Been really disheartening to watch the politics around alternative treatments. Personally, I expect this to be attacked as well, but am hopeful! The stuff really does seem effective, particularly when combined with other drugs...
It's a lot easier to work on AnotherCure(TM) for baldness, than touch this pile of political crap.
Can this system be improved? Definitely.
I understand what you’re referring in terms of “alternative medicine”, but that’s it’s own genre.
Once enough studies have been done, this off-label use for fluvoxamine will likely be blessed by the agencies that regulate these sorts of things and at that point it will become an approved treatment for long COVID symptoms. Most things spoken of as "alternative treatments" don't even get to the first stage of this process (since they can't be substantiated with evidence).
https://www.askdifference.com/therapy-vs-treatment/
Joe rogan explained what his doc gave him. He’s also had multiple doctors and researchers on his show providing information regarding treatments they are attempting. Frankly, Ivermectin and the like have more research than the vaccine, they’ve been deployed for longer and at least passed phase 1 trials, which the vaccine has not (only preliminary results).
https://www.modernatx.com/covid19vaccine-eua/providers/clini...
In terms of “off-label” drugs, the FDA approval process is there to protect against liability. Effectively, the government accepts some liability and in return medical companies get some protections. It’s highly likely you’ve taken drugs “off label” yourself.
https://www.goodrx.com/healthcare-access/medication-educatio...
Thus far, this research is promising. Similar to other treatments / therapeutics to covid19, and it has a known risk profile. Making it a potentially better alternative to the standard approach (stay hydrated if infected and vaccinate ahead of time if possible)
Off label drug use/ approval isn't about government liability. As far as I know, it has none. The noteworthy exception is the vaccine's, where the government has a special injury compensation fund, but I wouldn't call this liability . It IS about manufacturer liability, and insurance reimbursement.
That's very very unlikely. Even considering the Nobel prize for it. Simply because the sheer scale of the pandemic.
There are more vaccines in development and use against COVID than there are Ivermectin clinical trials in total.
> they’ve been deployed for longer and at least passed phase 1 trials, which the vaccine has not (only preliminary results).
That doesn't mean they are not safe. The phase 1 trials run to 2022 Nov, because there's a long follow up period.
Nothing can guarantee that there's not some mysterious missed interaction. It's probability is low and getting lower day-by-day. This tail risk is just not that important for safety. It makes very little sense to emphasize this, because we also don't know the long term interaction of Ivermectin and COVID-19.
This will be attacked by the alternative crowd.
Alternative medicine is nothing more than medicine that isn’t tested, because once it’s tested and proven it becomes, medicine.
Things move from "alternative medicine" to being "medicine" when people do good, peer-reviewed science to actually study the effects and find them to be effective. "Alternative medicine" like ivermectine or hydroxychloroquine have no scientific, properly studied basis for being used.
There are more than 60 peer reviewed studies showing positive effect for ivermectin. Similarly the single trial that the media touted as "proof" that HCQ did not work administered what amounted to an overdose to terminally ill patients, in contrast to the recommended early/prophylactic regimen.
These lies have gone on for far too long - no thanks to irresponsible and, frankly, inexcusable censorship by fb, youtube et al on grounds of "misinformation".
This site[0] has been up for over a year now and the citation count has continued to grow.
It seems people are more interested in poo pooing proponents of ivermectin/HCQ than actually examining evidence. Medicine should not be a political team sport.
0. ivmmeta.com
Just use google directly to find the trials I’m talking about, instead of being blinded by the ivm meta site creators (who created a similar site last year for HCQ). IvmMeta mixes in poor quality studies with studies that actually found no significant effect for IVM and claims they all are pro IVM.
I couldn't help but notice your use of purposely vague and misleading weasel words such as "positive effect".
Meanwhile I recall reading one of those ivermectin studies presented on another discussion on HN, and it certainly raised some red flags regarding how it was put together. For instance, if my memory doesn't fail me, it relied on an astonishingly small sample (100 patients, all reported as mild cases, divided into control and treatment) and to make matters worse the control group was given hydroxychloroquine instead of a placebo, effectively comparing ivermectin to hydroxychloroquine.
