions of concern about ivermectin research, we can rely on the stronger sources (EMA, etc.) to ensure we aren't unduly boosting fringe science. WP:EXCEPTIONAL applies. Alexbrn (talk) 08:01, 12 July 2021 (UTC)

• Seriously? This treatment is still said to be invalid and fringe on the page? Maybe Wikipedia has missed the boat on yet another current topic. Randy Kryn (talk) 16:25, 13 July 2021 (UTC)

  As long as you do not supply WP:MEDRS sources, we have to assume that the boat is at the bottom of the ocean and it was a good idea to miss it. --Hob Gadling (talk) 18:42, 13 July 2021 (UTC)

• Sunken treasure. Randy Kryn (talk) 18:47, 13 July 2021 (UTC)

Wow. Reading this section was disheartening, to say the least, but reading the talk section about this section is much more so. Leaving aside the question of which position on Ivermectin for either prophylaxis or treatment of Covid19 turns out to be more accurate, the tone of this section is blatantly propagandistic, which should be rather the opposite of the style of writing used to address the factual basis for claims of a given substance's efficacy as disease treatment. The section starts with (heavily politicized) assertions and conclusions about Ivermectin and Covid19, then casts not only opposing viewpoints but opposing evidence (and, whether one considers it high quality evidence or not, said opposing evidence has been widely published in relevant [and reputable, fwiw] sources, including a number of medical journals) as, essentially, baseless conspiracy theories of the sort no doubt common to the writers' political opponents (yes, tongue firmly in cheek here). Wikipedia is an encyclopedia, one which I've usually appreciated in the past for its even handed tone on biochem/small molecule/drug articles when the 'Research Directions' section comes up. This entry should be no exception, and its far from unreasonable to expect editors and contributors to put aside their political motivations and adhere to this standard. Even if we don't admit that there is far from consensus on this issue, we could write it in a much more factual way, using neutral language (i.e. "Some clinicians have advocated for" "various political figures have drawn attention to" "this evidence has, as of X date, not been accepted by X, Y, Z") instead of using words like "erroneously" and "misinformation" and the like, which are claims that are no different than the ones purportedly being "debunked". This section is really off on the NPOV, which given the importance of the topic could possibly have serious (life and death) IRL consequences. Truth is always important, but seems especially important here. As for the data, a simple perusal of The Lancet, CHEST (one of the top Pulmonary/Crit Care Journals) and even Nature should show that from an clinical trial/research data perspective, Ivermectin efficacy is at least an open question, nevermind its widespread use in actual clinical practice in many different jurisdictions (which is EXACTLY how we landed at using Dexamethasone for severe covid when existing "Gold Standard" reviews of the evidence for/against corticosteroids in ARDS had created doubt it would be of much use - fast forward some months, and now its a Gold standard treatment for critical covid patients. Ditto IL-6 inhibitors like Toci - they were pretty fringe but achieved widespread acceptance as part of the toolkit in no small part because some clinicians experimented). This style of writing seems reminiscent of mask wearing being dismissed as "ineffective" and 'misinformation' during the pandemic's early days. Even the WHO made that mistake in their public health advice. Please let's remember that, not make the same mistakes here, and keep the language measured and precise, instead of strident. 108.175.233.87 (talk) 00:53, 23 July 2021 (UTC)

After reading the top 30% of this diatribe: So you disagree with the conclusions of our reliable sources, and you want the article to be more on the fence. And why exactly? You should be aware that empty reasoning like "Wikipedia is an encyclopedia, one which I've usually appreciated in the past for blah blah" does not help at all when deciding that specific question. You could say the same, and people actually do say the same, about Holcaust denial. See WP:YWAB. So, cut all the filler and try again, restricting yourself to reasoning that actually says anything about ivermectin, using reliable sources. Ideally, sources that have not been brought forward and rejected for a good reason before. --Hob Gadling (talk) 09:59, 23 July 2021 (UTC)

Shouldn't this count as a source? Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection Published by Oxford University Press on behalf of Infectious Diseases Society of America. Authored by

• Andrew Hill - Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, L73NY, UK
• Anna Garratt - Department of Infectious Diseases, University Hospital of Wales, Cardiff and Vale, University Health Board, UK
• Jacob Levi - Department of Intensive Care, University College London Hospital, ULCH NHS Trust, London, UK
• Jonathan Falconer - Department of Infectious Diseases, Chelsea and Westminster Hospital, Imperial NHS Trust, London, UK
• Leah Ellis, Kaitlyn McCann, Victoria Pilkington, Ambar Qav, Junzheng Wang, Hannah Wentzel - Faculty of Medicine, Imperial College London, UK

The 13th 4postle (talk) 13:41, 9 August 2021 (UTC)

Sources

The 13th 4postle, here is the important text of that meta-analysis: "Many studies included were not peer reviewed and a wide range of doses were evaluated." If this were the only source, then that would be one thing. But we have many other sources saying the opposite, that are more stringent and reliable and include only peer-reviewed studies. Indeed, the IDSA itself (which you reference) does not yet agree that the evidence is robust enough to recommend use. We must defer to the highest quality sources. See the consensus template at the top of the page. Thanks.--Shibbolethink ^{(♔ ♕)} 15:14, 9 August 2021 (UTC)

