Talk:Ivermectin/Archive 1

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Archive 4

USE OF IVERMECTIN IN CAMELS

In Isiolo(Kenya)there has been an outbreak of an unknown disease that is killing camels without any symptoms. The animals dying are normally very healthy, either lactating or pregnant. Since the Minstry of livestock has not been able to diagonise the problem, Farmers are trying all sorts of medicines. Some farmers have tried the IVOMEC and are claiming to have stopped the deaths.41.223.57.34 11:21, 20 May 2007 (UTC)JAMES MACHARIA KARANI P .O. BOX 277 ISIOLO e-mail adress jamesmkarani@yahoo.com

Dangerous and illegal dosing information for pet owners

I am very concerned about the content in this article that advises dog owners of how to treat their pets with Ivermectin intended for cattle. The average citizen is not skilled in calculating drug dosages or administering drugs and could easily overdose their pet dog. Also, Ivermectin should not be administered for heartworm prevention unless the dogs are known to be currently free of heartworm disease. If a pet owner reads this information and administers Ivermectin to a dog that is infected with heartworms, it would cause a massive die-off of the microfilarial lifestage, which could cause kidney failure, respiratory distress, and an acute immune reaction by the dog. Basically, people could easily kill their pets by following the advice on this page. Also, it is illegal for a non-veterinarian to use veterinary drugs off-label, such as using a drug labelled for cattle in a dog. Please, for the safety of our pets, remove this off-label dosing information from this webpage. "A little knowledge is a dangerous thing." 03:46, 10 July 2007 (UTC) Someone who cares

Thanks for pointing that out. I made the changes. --Joelmills 04:01, 10 July 2007 (UTC)

Heartgard

This article ought to mention Heartgard to explain why it redirects here. ~ Booya ^Bazooka 18:05, 10 September 2011 (UTC)

Agreed. Ivermectin is the primary ingredient in Heartgard, used to treat heartworms in dogs (and perhaps other animals). I'm not sure I like the statement early in the article that Ivermectin is sold under certain brand names in various countries, as that list is certainly not completely inclusive, and sounds brand-preferential. IrishCowboy (talk) 23:12, 23 February 2012 (UTC)

All this talk of Heartgard and no one had added it :) I've added it. Cheers. P shadoh (talk) 19:47, 10 January 2014 (UTC)

Ivermectin Approved By FDA For Lice

See http://www.medscape.org/viewarticle/758988?src=cmemp - I don't have time to re-format the "Arthropods" section of the article. Paulburnett (talk) 21:50, 5 March 2012 (UTC)

Contraindications etc

There should be information in the article on contraindications, I'll find some info and try to add a section. Thanks. 152.38.65.133 (talk) 15:53, 20 April 2012 (UTC) Hey, it's the guy from above. I just made an account, and added some information. Hopefully, I can pull some people and information and expand the section a bit more. Cfowla (talk) 16:29, 20 April 2012 (UTC)

Potentially dangerous contraindication reported in grapefruit juice in humans. Source - http://www.everydayhealth.com/drugs/ivermectin - though some are suggesting it is good to use grapefruit juice as the extension of half life is a desired effect. — Preceding unsigned comment added by 2602:306:80A3:96D0:3E07:54FF:FE35:7D81 (talk) 04:12, 15 October 2016 (UTC)

Untitled comments

Where does the high toxicity information come from? It contridicts the previous paragraph that states it low toxocity in mamammals and gives a contradictory LD50. I am removing the high toxicity paragraph. --Richard Arthur Norton (1958- ) 06:08, 12 January 2006 (UTC)

It comes from [1]. The keyword in that phrase is pure. As used, most avermectin formulations contain very little actual avermectin, thus the low toxicity. Pure--undiluted--avermectin is highly toxic. I will restore that paragraph. --Lensim 03:21, 15 January 2006 (UTC)

In the Use in Humans paragraph, you mention that Ivermectin can be used for "certain scabies". I thought there was one species of scabies -- how many species of scabies are there, and which ones are not affected by Ivermectin? Margaret now 13:41, 14 March 2007 (UTC)

The particular edit you reference was made by User:68.57.36.46. See also Scabies. Lensim 16:18, 14 March 2007 (UTC)

Since when is an iPod nano a credible unit of measurement? This wikipedia entry paid for by Steve Jobs?

"Soolantra" Ivermectin cream

As of December 23, 2014, an Ivermectin cream called Soolantra has apparently been approved by the FDA for rosacea, per this press release. This information should probably be put into the article in some form. —BarrelProof (talk) 00:27, 1 January 2015 (UTC)

Eradication vs treatment of river blindness

Per the Carter Center:

"The Carter Center's Onchocerciasis Elimination Program for the Americas (OEPA) works to end illness and transmission of onchocerciasis in Brazil, Ecuador, Guatemala, Mexico, Venezuela, and Colombia....

As of September 2015, a total of 11 foci of the 13 endemic areas have eliminated or interrupted transmission as a result of health education and mass drug administration (MDA) with Mectizan®. Colombia (2007) and Ecuador (2009) became the first countries in the world to halt river blindness transmission through health education and semiannual distribution of Mectizan..... Thanks to these achievements, the Americas region will soon permanently free itself from the threat of this debilitating disease.

http://www.cartercenter.org/health/river_blindness/oepa.html — Preceding unsigned comment added by 73.162.132.47 (talk) 18:06, 5 October 2015 (UTC)

History

We don't need a MEDRS compliant source for the inventorship of avermectin, as MEDRS covers biomedical information only. Per MEDRS:

"This guideline supports the general sourcing policy at Wikipedia:Verifiability with specific attention given to sources appropriate for biomedical content in any type of article, including alternative medicine. Sources for all other types of content – including all non-medical information in medicine-related articles – are covered by the general guideline on identifying reliable sources rather than this guideline.:

Historical details of individual contributions to research is not medical content.

Omura's webpage states:

"The discovery of avermectins was the result of a collaboration with Merck Sharp & Dohme Research Laboratories."

The Nobel Prize Committe Press release states that

"Satoshi Ōmura searched for bioactive substances from the soil and isolated a new microorganism (Streptomyces avermitilis) with remarkable properties. William C. Campbell identified the antiparasitic activity of Ōmura’s microbial culture and characterized the effective component, named Avermectin, against a variety of parasitic worms in domestic and farm animals."

Please don't tell me you are suggesting that the Nobel Committee didn't do its research and that the co-Laureate is lying.

Annual Reviews in Pharmacology and Toxicology, 1992, 32:537 unambiguously states:

"The avermectins were discovered in 1975 at Merck and Co... They are produced by a culture that originated in a Japanese soil sample sent by the Kitasato Institute"

There's your MEDRS source if you require one.

73.162.132.47 (talk) 00:20, 6 October 2015 (UTC)

One of the revisions introduced a lot of passive voice into it, but looks ok now. Are you sure about Campbell and Omura "discovering the avermectin family of compounds". I got the impression that was mostly Omura, and that Campbell did the extraction of avermectin after getting samples from Omura. Later research at Merck developed ivermectin, which is what pharmcos do, to improve properties and make something they can patent. ~ juanTamad (talk) 03:10, 6 October 2015 (UTC)

That's what I thought. I think this raises legitimate questions of the discovery process. Omura discovered Streptomyces avermitilis and its "remarkable properties". What were those remarkable properties? Campbell identified the "antimicrobial activities."

If, as the entry reads now, "Omura identified avermectin from the bacterium Streptomyces avermitilis," that means Omura did the biggest part of the discovery job. He discovered Streptomyces avermitilis and avermectin, and handed the cultures over to Campbell for isolation and purification. So if Omura had already identified the bacterium and the drug, what was left for Campbell to discover?

But here's a version that says Campbell discovered and named avermectin:

https://www.bostonglobe.com/metro/2015/10/05/nobel-winner-there-some-way-can-verify-this/87yPyykypdfOrkDLUoSFmJ/story.html

Stunned Nobel winner: ‘Is there some way I can verify this?’

