Hacker News Reader

If it works, not very well. There were some very small underpowered studies that showed promise. Then large RCTs were done and it didn’t work. Brazil would certainly not be in the situation it’s in right now if ivermectin cured covid.

https://www.gavi.org/vaccineswork/ivermectin-why-potential-c...

It's weird how often on threads about covid, an entirely new HN account turns up to extol the virtues of Ivermectin. I'd say the chances of that being a coincidence are estimated to be 1 in 85 trillion.

This is the first time I see this and so at least to me, an actual counter to their points would have been more of a convincing argument, compared to accusations of shilling which might as well be FUD.

They aren't FUD. Click on the accounts mentioning Ivermectin, and they are just new, and only have one comment.

Sure, it might be that a dozen long time lurkers had to create an account to made people aware of it. Its plausible.

I think its more plausible that HN is suffering a disinformation attack by a cheap as botnet.

A limit of "wait 1 day after registering to comment" would make whatever cheap botnet is doing this much less effective. Since after 1 day most stories are not in the frontpage anymore.

It's not a botnet. Am a long-time hacker news reader who thinks ivermectin is a better covid cure based on science than what Pfizer is rushing to produce (Pfizer's drug hasn't even finished Phase 1 FDA trials, Ivermectin is FDA approved with ~40 years safety data). I use multiple machines and didn't remember the password for this account so created a new one. My interest is not in spamming, but having a genuine discussion, why ivermectin isn't more widely used. There are multiple prominent doctors who believe it could end the covid pandemic. Why get so excited about new medications when generics are cheaper, and have better safety data.

Other treatments have good data like Fluvoxamine, here's a good article from Steve Kirsh: https://www.quora.com/Is-there-any-cure-for-COVID-19/answer/...

Am interested in a genuine discussion of facts. There's a lot of censorship around Ivermectin. Youtube specifically says it can delete videos mentioning ivermectin as a treatment for covid. Since when is science advanced through censorship instead of debate?

> Since when is science advanced through censorship instead of debate?

Science is never advanced through debate; it's advanced through research. Research which gets repeated by different teams, in different places, in different circumstances, and conducted in different ways, while still producing the same results.

Random people on internet discussion boards who want to advance science via a "debate" is how misinformation is advanced.

I only see one single new account that has made multiple comments in this thread.

One guy signing up or creating a throwaway isn’t exactly unlikely.

Here in Brazil there is a manufacturer that finances a group that promotes its use.

"The sale of vermifuge ivermectin jumped from R$44.4 million in 2019 to R$409 million last year, an increase of 829%."

(In portuguese) https://negativando.medium.com/m%C3%A9dicos-pela-vida-s%C3%A...

If you are skeptical of financial motivated misinformation - are you concerned that the parent article - touting an unapproved FDA cure for covid - is placed on a website that advertises it sells sponsored content articles: https://www.postmediasolutions.com/solutions/content/

Or that the FDA promotes Remdesivir which make's Gilead billions of dollars, where the largest non-manufacturer sponsored trial by the WHO showed 0 benefit for saving lives?

Why is hacker news so excited about something that may take months to get to market, currently has less efficacy data than ivermectin, and will never have the safety profile of ivermectin?

Guidelines ask you to refute content rather than accuse of shilling. If you have evidence of shilling you should email the mods instead. Guidelines also ask you to not post the same comment twice.

Disclosure: no dog in the fight and never heard of this drug before.

Ivermectin is an antiparasitic in wide human and veterinary use since the early 1980s. It is also fairly broadly studied, in no small part because it's one of the most effective drugs in its class. That it should double as a highly effective broad-spectrum antiviral is not impossible, quite, but anyone advancing the claim badly needs to explain why, over all the dozens of studies and millions of doses over multiple decades, no one has noticed this supposedly very obvious antiviral efficacy before now. The next person I see try to explain that will be the first.

The discovery came years ago: "Dr Wagstaff made a previous breakthrough finding on Ivermectin in 2012 when she identified the drug and its antiviral activity with Monash Biomedicine Discovery Institute’s Professor David Jans, also an author on this paper. Professor Jans and his team have been researching Ivermectin for more than 10 years with different viruses." https://www.monash.edu/discovery-institute/news-and-events/n...

Lots of things work in vitro, this apparently included. Arsenic probably would too. Cell culture is a very different environment from a living organism, so all this says about whether the same drug works the same way in vivo is that it's worth finding out. Despite the usual mild tendentiousness one finds in press releases from academia, the linked article says as much, repeatedly and in detail.

Certainly on Twitter, hyping ivermectin as the cure is also good Bayesian evidence that the speaker also believes a bunch of unevidenced or plain wrong things about Covid19.

That's been my experience in the real world as well, which has the result of making me very skeptical of ivermectin.

