The Ivermectin Cautionary Tale


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Brian D. -

This was arguably one of the best EMRAP presentations I have heard. Great back and forth on the limitations of the medical literature in the era of COVID. Great lessons for all of us. Keep up the good work!

Gideon Meyerowitz-Katz is a very clever individual and a great speaker. It would be fantastic to hear from him again!

Marcel C. -

Please comment on the Brazil study published this month with 223,128 subjects testing Ivermectin prophylaxis.

Anand S. -

Marcel - thanks for raising this.
My initial thoughts: methodology is weak, unclear if patients assigned given ivermectin actually took it, serious COI from the authors, selection bias in terms of who got IVM and who didn't. They don't take into account whether patients were already taking ivermectin prior to the study. The follow up is a bit weak as well based on design. I also find it strange that the data was collected in December 2020 but not published for 13 months.
Finally, there are some issues in data reporting like the fact that there were no deaths in those < 30 before propensity matching but then there were deaths after propensity matching which is nonsensical.
Gideon has commented on this elsewhere:
Gideon Meyerowitz-Katz, an epidemiologist and Ph.D student from the University of Wollongong in Australia who often writes about COVID-19, said the research lacks critical information about the study’s participants, including how many Itajaí residents were already taking ivermectin before the program began and how many continued to take the full doses of the drug as prescribed.

"This sort of epidemiological study is very prone to biases resulting from characteristics that are inherently different between the intervention and control groups," Meyerowitz-Katz said. "There is essentially no information on how many people in either the intervention or control group actually took ivermectin, which is a fairly important consideration if that's what the authors were trying to investigate."

Also, here's a longer twitter thread from Gideon on the study:

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EM:RAP 2022 Special Report: The Ivermectin Cautionary Tale Full episode audio for MD edition 32:43 min - 35 MB - M4A