By Eric Boodman and Helen Branswell

STAT

October 05, 2015

Omura, a microbiologist who specializes in isolating natural compounds, sent Merck soil samples for bacterial research. But the freeze-dried samples sat on a shelf in the microbiology department for a year.

When Campbell and his colleagues in the parasitology department later came up with a new method for testing potential compounds against parasitic worms, the soil samples were tested.

To his astonishment, the samples contained a compound that paralyzed parasitic worms. That substance was named avermectin, which was later modified and named ivermectin.

--Nbauman (talk) 04:48, 6 October 2015 (UTC)

@Nbauman: I'd like to apologize for the overheated language I used above.

I think there is some confusion in the press regarding the process, which a lot of laypeople don't understand. My understanding from the more sophisticated sources is that:

1) Omuara's group specialized in obtaining novel microorganizm cultures and testing them for biological actiivity. They identified the bacteria that produces avermectin and detected that the crude extract of these bacterial cultures killed parasites

2) This by itself, did not complete the "discovery" of avermectin. Biological actiivity in crude cultures may be due to substances that are simply biocides or for other reasons, would not work in vivo. The discovery process was completed at Merck, where the spectrum of activity of the crude extract ws demonstrated to be of interest, the activity in animal models was confirmed and the active molecules in the crude culture extract were isolated and their chemical structure determined.

It is my understanding from the Nobel Committee press release, Omura's website, and the Annual Reviews paper. You guys can decide how to handle this, I will not comment further. Again, sorry for getting so overheated.

73.162.132.47 (talk) 10:00, 6 October 2015 (UTC)

Brand names

Is there any reason for this long list of international brand names in the introduction? There are so many more important things about ivermectin than its brand name in Canada or Nepal. I would keep the one or two most common brand names in the introduction, and move the rest to a section headed "Marketing," if we include it at all.

It is sold under brand names Heartgard, Sklice[1] and Stromectol[2] in the United States, Ivomec worldwide by Merial Animal Health, Mectizan in Canada by Merck, Iver-DT[3] in Nepal by Alive Pharmaceutical and Ivexterm in Mexico by Valeant Pharmaceuticals International. In Southeast Asian countries, it is marketed by Delta Pharma Ltd. under the trade name Scabo 6. While in development, it was assigned the code MK-933 by Merck.[4]

(Valeant is one of the companies that buys up small-volume drugs and raises their prices, so it might be interesting to find out whether they did the same to ivermectin.) --Nbauman (talk) 00:21, 12 October 2015 (UTC)

Archive 1

Archive 2

Archive 3

Archive 4

Infobox

I have hidden the Chemical data section of the infobox because something in there is breaklng the page and causing it to fill my browser window. It appears that {{nowrap}} templates are responsible, but I can't fix the error so I'll leave the section hidden. Cheers, Baffle gab1978 (talk) 02:42, 7 May 2016 (UTC)

User:Baffle gab1978 I am not seeing the problem. Maybe User:DePiep who is the expert in these things can help. Can you post a picture of the problem you see. Doc James (talk · contribs · email) 23:56, 7 May 2016 (UTC)

No USA FDA approved medicine for worms?

After some searches it looks like the FDA has not approved any medication for deworming in Humans in the USA. The article recommends this formula, but it can only be found available for horses, dogs and cattle. It should be discussed whether formulations for other animals can be taken by Humans as last resort and what are the dangers of doing do. — Preceding unsigned comment added by 108.30.56.204 (talk) 08:00, 3 September 2016 (UTC)

Hm. https://www.drugs.com/mtm/ivermectin.html looks like it's approved for the treatment of certain worm infections. Isn't Stromectol available in the US? --ἀνυπόδητος (talk) 07:22, 10 September 2016 (UTC)

Social Aspects Section

Perhaps a social aspects section could be added to discuss material such matters as donation of ivermectin by Merck, support for MDA by Carter Center, etc. This should be brief with link to main river blindness article (for example) as the prevention, treatment, and control of river blindness involves many other issues, such as vector control, treatment of water sources, and multiple drugs. Detailed discussion of social aspects ought to be in the river blindness article, rather than in this ivermectin article. The donations of ivermectin by Merck, support by the Gates Foundation, Carter Center, actions of WHO, national public health actions, etc are relevant. It didn't seem to me that this ought to be put in the medical uses section, though.Sbelknap (talk) 06:01, 22 December 2018 (UTC)

Bed bugs

We need a ref that ivermectin is used as a treatment. I am seeing nothing. Doc James (talk · contribs · email) 09:49, 26 December 2018 (UTC)

I've added a secondary source article in the body of the article supporting use of ivermectin for killing bedbugs.Sbelknap (talk) 21:15, 26 December 2018 (UTC)

Also, 99.9% of ivermectin use is for treating nematode infection. It seems odd that the lede begins with description of its use for arthropod infestation. Why was this change made?Sbelknap (talk) 21:18, 26 December 2018 (UTC)

The evidence supporting the use for bedbugs is very very weak. I have added some further concerns.

Among English speakers / readers of this article I would imagine lice and scabies are more common uses.

Were do you get the 99.9% figure? Doc James (talk · contribs · email) 10:20, 27 December 2018 (UTC)

The primary use in the EN speaking world would be lice and scabies both of which are very common. Doc James (talk · contribs · email) 18:45, 27 January 2019 (UTC)

Those of us who have been to places where filariasis and other nematode infestations are common discover that many of the healthcare workers prescribing and dispensing ivermectin speak English and many of the affected people speak English. Also, please understand the enormous scale of preventive treatment for nematode infestations. Through the MDP and its partners, including endemic countries, NGOs, the WHO, the United States Agency for International Development (USAID), the Department for International Development (DFID) and other donors and implementation organizations, more than 250 million people in 32 countries are reached each year for river blindness and LF. Since the inception of the program in 1987, Merck has donated more than 2.8 billion treatments for both diseases. In 2017, the Merck donation of ivermectin was expanded to provide an additional 100 million treatments per year through 2025 to support the elimination of LF globally, in countries where onchocerciasis is not endemic. Here's a link on Merck's donations: https://investors.merck.com/news/press-release-details/2017/Merck-Commemorates-30-Years-of-MECTIZAN-Donation-Program-Progress/default.aspx Sbelknap (talk) 19:08, 28 January 2019 (UTC)

River blindness affects 15.5 million. Scabies affects 204 million. Doc James (talk · contribs · email) 02:23, 30 January 2019 (UTC)

More than 350 million people will be treated this year with ivermectin for prevention/control/treatment of river blindness. Ivermectin is used for mass treatment of populations at risk for river blindness. I gave stats and link to the Merck page on this above.Sbelknap (talk) 04:52, 30 January 2019 (UTC)

Scabies is usually treated with topical permithrin or topical lindane, not ivermectin. (Arguably, ivermectin would be a better choice, but that is another issue.)Sbelknap (talk) 04:52, 30 January 2019 (UTC)

Both are common uses. Doc James (talk · contribs · email) 20:12, 30 January 2019 (UTC)

Eyes

This ref says "Importance of avoiding contact with eyes; if contact occurs, gently flush eyes with water."[2] Doc James (talk · contribs · email) 19:00, 13 February 2019 (UTC)

Price

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.

---

I fail to see why we have the price in the article, let alone in the lede. Pricing is typically a NOT and POV violation. Placing it in the lede moreso. --Ronz (talk) 15:00, 7 September 2019 (UTC)

The price is an important aspect of a substance / medication. Yes of course we have a very strong lobby which wishes to suppress pricing information but we are not censored.[3] Doc James (talk · contribs · email) 11:35, 8 September 2019 (UTC)

@Doc James:Please remove it from the lede if there are no sources available to demonstrate such prominence and encyclopedic value. If there's some wide consensus that applies, identifying those discussions would help as well. --Ronz (talk) 15:22, 8 September 2019 (UTC)

Ongoing lawsuits by industry to prevent having to disclose the price in commercials. Obviously that demonstrates that they are of encyclopedic value. Doc James (talk · contribs · email) 11:57, 9 September 2019 (UTC)

Sources? --Ronz (talk) 15:49, 9 September 2019 (UTC)

[4][5] etc. Yes industry wish to hide how much medications actually cost both from the general population. Doc James (talk · contribs · email) 02:00, 12 September 2019 (UTC)

Neither mentions ivermectin, correct?