Shibbolethink The problem is the wikipedia article explicitly states "Such claims are not backed by credible scientific evidence." That's not true and you're basically admitting it. There is scientific evidence and you're admitting that IDSA says that their is. That the scientific evidence is not robust enough to recommend treatment does not equal that there is no scientific evidence. The article is not giving readers a true picture of the scientific debate around Ivermectin and it's use in treating Covid. And we as editors of Wikipedia should not seek to be the arbiters of truth. We should simply point out the evidence for and against and let the readers decided. That would be a true neutral point of view. These are high quality sources and the Wikipedia article is acting as if they are conspiracy theories. The Wuhan lab leak was also considered a conspiracy theory and evidence against it censored. The 13th 4postle (talk) 15:45, 9 August 2021 (UTC)

The Hill source has already been discussed. It's an article by an Ivermectin advocate in a low quality journal reliant on likely fraudulent research. When we have the EMA, Cochrane collaboration, etc. we're not going to undercut them with WP:EXCEPTIONAL claims from such a poor source. Alexbrn (talk) 06:47, 10 August 2021 (UTC)

The key word is "credible". You keep pretending that the article says "no scientific evidence", but it says "no credible scientific evidence". Before, there were other adjectives. --Hob Gadling (talk) 08:45, 10 August 2021 (UTC)

And now, inevitably.[1] Alexbrn (talk) 12:58, 10 August 2021 (UTC)

Here are 9! Double Blind Randomized Control Trials which suggest that Ivermectin has a positive effect in treating patients with Covid-19. How is this not considered "credible scientific evidence?"

The 13th 4postle (talk) 12:14, 11 August 2021 (UTC)

Wikipedia requires reliable sources per WP:MEDRS. Primary sources are generally prohibited because they require expertise to interpret. This job has been done by many reliable secondary sources which are cited. Alexbrn (talk) 14:18, 11 August 2021 (UTC)

Okay, sure, but the problem is with the specific language that "During the COVID-19 pandemic, misinformation was widely spread claiming that ivermectin is beneficial for treating and preventing COVID-19.[19][20] Such claims are not backed by credible scientific evidence.[21][22]". There is credible scientific evidence. Why can't we change the wording of the article to reflect that while there are some double blind randomized controlled trials that support that Ivermectin could be used as a treatment for SARS-COV-2, it has not been recommended for treatment by the WHO, FDA, etc... because many of the trials have been criticized for their lack of size, procedures, and accuracy." Or something along those lines. I just don't think the wording in the article is accurate of the true scientific discussion going on. This isn't a conspiracy theory. The 13th 4postle (talk) 14:57, 11 August 2021 (UTC)

There is no credible evidence that backs the preposterous claims made for ivermectin. Sorry, Wikipedia isn't going to indulge quacks and quackery. Alexbrn (talk) 15:01, 11 August 2021 (UTC)

Wikipedia would be doing a deep disservice to its readers if we included language like "some double blind randomized controlled trials" support the use of treatment X. There are almost no treatments so pseudoscientific that there haven't been primary trials showing positive evidence. Stating so in all cases would actually cause harm. Instead, we rely on WP:MEDRS-quality sources to review the primary evidence, and we report their conclusions. Firefangledfeathers (talk) 15:04, 11 August 2021 (UTC)

We go by what the bulk of RS say.Slatersteven (talk) 15:02, 11 August 2021 (UTC)

Please note, we comment on the content, not users. If you have an issue with user take it to their talk page or wp:ani.Slatersteven (talk) 13:13, 14 August 2021 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

New Cochrane report regarding Ivermectin does not support the use of ivermectin

Also here: I cannot add it, but a new Cochrane report (PMID 34318930) came to the conclusion that "the reliable evidence available does not support the use ivermectin for treatment or prevention of COVID-19 outside of well-designed randomized trials.".--Julius Senegal (talk) 08:21, 31 July 2021 (UTC)

Jerusalem Post article

Just leaving this here if someone wants to use it as a source.] I don't know if the Post is enough to add some neutrality into that last lead paragraph, please have a look, thanks. Randy Kryn (talk) 04:22, 3 August 2021 (UTC)

 Not done. Source is not a WP:MEDRS, which is what is needed to make claims about the treatment of disease.--Shibbolethink ^{(♔ ♕)} 04:26, 3 August 2021 (UTC)

This isn't a request, leaving the source for others to use. Randy Kryn (talk) 12:16, 6 August 2021 (UTC)

Inserting unreliable sources to back up unfounded claims

Rickyjames, please take a look at the consensus template at the top of this page. Your edit adds content that is of a medical nature, declaring that a treatment is effective, but is not based on WP:MEDRS sources. This is why I reverted. Such content that is against scientific consensus (and editor consensus) must be based on extremely high quality sources. And ivmmeta, as the template at the top of this page describes, is not a reliable source for medical claims.--Shibbolethink ^{(♔ ♕)} 02:14, 5 August 2021 (UTC)

American Journal of Therapeutics

Leaving a source here for someone to use. Randy Kryn (talk) 12:15, 6 August 2021 (UTC)

American Journal of Therapeutics, fringe? Randy Kryn (talk) 12:20, 6 August 2021 (UTC)

Discussed and rejected ad nauseam for good reason, also see the FAQ at the head of this page. Alexbrn (talk) 12:51, 6 August 2021 (UTC)

Reliable sources and "current consensus"

It is disingenuous to caution against websites that are anonymous (see above “Current consensus”, #3), since WP itself is proud to be anonymous. Niemandsbucht (talk) 20:42, 19 August 2021 (UTC)

We are fairly consistent on the point: WP:Wikipedia is not a reliable source. Firefangledfeathers (talk) 21:37, 19 August 2021 (UTC)

Stromectol?

Why does "Stromectol" get top billing at the top of the article? Is this not pure commercial promotion?

200.68.169.188 (talk) 18:16, 24 August 2021 (UTC) baden k.