Fraudulent studies on ivermectin open a new battleground between science and disinformation | Health
Dr Carlos Chaccour encountered difficulties when he and his colleagues started recruiting patients in Peru for their study to determine the effect of a daily dose of the antiparasitic drug ivermectin on people infected with Covid-19.
“We would call the patient and say, ‘You have just been diagnosed with Covid and you are eligible for this study. Are you taking ivermectin? ‘ He said.
“And they would say ‘Of course’.”
The former Minister of Health of Peru and responsible for the study, Patricia García, says Nature: “Out of a dozen people who come [to the hospital], I would say eight took ivermectin and cannot participate in the study.
Ivermectin has never been proven to be an effective Covid treatment, and the studies that have said so have either been poorly conducted or too small for their results to be applied more widely or downright falsified. Yet the popularity of the drug has skyrocketed.
One of the first fraudulent studies on ivermectin came to light just months after the start of the pandemic, even before it was widely used or promoted to treat the virus. This study found that ivermectin resulted in improvement and reduction in mortality in hospitalized Covid-19 patients around the world. The article was eventually withdrawn by the medical journal that published it after the data turned out to be falsified and the patients did not exist.
But the damage was done. Prior to the retraction, the Peruvian government included ivermectin in its national Covid-19 treatment guidelines, their advice partly informed by the article on ivermectin.
Other studies have found ivermectin has no significant impact on the viral load of Covid-19 patients, and that further studies are needed to properly assess any impact of ivermectin on Covid-19. Despite all of this, the drug has taken off beyond Peru and is now in use around the world, promoted by politicians, celebrities and even some doctors and scientists as a credible treatment for Covid-19.
Chaccour, who has researched ivermectin for its ability to control tropical disease for over 15 years, says the hope and use of ivermectin is almost understandable when people die in waiting rooms. and that there is a lack of supply of Covid-19 vaccines.
Countries with widely available vaccines, such as the UK, US and Australia, have also been hit by the ivermectin hype, with people trying to get the drug and even resorting to it. formulations used to treat parasites in animals. General practitioners, in some cases, readily prescribe it. Influential politicians and controversial researchers frequently tweet studies claiming to support its use.
But most of these studies prove problematic.
In July, Guardian Australia revealed that the results of a randomized controlled trial conducted in Egypt had been withdrawn after serious ethical concerns were raised, along with questions about the data.
In September, Buzzfeed News reported that an influential study of Argentina claiming ivermectin prevented Covid-19 100% of the time contained suspicious data and was based on flawed methodology.
In research, a control group is the group of study participants who do not receive the intervention – in this case ivermectin – and is an essential part of a reliable study. If most people are already taking the drug you want to review, you cannot do a proper clinical trial.
The control group and the experimental group should be similar in all other respects, such as gender distribution, age groups, severity of Covid, and overall health, to increase the likelihood that any effect observed in the experimental group. or the result of the intervention.
These studies are known as randomized controlled trials (RCTs) and the strongest of them are also ‘double-blind’ – neither the researchers nor the participants know which patients are receiving the intervention or the placebo treatment, which is usually a sugar pill or, in vaccine trials, a saline solution.
Due to the strength of RCTs, they are essential in the fight against Covid-19. The more participants enrolled in an RCT, the stronger the results and the more likely it is that the results will be “replicated” in future studies and when the intervention is administered to the general population. Governments and drug regulators largely rely on the findings of RCTs to make recommendations on which drugs to approve.
Thursday, the prestigious medical journal Nature Medicine published an article written by concerned epidemiologists and researchers who interviewed studies on ivermectin.
“Hundreds of thousands of patients have been given ivermectin, relying on an evidence base that has evaporated significantly under close scrutiny,” the authors wrote.
“Several … studies that claim a clinical benefit for ivermectin are also onerous and contain impossible numbers in their results, inexplicable lags between trial register updates and published patient demographics, alleged timeframes that are not consistent with the veracity of the data collection, and methodological weaknesses.
Gideon Meyerowitz-Katz, an epidemiologist at the University of Wollongong in New South Wales and co-author of the Nature Medicine article, says he and his peers have reviewed more than a dozen studies which claim that the ivermectin is beneficial either as a preventative or as a treatment for Covid19.
“Of these studies, we have serious concerns about four that have been made public and several more that we are still investigating,” he said.
Some of the authors have not shared their research data, which Meyerowitz-Katz says “is a very worrying sign at this point.”
“There has only been one retraction so far, but I suspect more are on the way,” he said.
Misinformation fuels conspiracy theories
When asked why researchers would make so many mistakes or worse, deliberately mislead, distort and tamper with data, he replies: Much fraud really isn’t that hard to identify.
Chaccour believes that pressure on academics plays a role.
“A lot of people are working at the entry level and on doctorates, putting in 120 hours a week for less than minimum wage,” he says. “The more you publish and the bigger the article, the more recognized the journal that publishes it, the closer you get to a more stable lifestyle and career recognition.”
In the case of ivermectin, recognition has come from researchers who cite the articles, pushing the articles up the academic rankings and giving the journals or websites where they are published prominence. But politicians, celebrities and journalists are also promoting the results.
Fancy websites have sprung up publishing “treatment protocols” for ivermectin. Some even sell merchandise, including T-shirts with the slogan “Covid kills, ivermectin saves lives”.
Chaccour says he watched with desperation as reporters began to attribute a reduction in Covid-19 in Peru to ivermectin rather than strict lockdown measures that were introduced before the disease rates fell. This misinformation was helping fuel conspiracy theories that the medical establishment was deliberately hiding ivermectin because the drug has been around for decades, is cheap to produce, and therefore unprofitable.
In fact, Chaccour says, the chemical companies that produce the ingredients for ivermectin have seen their profits skyrocket. Meyerowitz-Katz says that even though ivermectin is not patented – meaning rival drug companies can produce inexpensive generic versions of the drug – the Stock prices of two companies that make patented ivermectin products have skyrocketed.
Chaccour clarifies that he does not believe these companies are behind the ivermectin surge, but says it is wrong for those promoting ivermectin to say that the drug has been downplayed because it doesn was not as cost effective as the new patented drugs.
“I think for those who are promoting ivermectin, there is a level of ignorance and lack of education…,” he says.
In Australia, the National Covid-19 Clinical Evidence Taskforce is developing Covid-19 recommendations for clinicians based on the most recent and strongest evidence available. The group does not recommend the use of ivermectin outside of randomized controlled trials and makes the methodology behind its public recommendations.
Despite this, task force leader Assoc Prof Tari Turner says she and other members of the task force are frequently approached and criticized for not supporting the results of some ivermectin studies in their recommendations.
Turner said she didn’t know why, despite all the reputable organizations explaining the lack of evidence for ivermectin in the treatment of Covid-19, people still viewed it as a wonder drug.
“The task force’s job is to find evidence that allows us to determine the effectiveness of ivermectin and other treatments,” she says. “While it seems to me that many advocates of ivermectin, and previously hydroxychloroquine, are only looking for evidence to show that it is effective.”