If you are trying to have an exception to NOT and POV so we start adding prices for medication articles in general, this is a poor way to try to do so. Better if you started with a medication that's notable for it's pricing. --Ronz (talk) 02:21, 12 September 2019 (UTC)

• Hi, I came here as a Third Opinion. Pursuant to MOS:LEAD, The lead section should briefly summarize the most important points covered in an article in such a way that it can stand on its own as a concise version of the article. The price of this drug is not mentioned in the article, and even if it were mentioned, I doubt it would be one of the "most important points" unless there are sources which show that this drug's pricing is unusually noteworthy. So, I would say that the price should not be in the lead. May His Shadow Fall Upon You ^Talk 18:28, 17 September 2019 (UTC)

Also came here as a Third/Fourth Opinion (since it was still open). While I'm generally a fan of MOS:LEADREL, providing prices of drugs in the intro seems to be standard across Wikipedia, as can be seen in articles from Aspirin to Xanax. The issue may be resolvable with an RfC somewhere like Template talk:Infobox drug. My own instinct would be that the price of a drug (if stable and reliably sourced) is inherently a relevant and important piece of information regardless of whether you can write a paragraph about it. ─ ReconditeRodent « talk · contribs » 00:32, 18 September 2019 (UTC)

A "standard" in this case means it was added and not removed. I've yet to find any discussion. Xanax is a GA at least, and became a GA long before the pricing was added. --Ronz (talk) 03:12, 18 September 2019 (UTC)

Perhaps the price could be suitable for an infobox, but if the purpose of a lead paragraph is to summarize the article (which it is, as per the Wikipedia Manual of Style), then it would be inappropriate for the lead paragraph to contain something which isn't in the article - regardless of how useful that information may be. Just because this error has been made on other pages doesn't mean that it should be made here. May His Shadow Fall Upon You ^Talk 14:06, 18 September 2019 (UTC)

So basically we have one opinion in each direction... Have added it to the body of the text aswell. Doc James (talk · contribs · email) 04:01, 19 September 2019 (UTC)

Welcome back. Please revert. Can you address the policies?

How about we remove it from the lede, given the lack of sources demonstrating such weight? --Ronz (talk) 17:00, 19 September 2019 (UTC)

I've gone ahead and removed from the lede. Without better sources, it's a NOT and POV vio in the lede, and questionable in the article body. --Ronz (talk) 16:59, 26 September 2019 (UTC)

It is well sourced? I can add further references... Doc James (talk · contribs · email) 23:01, 26 September 2019 (UTC)

There's absolutely nothing that demonstrates encyclopedic value. That was my initial concern and remains.

Please revert and address the policies. --Ronz (talk) 23:03, 26 September 2019 (UTC)

Price is present in medical textbooks thus making it sufficiently notable.

Also here by the US government https://data.medicaid.gov/Drug-Pricing-and-Payment/NADAC-as-of-2019-09-25/s3gx-n3zd

Yes prices are a key aspect of a medication. It often determines if an individual or country is able to access a treatment.

Every version of the British National Formulary contains the price in the UK. Doc James (talk · contribs · email) 23:06, 26 September 2019 (UTC)

That's all OR. How about reverting it from the lede, then we can have an RfC.

Can I assume you've been adding prices to other medication articles? Should we start somewhere else to address the general case of all medications? --Ronz (talk) 23:20, 26 September 2019 (UTC)

There is pricing information in a lot of articles such as IPhone_11#Price. That article on medications and procedures contain prices is common practice. Doc James (talk · contribs · email) 00:56, 27 September 2019 (UTC)

agree w/ Doc James, pricing should be included--Ozzie10aaaa (talk) 01:03, 27 September 2019 (UTC)

That article on medications and procedures contain prices is common practice If this comment was intended to further the discussion or was in response to any concerns, then I don't know what it refers to. --Ronz (talk) 16:50, 27 September 2019 (UTC)

That we have lots of secondary source that mention prices is enough to support notability. It is at least as notable as the "molecular mass" and I am not suggesting we remove that. Doc James (talk · contribs · email) 23:03, 27 September 2019 (UTC)

Nothing but OR that demonstrates encyclopedic value, nor ignoring NOPRICES. --Ronz (talk) 14:35, 28 September 2019 (UTC)

NOT says, An article should not include product pricing or availability information unless there is an independent source and a justified reason for the mention. Encyclopedic significance may be indicated if mainstream media sources (not just product reviews) provide commentary on these details instead of just passing mention. Putting it in the article at all ignores the need for "commentary" rather than "passing mention". Putting it in the lede suggests that it is somehow related to it's notability. --Ronz (talk) 14:51, 28 September 2019 (UTC)

I'd hoped that discussions like Wikipedia_talk:WikiProject_Medicine/Archive_84#Price_of_medications would have been included, which concludes: Except in the cases where the sources note the significance of the pricing (which did have consensus), there is no consensus to add the pricing to the articles --Ronz (talk) 14:56, 28 September 2019 (UTC)

pricing, in this case(article), would benefit the reader...IMO--Ozzie10aaaa (talk) 02:31, 29 September 2019 (UTC)

Again, OR.

We have a content policy and an RfC already saying better sources are required. I take it if they were available, they would have been offered. It needs to be removed per policy, the RfC, and ONUS. Please do so. --Ronz (talk) 02:48, 29 September 2019 (UTC)

The content in questions is supported by multiple medical textbooks. These are not product reviews.

Ronz the majority of people commenting here disagree with you. Doc James (talk · contribs · email) 17:46, 29 September 2019 (UTC)

WP:CONLEVEL: Consensus among a limited group of editors, at one place and time, cannot override community consensus on a wider scale. --Ronz (talk) 22:01, 29 September 2019 (UTC)

Lots of excellent sources around pricing of this medication. Have added a bunch more. Interesting history in fact. Doc James (talk · contribs · email) 17:56, 30 September 2019 (UTC)

If you'll note, I was agreeable to including the content in the article body. I appreciate your taking time to find justification for that section of the article. However, I think you're ignoring all policy, all discussion, and the RfC still. --Ronz (talk) 18:24, 30 September 2019 (UTC)

Per Wikipedia:Prices "Wikipedia has no specific policy on presenting prices of products." Doc James (talk · contribs · email) 18:39, 30 September 2019 (UTC)

agree with Wikipedia has no specific policy on presenting prices of products--Ozzie10aaaa (talk) 18:51, 30 September 2019 (UTC)

An essay does not overrule policy. You two know better. Repeating your viewpoints gets us no where. --Ronz (talk) 19:48, 30 September 2019 (UTC)

Pricing, per policy, is not permitted in articles, with rare exceptions when the price is a significant part of something's notability or is very extensively commented on (not just mentioned). Seraphimblade ^{Talk to me} 03:17, 30 December 2019 (UTC)

If you disagree with the AN/I close you can start a discussion elsewhere. QuackGuru (talk) 12:47, 30 December 2019 (UTC)

All discussion so far supports removal: Wikipedia_talk:Manual_of_Style/Medicine-related_articles. --Ronz (talk) 17:32, 30 December 2019 (UTC)

Ah lots of discussion supports keeping it. Doc James (talk · contribs · email) 02:05, 31 December 2019 (UTC)

Absolute nonsense. --Ronz (talk) 02:31, 31 December 2019 (UTC)

Saying something doesn't make it true. Consensus is built on policy, not Argumentum ad populum. --Ronz (talk) 02:40, 31 December 2019 (UTC)

The consensus at MOSMED so far is that the content in this article violates OR and POV. --Ronz (talk) 02:48, 31 December 2019 (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.