Correct dosage and a dependency on administering in conjunction with Zinc. This is well-established in controlled studies conducted over the past year. Look at the data from the many controlled human trials, it's conclusive. Suppressing it kills people.

Where is that data? You seem very familiar with it. Why not link it? Why do all the links you do post point to random novel .coms with huge batches of totally unrelated studies that just happen to have "Covid-19" or "SARS-CoV-2" in the name, rather than to PubMed, BMJ, or any other more direct source? Why not detail the analysis that led to the conclusion you present? Why do you prefer to talk about your claims of censorship and suppression than talk about the science?

Your statement about "huge batches of totally unrelated studies" is completely false.

All studies on c19ivermectin.com are directly related to Ivermectin efficacy versus SAR-Cov-2, a small number relate to Ivermectins viral efficacy in general.

Hot off the press (all peer-reviewed):

Ivermectin SARS-Cov-2 binding:

https://link.springer.com/article/10.1007/s13721-021-00299-2

https://www.frontiersin.org/articles/10.3389/fmicb.2020.5929...

https://www.nature.com/articles/s42003-020-01577-x

Ivermectin in humans, versus COVID-19:

768 outpatients, prospective trial vs control, significant improvement:

https://www.sciencedirect.com/science/article/pii/S120197122...

Infections - 0 of 788 treated, versus 237 of 407 in control group:

https://medicalpressopenaccess.com/upload/1605709669_1007.pd...

Retrospective, 3099 infected patients treated, 1 death:

https://www.longdom.org/open-access/the-use-of-compassionate...

Examples of counter-studies against Ivermecitn or HCQ (similar profile and response) in journals you love:

https://jamaletter.com/

The infamous Lancet front-page retrospective observational study on HCQ which turned out to be based on zero verifiable data, despite passing Lancet's "peer-review". (Sorry no link, it's been retracted.)

Maybe potentially saving lives by providing negligently under-reported and big-coughtech suppressed information is enough to motivate someone to set up an account?

Looks like Ivermectin has generated a lot of buzz that many are self medicating. The first link that google throws up when searching for Ivermectin is the FDA page "Why You Should Not Use Ivermectin to Treat or Prevent COVID-19" https://www.fda.gov/consumers/consumer-updates/why-you-shoul...

I have no opinion on Ivermectin, but I find it odd that the FDA keeps implicitly recommending remdesivir [0] while the WHO (together with several European countries) recommends against it [1]. I believe the FDA is compromising its credibility, which is sad.

FDA: "The FDA has approved the antiviral drug Veklury (remdesivir) for adults and certain pediatric patients with COVID-19 who are sick enough to need hospitalization."

WHO: "WHO has issued a conditional recommendation against the use of remdesivir in hospitalized patients, regardless of disease severity, as there is currently no evidence that remdesivir improves survival and other outcomes in these patients."

[0] https://www.fda.gov/consumers/consumer-updates/know-your-tre...

[1] https://www.who.int/news-room/feature-stories/detail/who-rec...

[2] https://www.has-sante.fr/jcms/p_3201940/fr/evaluation-des-tr...

Had discussions on this with our close friends who work as doctors at the covid front line (emergency & intense care unit) in Switzerland's biggest hospital (since wife is a doctor herself we know a lot of them).

The feedback? Meh, provably doesn't work in regular doses, +-works in lab culture when dosage is 1000x the regular one with god knows what side effects, and thus no doctor here uses it. Its not some emotional dismissal, but deep study of available research by top medical virology experts in a country which has more money to spend than any other on this, and plenty of this medicine if its proved working. They discuss & evaluate daily all available information, and Ivermectin simply doesn't pass as anything even remotely working.

Now I am far from virology expert myself, but I don't mind listening to massive group of experts. I've seen some people propagating this drug, presumably in good faith. But from the outside it looks exactly like another conspiracy theory when you can't discuss with people about simple facts. All this because of some web page, youtube channel etc going mental in one single direction, about one 'expert' who discovered truth that governments and pharma corporations don't want you to know

Sounds like the doctors you spoke with didn't have any experience with ivermectin and are referencing old information (1000x standard dosage is needed). There are many doctors who do use it and see good results. Slovakia recently started using Ivermectin widely in March (https://twitter.com/BIRDGroupUK/status/1385990416730923013) and saw steep reduction in deaths. If you are interested in having a good faith discussion about ivermectin facts, that would be great. What questions do you have?

Tens of thousands of patients have been tested in double-digit, peer-reviewed RCT's, showing high efficacy:

https://c19ivermectin.com/

> also proven very effective against preventing and treating sars-cov-2 virus in vivo

No. India and Brazil are giving Ivermectin liberally. See how good they're doing

> is estimated to be 1 in 85 trillion (p = 0.000000000000012).