In the end the study reported that the fatality rate in the control and treatment groups was the same, and the only claim was that the statistical analysis suggested more patients from the ivermectin group were discharged earlier, which could very well be just statistical noise. Other than this the paper reported no benefit at all.
So, this is what weasel words buy: they are used to hide facts and misguide people. So unless you actually substantiate your claims and point exactly the very best study you feel shows that said "positive effect" is and how it was quantified, I have to dismiss your claim as something between a baseless assertion and blatant misinformation.
But then you pull a bait-and-switch in your own comment, complaining about just one study, which you completely neglect to cite (so it could be made up, for all we know). You subtly outsource your opinion, trying to lend it an air of objectivity by saying that it "raised some red flags" (after you accused him of using weasel words). You couch the whole comment in an air of faux fairness by writing as if you are some judge called upon to arbitrate a dispute, who just has to rule a certain way because, of course, that's what the evidence requires. And you imply that your unsourced complaint about one study invalidates all such studies, therefore he must be wrong.
You accused him of being purposely misleading, but at least he offered a link, and he didn't try to trick people into thinking that a criticism of one thing invalidates other things, which you did.
Your whole comment is a textbook example of propaganda techniques. And then you wonder why people don't know what to believe anymore. It's like the whole Internet is a political, psychological battleground for public mindshare, and the truth doesn't matter at all.
I did more than that: I pointed out not only the use of weasel words but also that no assertion is substantiated in what boils down to a baseless appeal to authority.
Consequently, it's critical that, for the sake of objectiveness and to avoid spreading misinformation, these personal assertions cannot be backed up by handwaving and instead must be supported by concrete evidence, such as references to said studies, if they exist at all.
I suppose it would be easier to just point out a single paper out of said 60 that supported the thesis that ivermectin works.
Somehow, in spite of the claim that there are so many papers, it seems it's impossible to actually find a single one that does support the claim.
Actually it is. The whole point of that was to illustrate the importance of actually looking into what these papers actually said, if they exist at all, instead of pulling the appeal to authority card with numbers pulled out of thin air.
The OP asserted that ivermectin worked. He proceeded to state that 60 papers report it. Well... Where are they? Can anyone like me actually take a look at one of these supposedly decisive papers? I'd be happy if I could just check the best one out of the hypothetical 60.
>I couldn't help but notice your use of purposely vague and misleading weasel words such as "positive effect".
This isn't a weasel word, this is exactly the correct term to capture the uncertainty considering that there has to my knowledge not been a large scale double blind RCT. But there are, once again, over 60 studies showing positive effect which, individually, are not absolute proof that the medicine works, but together clearly show promise. Your bias is rather extreme and frankly I don't appreciate your dishonest insinuation that I am somehow arguing in bad faith. Again, I linked a collection of more than 60 positive studies. It is unlikely that every one is poor quality and/or fraudulent.
Here is the link again[0], maybe you could actually click the link before responding, as you should have done previously. And yes, I've read a number of them. I can also provide the following [1] which suggests (in silico) the mechanism of action of ivermectin is inhibition of protease, which is the target enzyme of at least one other drug under development by pfizer for treatment of covid.
If you think "positive effect" is a weasel word then perhaps you do not understand the scientific process. I'm not claiming with certainty that ivermectin works, only that in light of, again, some 60 studies showing positive effect, inneffectiveness is unlikely. While you check these sources, please also check your rabid bias.
[0]ivmmeta.com
When a medical doctor prescribes a drug for a purpose that is currently being studied scientifically, that is not "alternative medicine". Ivermectin is still being studied. Hydroxychloroquine was emergency authorized by the FDA.