Incorrect structural formula B1b

The isopropyl group in B1b (rightmost functional group) cannot have a chiral centre, the dashed line must be a solid line. — Preceding unsigned comment added by 85.212.126.195 (talk) 18:14, 4 April 2020 (UTC)

Infobox cleanup tag

There is a cleanup tag that says "Infobox/article is about two different chemicals, but many infobox fields are specific to only one of them." However, looking at one of the links shows that Invermectin is a mixture of both B1a and B1b so this is not a discrepancy. currently ref1 (used several times). RJFJR (talk) 17:51, 20 June 2020 (UTC)

@RJFJR: Ivermectin as a generic term or drug-material may refer to multiple/mixture. But I said "chemical". There is a single SMILES and a single InChI, and these tokens by their fundamental definition each refer to a single structrure (these each are specific to one of B1a or B1b. Contrast that with there being two different molecular formulas (one for B1a, a different for one for B1b). DMacks (talk) 13:37, 21 June 2020 (UTC)

Looks like these fields actually do contain the "mixture". What originally brought me here was desire to see 3D images of it. And they are clearly wrong (JMol fails for non-planar polycyclic-macrocycles using just connectivity data). DMacks (talk) 13:16, 22 June 2020 (UTC)

3D model fail?

I’m not seeing it in mobile browser. Technophant (talk) 21:10, 28 August 2020 (UTC)

Missing explanations

"Ivermectin is sometimes used as an acaricide in reptiles, both by injection and as a diluted spray. While this works well in some cases, care must be taken, as several species of reptiles are very sensitive to ivermectin. Use in turtles is particularly contraindicated" = It doesn't explain why. And the toxic schock caused by worms' toxines, and the method to avoid this (there are some). — Preceding unsigned comment added by 87.91.51.235 (talk) 12:04, 13 November 2020 (UTC)

New Research on Ivermectin vs. SARS-COV2 Should Be Publicized

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3570270

The research is being conducted this moment...and it is more than merely "notable"...the cautions and advisories of the FDA, etc. targeted to the civilian population who might misuse their dog medicine on themselves is valid, but equally valid is this emerging scientific data on the utilization of Ivermectin (interfacing naturally, the empirical issue of proper dosage metrics) against human Coronovirus… The above paper is only one among many recent "investigational' (but no less 'legitimate') papers re: Ivermectin and COVID2; experimental attempts by certain doctors and scientists to deploy the drug as "transliterated" into (safe, effective) human terms, are appearing every day, literally... Simply because an FDA-stamped, formalistic-bureaucratic decade-long clinical trial has not been done, given the pathogen is literally only a few months old as de novo, does not mean the efforts of these persons should be so thoughtlessly omitted, as in the current article... If anyone doubts top-level scientists, doctors, etc. are experimentally deploying Ivermectin in relation to the current Corona-pandemic, the most shoddy search engine can disillusion confused or ignorant minds here...

Um, there is no subjectivist delusion here. Currently, Ivermectin is being INTENSIVELY studied in relation to the Covid Pandemic and, in terms of human medicine, the entire medical world agrees the existing data more than warrant further attention and ideally, rigorous empirical application. The complexities involved in the unknown dosage metrics inevitable in humanly-transitioned testing (not touching upon for the moment the fallacious "FDA-Americanist legitimation theory") are daunting, and the ethical component is definitely serious, but the ENTIRE MEDICAL PLANETARY COMMUNITY IN TOTO minimally STRONGLY encourages future, ethically-grounded research apropos Ivermectin. "Investigational" trials not constricted by American, FDA regulatory shackles are actively being undertaken, popping up every day, gathering positivistic results, creating a wealth of empiricism of medicinal hard granitic brute datum, globally; and even in America, "unofficially," by independent-minded doctors and scientists, and more covertly, internal American governmental forces.

Do I really need to cite more, clog the article, etc.? The information regarding the subject is so exhaustively copious, one does not even know where to begin... YET, the little posted was hyper-aggressively deleted...so...what is really happening here...?

OKAY, HERE IS ONLY ONE OF THE MANY REAL-WORLD PHENOMENA THE ARTICLE COULD THEORETICALLY NOT SUPPRESS MENDACIOUSLY -

The French biotech/pharm company MedinCell has been directed (in syndicalist co-operative union) by the Bill Gates Foundation to divert millions of dollars originally intended for anti-malarial research, in the context of the present Corona-virus situation, to channel these millions into the utilization of Ivermectin (per MedinCell, in injectable form) in the "war" against the chaotic virus, to name only one of the most obvious examples...

https://invest.medincell.com/wp-content/uploads/2020/04/PR_MedinCell-Covid19-EN.pdf

As said, the information as relating to the subject-matter is so abundant, one is perplexed as to where to begin... The previous information was bizarrely deleted for unknown reasons. That was only one single, random "investigational" piece of the picture - its strangely rapid, schizoid and irrational deletion undermines the credibility of the editorial staff here seriously, to say the least...

I mean, are you...ahem..."editorial personages"...really doing your job here...? Wikipedia reports as significant the American FDA advisory against the consumption of veterinary heartworm, etc. medicine by the intellectually regressed American populace, but the deeper background and context of the whole subject, is going to be militantly censored? This is pure mischief, not scholarship. Who are these mysteriously motivated editorial activists...? — Preceding unsigned comment added by 2602:304:B34B:A940:8CD9:B248:72C8:B9E0 (talk) 10:13, 3 May 2020 (UTC)

It also has been promoted as a treament by dubious sources such as Surgisphere.[6] I tagged the article for the COVID-19 WikiProject so more interested editors may notice it. —PaleoNeonate – 07:00, 5 June 2020 (UTC)

The section on ivermectin's antiviral effects needs a major revision. Messy, inaccurate (SARS-COV-2 is a positive-sense RNA virus, not negative), and in general trying to get ahead of the research being done. In my mind, the most important point is that so far, no study has found clinical efficacy for ivermectin against any virus in human patients - all the promising results have been in cell culture or animal models. We must use caution when interpreting these results.Shiokla (talk) 08:37, 21 June 2020 (UTC)

Slightly out of date, being as it's over half a year old. If any of you really cared about developments you'd have rushed in here with updates from the studies by Marik and Kory.

Agree - Wikipedia is no crystal ball nor do we need to summarize news reports. When reliable medical sources weigh in, we can summarize neutrally. — soupvector (talk) 15:30, 17 November 2020 (UTC)

Additional COVID-19 Studies

Hipal (talk) requests that the following article content in section Ivermectin#SARS-CoV-2 be made less promotional in line with WP:SOAP, WP:MEDRS guidelines. Please assist. Many thanks. -- Sdesalas (talk) 00:55, 23 June 2020 (UTC)

On 10 June 2020, Florida Broward Health released results of front-line clinical study of 280 hospital patients showing an association between Ivermectin and lower mortality in confirmed COVID-19 infections. The study showed that the mortality of patients with severe pulmonary disease treated with ivermectin was less than half (38.8% instead of 80%) that of patients that did not receive the treatment.

References

Thanks for starting a discussion.

The reference fails MEDRS, so should not be used, correct? --Hipal/Ronz (talk) 01:52, 23 June 2020 (UTC)

Agree - should not be used to support medical claim. — soupvector (talk) 15:27, 17 November 2020 (UTC)

Advertising?