Their estimation is BS. Or better, it's the famous "CICO" (crap in, crap out) statistics

"Oh but it won the Nobel prize". Yes and John Voigt won an Oscar, doesn't mean his performance in Anaconda was up to snuff

Incorrect, only certain areas in Brazil and India are using Ivermectin which makes for excellent epidemiological studies showing ivermectin's effectiveness in areas that use it versus areas that don't: https://covid19criticalcare.com/ivermectin-in-covid-19/epide... (India and Brazil are towards, the bottom of the page, several other countries data show identical results where introducing ivermectin treatments causes death rates to drop)

> only certain areas in Brazil

Incorrect, if you go to any pharmacy in any area of Brazil you'll find it being liberally sold even without a prescription. (one of multiple references https://g1.globo.com/sp/sao-paulo/noticia/2021/03/29/uso-de-... )

Also go look up the numbers of Drug-induced hepatitis caused by Ivermectin in Brazil

My understanding is that even if the drug is available in Brazil OTC it has become politicized, so it's not considered standard of care. Do you have any links where health authorities in Brazil have made it standard of care?

Ivermectin is incredibly safe. "Acetaminophen overdose is the leading cause for calls to Poison Control Centers (>100,000/year) and accounts for more than 56,000 emergency room visits, 2,600 hospitalizations, and an estimated 458 deaths due to acute liver failure each year." https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.20...

"Hepatic adverse events Ivermectin was suspected to be a hepatotoxicant. In fact, this claim reproduced in several publications was based on few individual case reports [Sparsa, 2006; Veit et al., 2006; Hirota et al., 2011] where the causal relationship with ivermectin treatment was not convincingly established. The last update of LiverTox [2018], a database of drug-induced hepatotoxicity, did not classify ivermectin as a known hepatotoxicant, a conclusion recently confirmed by the US National Institutes of Health [NIH, 2021]."

Taken from a recent 48 page review of the the entire literature on Ivermectin safety by a medical toxicologist: https://www.medincell.com/wp-content/uploads/2021/03/Clinica...

(edit: not 50,000 liver failures, 56,000 er room visits :)

> it's not considered standard of care. Do you have any links where health authorities in Brazil have made it standard of care?

"Nobody cares" about standard of care. The medical college (CRM) has pretty much said that the doctors are free to prescribe whatever they want

> Ivermectin is incredibly safe.

Yes, at the recommended doses for parasite control (which is a single or dual dose), not for usage for several consecutive days or weeks (and I agree with the Paracetamol criticism)

Anti-depressants are approved after a few weeks of study, and people use them for years without safety concerns. People have taking 10 times the dose of regular ivermectin without harm (https://pubmed.ncbi.nlm.nih.gov/12362927/). I guess we are in slightly uncharted waters with ivermectin, but there is no evidence from the people who chronically prophylax for covid that regular dosing has caused them issues.

And ivermectin is safest of the current covid treatments, so I find it hard to accept that we shouldn't use it because of safety concerns (for comparison, since 1992 the pharmocavigilance database shows less than 1 death per year from ivermectin, where Remdesivir has 500+ deaths, vaccines has over 2000 deaths with only months of usage).

There's no evidence that it works. The studies used concentrations that were roughly 1000x a regular human dosage.

https://sciencebasedmedicine.org/ivermectin-is-the-new-hydro...

The theory that ivermectin’s anti-viral activity is dependent on unachievable tissue concentrations is incorrect as follows:

In the cell culture study by Caly et al from Monash University in Australia, although very high concentrations of ivermectin were used, this was not a human model. Humans have immune and circulatory systems working in concert with ivermectin, thus concentration required in humans have little relation to concentrations used in a laboratory cell culture. Further, prolonged durations of exposure to a drug likely would require a fraction of the dosing in a short-term cell model exposure. There are multiple mechanisms by which ivermectin is thought to exert its anti-viral effects, with the least likely mechanism that of the blocking of importins as theorized in the Monash study above. These other mechanisms are not thought to require either supraphysiologic doses or concentrations and include competitive binding of ivermectin with the host receptor-binding region of SARS-CoV-2 spike protein, limiting binding to the ACE-2 receptor; binding to the SARS-CoV-2 RNA-dependent RNA polymerase (RdRp), thereby inhibiting viral replication (Swargiary, 2020); binding/interference with multiple essential structural and non-structural proteins required by the virus in order to replicate. The theory that ivermectin would need supraphysiologic tissue concentration to be effective is most strongly disproven by the now 24 controlled clinical trials which used standard doses of ivermectin yet reported large clinical impacts in reducing rates of transmission, deterioration, and mortality.

Are you Brazilian?