Take for example acetaminophen (aka paracetamol/tylenol): it is borderline ineffective, has been superseded by ibuprofen for almost all use cases, and the required dosage for its tiny effect is also very close to dangerous levels. Yet it is still the go-to drug of parents, GPs and hospitals for a range of ailments from the common cold to post-operative pain. "Good old paracetamol" is in every medicine cabinet in the Western world. I've told my folks a hundred times that it simply doesn't work, but they use it for pretty much any condition. Mum even gave it to her old dog. It's trusted like oxo cubes, Campbell's soup or a nice cup of tea. And that's why it's the foremost cause of acute liver failure in the Western world. While it hasn't had it's approval removed yet, I wouldn't be surprised if it did some day, and I doubt it would be approved today if it were being introduced.
Even so: is it still very much "medicine", not "alternative medicine".
This is only really accurate in a small window of analysis. It's been shown that paracetamol + ibuprofen has synergistic effects for most pain-related issues and paracetamol is superior to ibuprofen for migraine headaches; furthermore, the obvious correct headache drug of choice is aspirin/paracetamol/caffeine, aka Excedrin, which is vastly superior to ibuprofen.
I won't argue that paracetamol has acute liver toxicity issues (the largest drug of overdose problems, though a lot of this is intentional rather than accidental), but ibuprofen is abused in a chronic fashion with buildup over time leading to renal failure and worse (pro/amateur athletes are particularly at risk of chronic abuse issues).
I won't argue that paracetamol is way more dangerous than people think, and there should be far more warning labels (which J&J fights against), but I would be genuinely shocked if it got its approval revoked; similarly, I'd expect it to be approved if it was around today as well - especially if we knew about the synergistic effects it has with aspirin and caffeine.
Unfortunately, it means just "trusting a peer reviewed study" is even harder than it should be. You have to dig into the study to see if it even makes any sense which can be very difficult. And you have to follow the money, not "even" if the study says what you think it ought to say, but especially when it says what you want it to say.
Very disappointing when you go digging in.
It really is, as there is absolutely no evidence it has any effect whatsoever and at best it only serves as a placebo. In short, it's snake oil. Worse: politically-motivated snake oil.
Complementary and alternative medicines (CAMs) are treatments that fall outside of mainstream healthcare.
> Are the people participating in the scientific studies of the drug participating in alternative medicine?
Well the placebo group taking sugar pills for their cancer are not exactly going 'by the book' or lamestream healthcare and the active group taking whatever ... well lets just agree to disagree shall we?
Please let me know when a reputable study that undergoes peer review in an established and respected journal reports that the drug does work as their fans and militants claim.
Until then, keep in mind that "alternative" in "alternative medicine" stands for "hand-waving". As the old adage goes, alternative medicine that works does have a special name. It's called medicine.
There is one ongoing right now: Oxford University's PRINCIPLE trial. Until results of that trial are reported, about the only accurate thing anyone can say is that current evidence is ambiguous.
https://www.principletrial.org/news/ivermectin-to-be-investi...
Note: This isn't a political statement or criticism. It's Human Comms and Human Behaviour 101.
Seems pretty political to me.
Again. These are properties of human behavior.
If the peer reviewed research shows them to not be effective, and if snake oil salesmen figure out a business model to fleece people with it, that’s when it becomes “alternative” medicine.
Perhaps Snake Oil [1] is worth a study or two.
[1] - https://www.organicfacts.net/health-benefits/oils/snake-oil....
At least it can't be called a "horse dewormer".
The reference to "horse dewormer" is the fact that a substantial volume of people started actually ingesting horse dewormer bought straight from farm supply stores because ivermectin was listed as a component.
Demand for horse dewormer intended for this ad-hoc use grew so much that its availability was jeopardized, and in some cases ceased to be available to farmers who needed it to treat their cattle.
CNN used the term to falsely describe what Joe Rogan took to treat COVID - he did not take horse dewormer but a normal human dosage prescribed by a doctor.
Sure, there were reports of people taking horse dewormer and nobody objects that reporting, just the usage of the term in relationship to JR.