The mention of Sklice in the lead looks a bit like advertising. I can't see why a particular brand should be given prominence in this way. Arcturus (talk) 23:18, 28 November 2020 (UTC)

I agree, I've removed the paragraph for now. If there's some reason it should be kept and I'm just not aware of Sklice's broad importance to the article, I'm happy to be educated. Ajpolino (talk) 23:34, 28 November 2020 (UTC)

I think it was fine to remove it. The brand is mentioned, along with others, in the Society and culture section, so that should cover it. Arcturus (talk) 00:01, 29 November 2020 (UTC)

Unreliable sourcing

‎Magnovvig is edit warring[7][8] unreliable health claims into the article. Of particular concern is the re-insertion of a claim directly into the lede that "A five day course of ivermectin for the treatment of COVID-19 may reduce the duration of the illness", sourced to https://doi.org/10.1016/j.ijid.2020.11.191 which is a primary source and therefore unreliable for this claim per WP:MEDRS. The user is aware of general sanctions in this area which they are now in direct breach of. Pinging RexxS as an admin actively considering applications of these sanctions, to review this. In the mean time I suggest a self-revert, ‎Magnovvig, may be in order. Alexbrn (talk) 12:03, 15 December 2020 (UTC)

Hi Alexbrn I have now used Citation Bot to document what are considered genuine articles, so as to puncture your claim of unreliability. As your claim was invalid, my contribution cannot be considered an edit war. Magnovvig (talk) 12:08, 15 December 2020 (UTC)

First, Edit-warring is explicitly identified as not being about the content itself, but merely the behavior of doing the same edit repeatedly. Second, the concern is that your sources are not sufficient by wikipedia standards (WP:MEDRS in particular), even if you think they are "genuine" (itself an undefined concept). DMacks (talk) 12:14, 15 December 2020 (UTC)

Right, and per WP:General sanctions/Coronavirus disease 2019#Application notes the expected standards of behaviour are particularly strict here. It seems fairly obvious that this user doesn't understand what a MEDRS source is, which is fine. But doubling down on misinforming edits with battleground-y comments is not. Alexbrn (talk) 12:20, 15 December 2020 (UTC)

@Alexbrn and DMacks: I have blocked Magnovvig for 31 hours as an ordinary admin action because I cannot be sure that they were aware of the full implications of the general sanctions. I've now placed a banner notice at the top of this page. Please check through the disputed edits and remove any improperly sourced content. Thanks for your vigilance. --RexxS (talk) 15:42, 15 December 2020 (UTC)

Sounds like a good course of action. DMacks (talk) 16:14, 15 December 2020 (UTC)

"In November 2020 a meta-analysis found only weak evidence of benefit.[89]"

I propose changing this vague and ambiguous sentence to, "In November 2020 a meta-analysis found a 47% reduction in mortality (statistically significant) for Ivermectin-treated Covid-19 patients, however, due to a relatively small sample size (629 patients) the evidence is considered weak. [9]

AussiePete56 (talk) 04:28, 25 December 2020 (UTC)

Sorry - I put this in the wrong place AussiePete56 (talk) 04:32, 25 December 2020 (UTC)

We are meant to summarize for a lay audience, so the current text is superior, especially for omitting the confusing "statistically significant" term, and through not having the weak evidence labelled as only "considered" so, which is POV. Alexbrn (talk) 08:26, 25 December 2020 (UTC)

I submit that vagueness and ambiguity in an encyclopedia should never be accepted. Taking your comments on board, I propose changing the sentence to, "In November 2020 a meta-analysis found a 47% reduction in mortality for Ivermectin-treated Covid-19 patients, however, due to a relatively small sample size (629 patients) the evidence is officially deemed to be in the "weak" category" AussiePete56 (talk) 13:51, 26 December 2020 (UTC)

That's not a summary, and misleading with its strange "officially deemed" invention and scare quotes. The evidence is as the paper says "very low quality". Absent new sources, we're done here and I shall not respond further unless new good sources emerge. Alexbrn (talk) 14:40, 26 December 2020 (UTC)

I am responding to the request for a third opinion. My initial take looking over the edits is that there is large interest in information about experimental Covid treatments and there is interesting, sourced content to present here; however, presenting that information in a suitably circumspect way seems to be the key issue. Teishin (talk) 22:03, 27 December 2020 (UTC)

Thanks Teishin. My feeling is that Alexbrn is not complying with Wikipedia's prohibition on information suppression, and is not bringing a NPOV to his edits. The phrase "weak evidence of benefit" is both vague (exactly what is the benefit?) and ambiguous (a layperson could easily confuse this with "evidence of weak benefit") I fixed this dual problem with a single sentence. In response, Alexbrn said, "That's not a summary". It undisputedly is a summary of the meta-analysis, and I maintain, a better one than the original. He says that the phrase "officially deemed" is "strange" and misleading. It is a normal use of the English language and not misleading at all. However, I would accept deleting the phrase, "officially deemed to be". The charge of using scare quotes is false, since the word "weak" is indeed a direct quote and is therefore allowed under the guidelines. Alexbrn then goes on to write, "Absent new sources, we are done here." What new sources could he be referring to? I'm just trying to improve a vague and ambiguous sentence. He then closes down further discussion which is not helpful.

As a result of all this, I'm concerned that Alexbrn is ideologically committed to suppressing any information which favors the view that Ivermectin might turn out to be a safe and effective treatment for Covid 19 — Preceding unsigned comment added by AussiePete56 (talk • contribs) 01:04, 28 December 2020 (UTC)

NPOV is often difficult to achieve. People are motivated to edit because of their POVs. In this case it seems like there's a potential for mutually acceptable inclusion if it can be carefully worded. It's useful to consider that people with substantially different views about a matter will interpret seemingly obvious statements in non-obvious ways, as their perspective is so different. It's helpful to try to avoid any language incorporating value judgments unless those value judgments are sourced. Teishin (talk) 01:18, 28 December 2020 (UTC)

• Thank you, Teishin. I went back and consulted the source to ensure what Wikipedia had was correct. Wikipedia does not generally surface study figures in medical research, and to do so here it would need to discuss (per the source) how they are likely biased and based on methodologically unsound data gathering. In short, if anybody wants the full detail they would need to read the whole paper, but such detail is below the summary level of an encyclopedia. I did notice however we were not mentioning that this research was only into ivermectin's use as an adjuvant, for people with less-than-severe COVID symptoms, and have tweaked the text accordingly. Alexbrn (talk) 07:28, 28 December 2020 (UTC)

I see that Alexbrn's change is not any kind of compromise, but a doubling down on the suppression of the most important part of the study - the 47% reduction in mortality. He then goes to the trouble of stating that Ivermectin only showed benefit for people with mild symptoms - that there is no evidence that it works on more serious symptoms. In fact, of the 629 patients included in the study, 161 of them were moderate to severe cases, two-thirds of which were in the Ivermectin treated group. He then goes on to state that, "The World Health Organization and National Institute of Health abandoned trials of ivermectin for use treating COVID-19, because of a lack of promising evidence" and he gives a link to a study which says no such thing. It is hydroxychloroquine which was abandoned by the WHO and NIH.

Due to all these factors, I suggest that Alexbrn be encouraged to stand down as the editor of the Ivermectin page due to ongoing evidence of information suppression and a lack of NPOV. AussiePete56 (talk) 23:23, 28 December 2020 (UTC)

Every time you say [some number, therefore it's a significant effect and therefore we should report it], you are engaging in WP:OR analysis of the signifiance of primary-sourced data. That's fairly well forbidden even for regular articles, let alone the stricter standard for medical articles, let alone-alone a rapidly-changing one with such human impact. No, wikipedia is by consensus conservative and behind the curve of cutting-edge research. Instead, we wait for review articles to illustrate what is significant. DMacks (talk) 23:59, 28 December 2020 (UTC)

I suggest trying to eschew commentary about other editors so that a productive editing environment may be preserved. "Talk about the information, not the editors" is a good maxim.Teishin (talk) 01:45, 29 December 2020 (UTC)

AussiePete56 is however correct about the WHO/NIH position. My mistake - I misread the paper, apologies, I have removed this content. As for the rest, it would not be fair or encyclopedic to tease out an individual figure and re-frame it to give it more significance than the cited secondary source does. What we have is fine. Alexbrn (talk) 06:28, 29 December 2020 (UTC)

Thank you DMacks, Teishin and Alexbrn. DMacks said, "we wait for review articles to illustrate what is significant". Sir, the article in question is a review article - it is labelled "a systematic review and meta-analysis." It is a secondary source, not a primary source. You wrote, "Every time you say [some number, therefore it's a significant effect and therefore we should report it], you are engaging in WP:OR analysis of the signifiance of primary-sourced data." That is simply not true. The "47% reduction in mortality" figure is the RESULT of the secondary-sourced meta-analysis - it is the "answer" to the question, the object of the whole exercise. It is far and away the most important part of the entire meta-analysis, and it is a figure that has not been mentioned even once in any version of the summary that Alexbrn has so far produced. (By the way, that figure rises to 50% when the authors included a late-arriving study that missed their original deadline -see page three of the report)

Alexbrn takes up this argument when he wrote, "it would not be fair or encyclopedic to tease out an individual figure and re-frame it to give it more significance than the cited secondary source does." This is ironic on a couple of different levels. Firstly, How can I "reframe" that number when it hasn't been "framed" (mentioned) in the first place? The fact of this figure's suppression (inadvertent or deliberate) is the whole point of my argument. Secondly, earlier, Alexbrn objected to my inclusion of the phrase "statistically significant" (taken straight from the report) which he called "confusing", (see above), yet here he is apparently arguing that the phrase, "an OR of 0.53" is preferable to the phrase, "a 47% reduction in mortality." Obviously you can't argue both contradictory points at the same time. I suspect that not one person in a hundred would even know that "OR" stands for "Odds Ratio", or would know how to interpret an OR figure. I solved that problem by using the phrase, "a 47% reduction in mortality" which is the exactly correct interpretation of "an OR of 0.53 for the primary outcome of all-cause mortality".

Alexbrn has not addressed the issue of the falseness of his claim that Ivermectin's benefit is "for people with mild symptoms from COVID-19; there is no evidence for people with more serious symptoms". In fact, 31.2% of the study participants had moderate to severe symptoms. So I assume that deletion of this section of Alexbrm's current summary is non-controversial.

My suggestion for the replacement of the current summary is, "The first systematic review and meta-analysis of Ivermectin's therapeutic potential as an add-on treatment for Covid 19 revealed a 47% reduction in all-cause mortality - however the authors cautioned that the quality of evidence was very low." AussiePete56 (talk) 10:08, 29 December 2020 (UTC)

AussiePete56 what you seem to be missing it that this 47% figure has been effectively "framed" by the review, as being intrinsic to a very low-quality data set, as the source discusses at some length; hence its tentative overall conclusion. You have conjured the figure from that poor data in a way which the sources does not do itself, and then seem to be wanting to put it prominently out front and have text which sneers at the designation of the data as poor by using scare quotes or phrases such as "officially designated" (by which "officials"?). Wikipedia gives a high-level English summary and medical articles very seldom pull out single figures from data sets as that is not good summary style. As to severe cases of COVID, the source addresses this specifically, and I have included a quotation from the reference as a bonus. Wikipedia needs to be cautious and conservative on medical topics, especially on topics of high interest, and even more especially on topics (like this) where medical misinformation is at large all over the internet falsely portraying ivermectin as some kind of wonder drug "they" don't want you to know about. Your proposed edit would be subtly misleading in a way which feeds that narrative. Alexbrn (talk) 10:36, 29 December 2020 (UTC)

I have delayed replying to give DMacks and Teishin a chance to contribute, but I guess they have given up. The meta-analysis was written for a reader who has the ability to understand the concept of Odds Ratio and how to interpret OR numbers - Wikipedia is not. To explain here what an Odds Ratio of 0.53 means is perfectly reasonable, unless you want this detail to remain obscure to Wikipedia readers, which I suspect is the case with Alexbrn. He says that Ivermectin is falsely being portrayed as some kind of wonder drug, and he wants to push back against that. I'm in favour of clearly and accurately reporting the results of this meta-analysis, which can't possibly be reasonably described as "subtly misleading".

In the spirit of compromise, I have this suggestion to replace the current summary, "The first meta-analysis of Ivermectin's effect on Covid 19 patients found a modest utility of Ivermectin in reducing all-cause mortality and improving clinical outcomes" This is a direct quote from the "Conclusion" paragraph of the study. AussiePete56 (talk) 23:36, 30 December 2020 (UTC)

That still seems too complicated for Wikipedia's broad audience. --Hipal (talk) 00:42, 31 December 2020 (UTC)

Which part do you think was too complicated - the "modest utility" phrase? Would you prefer, "The first meta-analysis of Ivermectin's effect on Covid 19 patients found that Ivermectin reduced all-cause mortality by 47% and improved clinical outcomes by 98%"? I agree that's better, but Alexbrn wants to down-play effectiveness and emphasise unreliability, so I'm trying to compromise. AussiePete56 (talk) 01:42, 31 December 2020 (UTC)

It's more misrepresentation. The quoted text is not a "direct quote" of the article, and turns the source's finding of a suggestion (it says "suggests the modest utility of ivermectin ..."), into a flat out finding. The reason why the evidence is only suggestive (explicitly _not_ definitive) is because it is of such poor quality - something the article spend much time belabouring ... which is why Wikipedia summarizes it as it does. Anyway, having broken my resolution once, I am not not responding unless more sources are produced since we are now deep into WP:DEADHORSE territory. Alexbrn (talk) 02:23, 31 December 2020 (UTC)

AussiePete56, please focus on content and stop making comments like but Alexbrn wants to down-play effectiveness and emphasise unreliability, My feeling is that Alexbrn is not complying with Wikipedia's prohibition on information suppression, and is not bringing a NPOV to his edits. and which I suspect is the case with Alexbrn. Refactoring them would be helpful. Editing Wikipedia requires collaboration with fellow editors. --Hipal (talk) 02:49, 31 December 2020 (UTC)

Once again, you raise the issue of "more sources" which makes no sense in relation to the task of how to summarise the meta-analysis. You want to shut the discussion down because you are losing every argument. How immature. The study didn't "find a suggestion" - it "supports the finding of the effectiveness of Ivermectin as an add-on therapy for patients with Covid 19" and "suggests the modest utility of ivermectin in reducing all-cause mortality and improving clinical outcomes."

Here is another compromise suggestion for the summary: "The first meta-analysis of Ivermectin's effect on Covid 19 patients supports recent observational studies which have reported the effectiveness of this drug as add-on therapy in patients with COVID-19, and suggests the modest utility of ivermectin in reducing all-cause mortality and improving clinical outcomes." AussiePete56 (talk) 02:51, 31 December 2020 (UTC)

Hipal, do you have any suggestions on how to collaborate with someone who shut down the discussion before the issue is resolved? AussiePete56 (talk) 02:56, 31 December 2020 (UTC)

I already did: WP:FOC. If you're unable to do so, you'll have a very difficult time here at Wikipedia, and eventually face a ban or block. --Hipal (talk) 17:31, 31 December 2020 (UTC)

Remember that "resolved" is often substituted for "decided as one wishes." Remember also that "collaborate" involves the contribution of labor. It often happens that people are attracted to volunteering for Wikipedia because they wish to contribute on a pet topic (because of their opinions), and that topic happens to be controversial, so they bump up against people with different opinions. Clashes of opinion are the most aggravating aspects of editing here. Some of these clashes are difficult to resolve on the basis of the guidelines, as those are subject to opinion also. So, there's this grey area subject to forces of persuasion and credibility and, to mob factors. Because of all of these things, I would predict that there will not be an outcome here that you will consider to be successfully in the "resolved" category. While I am not siding here with shutting down the discussion, I think it is important to consider what your objective is. If your only objective concerns what this article says, then my suggestion is to look at the bigger picture of what everybody is trying to do here in order to get a better sense of what "collaboration" means in this context. If your objective is to become a volunteer editor for Wikipedia and this topic just happens to be your point of entry, I suggest you've picked a topic that is too difficult and contentious and that you should get a better sense of what "collaboration" here means from editing easier, less contentious topics. Teishin (talk) 18:15, 31 December 2020 (UTC)

Bad medical sourcing

Jcozzy, who is aware[10] of the general sanctions is trying to add non-WP:MEDRS content to the article, specifically in this[11] edit despite being previously told[12] that PMID 33234158 is not a reliable source. I am pinging RexxS and DMacks as administrators who have been actively considering how the COVID-19 sanctions might apply, to consider this. Alexbrn (talk) 06:20, 28 December 2020 (UTC)

Jcozzy substantially changed the claim between the first edit and the second, assuming good faith, it would appear to be an attempt to meet the objection that was raised. Teishin (talk) 15:16, 28 December 2020 (UTC)

The issue is that the sanctions say "Any content or source removed in good faith and citing a credible policy-based rationale should not be reinstated without prior consensus on the article's talk page". The unreliable source has be reinstated. We should not be basing medical content on unreliable sources, and violating sanctions, no? Alexbrn (talk) 15:34, 28 December 2020 (UTC)

Yes, the sanctions say that, but how was Jcozzy to understand what specifically you were objecting to? Teishin (talk) 15:55, 28 December 2020 (UTC)

From my original edit summary and because I spelled it out explicitly[13] on my own Talk page. Alexbrn (talk) 16:18, 28 December 2020 (UTC)

Thanks. It did not occur to me to look at your Talk page for history. But now the issue looks different to me. It looks like the problem is that Jcozzy failed to discuss the edit as requested and instead edited.Teishin (talk) 16:29, 28 December 2020 (UTC)

• I have to agree that this is not a reliable source. Ordinarily I might still consider it interesting enough to mention that such research is in progress, so this latest edit by Jcozzy might be acceptable. However given that there is a specific rule for this specific subject, obviously I agree with Alexbrn. Invasive Spices (talk) 20:49, 28 December 2020 (UTC)

Perhaps Jcozzy or someone who wished to pursue this issue could search to find an acceptable source. Teishin (talk) 21:21, 28 December 2020 (UTC)

The result of a Google Scholar search will, though, have a very low signal-to-noise ratio. A filtered PUBMED search[14] will be better, but even then a lot of this is now out-of-date. We already cite the WP:BESTSOURCES I think. The big picture here is that science seems to have moved on and for reasons I don't understand to do with US politics, the idea of ivermectin-as-wonder-drug seems to have become part of the COVID denial scene. We should also remember that, per MOS:MED Wikipedia does not say "Further research is needed" (or variants thereof) because it is banal, and likely to be misinterpreted. Alexbrn (talk) 08:43, 29 December 2020 (UTC)

False quotes

It seems like there are false statements on this page? "there is no evidence for people with severe disease.[85]" -> there is plenty of evidence at least:

https://www.researchsquare.com/article/rs-100956/v2 https://www.sciencedirect.com/science/article/pii/S1579212920302792?via%3Dihub https://journal.chestnet.org/article/S0012-3692(20)34898-4/fulltext - this notes that "Ivermectin treatment was associated with lower mortality during treatment of COVID-19, especially in patients with severe pulmonary involvement. "

This is a very strong statement to make "there is no evidence" -> could we replace it with something less contraversial? — Preceding unsigned comment added by 94.10.55.125 (talk) 22:20, 29 December 2020 (UTC)

The statement is WP:Verified by the cited source, which says:

the complication rate and mortality amongst patients with severe disease have been reported to be very high. In such patients the effectiveness of add on ivermectin has not yet been explored

If and when reliable, WP:MEDRS sources appear with different information, Wikipedia can follow. None of the sources you link are WP:MEDRS. Alexbrn (talk) 06:36, 30 December 2020 (UTC)

Actually, I think you are misinterpreting the source. The quote you include is followed by a footnote number (22) which, (if you look at the last line of the publication) refers to a study published in the Lancet back in March. It is not a reference to this meta-analysis. 161 "moderate to severe" patients were included in this meta-analysis, but they were not segregated into two separate categories, hence the comment, " In such patients (severe) the effectiveness of add on ivermectin has not yet been explored." AussiePete56 (talk) 12:16, 30 December 2020 (UTC)

You are simply wrong. Alexbrn (talk) 12:21, 30 December 2020 (UTC)

Contradiction is not rebuttal AussiePete56 (talk) 14:46, 30 December 2020 (UTC)

It is. If you are going to make assertions about "footnotes" which apparently follow a given quotation and change its meaning, but on checking the article has no footnotes and nothing follows the quotation other than a paragraph break, then we are in la-la land. Alexbrn (talk) 15:00, 30 December 2020 (UTC)

I have no idea what prompts you write that. The article has an entire page of references (page eight) which correspond to the footnote numbers scattered throughout the article, 20 such references in the Introduction alone. The reference number in question (22) is located between the last and second-last sentence in that paragraph. AussiePete56 (talk) 22:37, 30 December 2020 (UTC)

Ah, so you mean the reference number in the middle of the quotation? And that somehow is meant to modify the authors' meaning in the next sentence? That sounds like a stretch. The only thing I can think is that this secondary source is using "severe" to mean more severe (i.e. with complications) than the primary sources, or that the data are insufficient for the authors to consider there has been "exploration" of use of ivermectin in severe cases. Wikipedia could guard against these by having "there is no good evidence for people who have the disease most severely." Or by removing it entirely. Alexbrn (talk) 01:01, 31 December 2020 (UTC)

You're suggesting adding the word "good" in the sentence, "there is no evidence for people with severe disease"? I agree that that would be an improvement. Removing any reference to Ivermectin not being useful to people with severe disease would be better, since there are nine studies showing benefits for people with late stage Covid 19 disease - (average reduction in mortality - 75%) Even the NIH's own Ivermectin page references one such study. AussiePete56 (talk) 14:07, 1 January 2021 (UTC)

 Done. Removed. Alexbrn (talk) 14:11, 1 January 2021 (UTC)

Misinformation

This sentence seems to be a regurgitation of mainstream media propaganda: In December 2020, American politician Ron Johnson used a Senate hearing to promote fringe theories about COVID-19.[72] Among the witnesses was Pierre Kory, a pulmonary and critical care doctor, who erroneously described ivermectin as "miraculous" and as a "wonder drug" to be used against COVID-19. Video footage of his statements went viral on social media, receiving over one million views.[73]

Where are the reputable scientific studies referenced to prove that they were promoting "fringe theories" about covid? There is a large scientific body of evidence (including the meta-analysis already referenced by this wiki) that shows the effectiveness of Ivermectin. How is that a Fringe Theory?

For this to be an impartial wiki entry (instead of a politicization of treatment for a pandemic) the statement should be:

In December 2020, American politician Ron Johnson used a Senate hearing to promote public discussion about possible early and prophylactic treatment of COVID to try and save lives and reduce stress on the public health system by early treatment, since the late phase of the disease is extremely difficuly to manage.[72] Among the witnesses was Pierre Kory, a pulmonary and critical care doctor representing a group of highly published critical care specialists from major academic medical centers with collectively over 1,000 medical publications. Critical Care Specialist Pierre Kory was so excited about the potential benefits of prophylactic and early treatment with ivermectin that he described the drug as "miraculous" and as a "wonder drug" to be used against COVID-19. Video footage of his statements went viral on social media, receiving over one million views.[73] Mainstream media fact checking sites have jumped on his use of the word "miraculous" and "wonder drug" to discredit everything that he said, while one can argue that a drug that could have saved only 10% of the over 1,800,000 worldwide deaths (i.e 180,000 lives) could be classified as a miracle or wonder drug, Ivermectin has actually been shown to be much more effective than that in some studies, with not a single study not showing at least some benefit, one can easily make an argument for the use of Miraculous and Wonder Drug, especially considering it is widely available, cheap and safe. — Preceding unsigned comment added by Adriaandh (talk • contribs) 17:48, 31 December 2020 (UTC)

Welcome to Wikipedia. We work from reliable sources here on Wikipedia, not from original research. If you have reliable sources that support anything you've mentioned above, please identify them. You'll want to review what it means to present a neutral point of view as well. We don't simply dismiss or otherwise ignore high-quality references. --Hipal (talk) 22:08, 31 December 2020 (UTC)

"We work from reliable sources here on Wikipedia..." So why are we referencing an article written by a reporter with no medical training? AussiePete56 (talk) 16:09, 2 January 2021 (UTC)

See WP:RSCONTEXT (followed maybe by WP:EXCEPTIONAL, WP:MEDRS and WP:PARITY if you're genuinely interesting in understanding). Alexbrn (talk) 16:21, 2 January 2021 (UTC)

Given the impossibility of defining "miraculous", why does Wikipedia waste its time trying to disprove it? Stating that the use of the word "miraculous" was an error makes no sense. It was a piece of rhetorical hyperbole in a spontaneous unprepared speech to the Senate committee. Instead of looking at the data behind Professor Kory's claims, there is meaningless focus on that single word. Citing an article written by an un-named reporter who allegedly asked the opinion of a couple of alleged experts about the speech, falls short of Wikipedia's standards on verifiability and NPOV. AussiePete56 (talk) 14:15, 3 January 2021 (UTC)

Wikipedia neutrally reflects reliable sources. The "miracle" claim is repeated on the front page of the FLCCCCC web site too. It's this kind of quackery which has raised alarm: another RS is here which might be good to add. Alexbrn (talk) 14:32, 3 January 2021 (UTC)

Although I don't agree with the "miracle" claim, Alexbrn calling it "quackery", and defacto "erroneous" the claims of Dr Kory is unwarranted and may be biased. Especially in view of mounting evidence (not conclusive albeit ok) for the positive effect of IVM in both prophylaxis and therapy of covid-19. It is so because Alex accepts the view of 2 journalists and an oncologist as fact (!), against Dr Korry view (who is a proven, highly published lung specialist with already important and universally accepted contributions in covid therapy). I am humbled by the amount of research the team of Dr Marik (the FLCCC protocol is a collaboration under Dr Marik) has published in peer review journals. I give below just some indicative publication statistics:

https://www.semanticscholar.org/author/P.-Marik/3887524 756 pubs, 32900+ citations(!!) In particular covid research: 10+ publications, with already close to 100 citations and 3 highly influential ones.

https://www.semanticscholar.org/author/P.-Kory/3462977 79 pubs and 826 citations, 10's of highly influential ones. (I didn't bother to check the credentials of the oncologist in COVID therapy, but I'm sure his opinion is much less important, (As for the AP journalists: I reserve my comment for maybe later) Therfore I ask a moderator to replace the "erroneous" with disputed, and to reference the credentials of Dr Marik's team. Artemon ge (talk) 12:17, 6 January 2021 (UTC)

Hello and best wishes for the new year. We must also remember that it was official policy of the South Africa, and for many years, that AIDS is NOT(!)caused by HIV. So I would be extremely cautious here ,see: AIDS/HIV denialism. The Peru case is more interesting. In WP:RSCONTEXT WP:EXCEPTIONAL, WP:MEDRS and WP:PARITY I did not see a mention for research results published in clinicaltrials.gov: Is it a reliable source? Artemon ge (talk) 01:24, 6 January 2021 (UTC)

It's ironic that the South African regulatory authority quoted safety concerns for the banning of Ivermectin - after 3.7 billion doses taken over 40 years, the one thing Ivermectin indisputably has going for it is its safety. Even the WHO declares it to safe [[15]]

Prof. Kory was called a quack back in May when he gave his first address to the Senate committee recommending the use of corticosteroids against Covid 19 - that is now standard practise

If we are going to use an unnamed Associated Press reporter as a source of criticism of Prof. Kory's comments, then it should be balanced with a refutation of the same AP article. [[16]] AussiePete56 (talk) 06:44, 4 January 2021 (UTC)

It is really amazing that an APNews article written by a reporter with zero medical background without any references is fine to use as evidence that can shape medical treatment/narrative about a pandemic by wikipedia, but reviews of medical studies by experts in their fields are not. Read URGENT COVID-19 information. Another reputable scientific source stating that Ivermectin is a miracle drug in the context of this pandemic. The thousands of people that could have been saved since this information has been made public is keeping me up at night. I had a certain level of faith in the media and especially in sources like Wikipedia to actually be impartial and not reinforce clearly political hit jobs and smear campaigns against serious medical professions trying to save people's lives. In a few weeks time there will be nowhere to hide anymore and the mainstream media and public health authorities will be forced to accept the facts. All of these news sources that slandered these doctors's good names should make public apologies when that happens, but they won't. They will just act as though all of this is wonderful new information, that the science finally came in blah blah. This singular topic has opened my eyes to the state of the public discourse and so called "reliable" sources of information in the world today. This wikipedia page is shameful and unethical and contributing to unnecessary loss of life. Feel free to delete all of my comments on wikipedia and delete my account since I will not waste my time anymore trying to shape the information contained on these pages for it is clearly a fruitless and meaningless endeavor. I am glad I tried though, as now I know not to trust any of these pages. Perhaps I will come looking for reliable information in the Talk pages if ever I find a requirement to use wikipedia in future. — Preceding unsigned comment added by Adriaandh (talk • contribs) 03:09, 6 January 2021 (UTC)

Ivermectin in COVID-19

I edited the section Research/COVID-19 which was reverted by Alexbrn. There were two parts to the edit. The first part of the edit was simply to give the date for that the NIH guidelines on ivermectin were released. That information is on the NIH website. I will insist on my edit unless it incorrect or misleading in some way.

My edit:

The National Institutes of Health recommend against the use ivermectin for COVID-19,[86] in Covid-19 Treatment Guidelines released on August 27, 2020.

Alexbrn version:

The National Institutes of Health recommend against the use ivermectin for COVID-19.[86]

The second part of my edit was related to a meta-analysis of clinical trials on ivermectin.

My contribution was:

A meta-analysis funded by the World Health Organization showed an 83% reduction in mortality in hospitalized patients treated by ivermectin. A presentation of the work by Andrew Hill was given at "Ivermectin Against COVID-19 Collaborative Workshop", December 15-17, 2020, sponsored by MedinCell, S.A..

The contribution was removed in Alexbrn's version

The explanation give by Alexbrn was: "Unreliable source per WP:MEDRS, and misrepresented to boot". The source of information was a talk at a scientific conference on COVID-19. Unless there is a more specific justification of removal of this contribution I am going to insist that it is included. What exactly is "unreliable" and was is "misrepresented"? --Vrtlsclpl (talk) 21:41, 5 January 2021 (UTC)

See WP:RS and WP:MEDRS. --Hipal (talk) 23:15, 5 January 2021 (UTC)

Again, the material that was posted refers to a presentation at a scientific meeting. Is there a specific prohibition against such a reference? On the other hand, the guidelines specifically encourage references to meta-analysis of randomized controlled trials. That was exactly the subject matter that I referred to. The quote from the quidelines is as follows:

The best evidence for treatment efficacy is mainly from meta-analyses of randomized controlled trials (RCTs).[12]--Vrtlsclpl (talk) 00:17, 6 January 2021 (UTC)

It would be of great help if you could specifically indicate here on this talk page the reference, what you want changed, and why. --Hipal (talk) 00:55, 6 January 2021 (UTC)

The addition that I made and was deleted by Alexbrn was:

A meta-analysis funded by the World Health Organization showed an 83% reduction in mortality in hospitalized patients treated by ivermectin. A presentation of the work by Andrew Hill was given at "Ivermectin Against COVID-19 Collaborative Workshop", December 15-17, 2020, sponsored by MedinCell, S.A..

The reason for this entry is that the description of this pharmaceutical is missing important information in this Wikipedia article.--Vrtlsclpl (talk) 01:15, 6 January 2021 (UTC)

Thank you. So there's nothing published by a reliable medical source? --Hipal (talk) 03:06, 6 January 2021 (UTC)

I presume your question is rhetorical, but no, the meta-analysis presented at that conference is unpublished. Are you implying that presentations at scientific conferences are categorically prohibited as sources? I don't think anyone is questioning the authenticity of the video.--Vrtlsclpl (talk) 04:38, 6 January 2021 (UTC)

The "meta-analysis" is neither complete nor published. It's unreliable (and, as Hill sets out, based on poor quality data - which is why they are waiting for better data before finalizing the analysis, which did not "show" anything, other thn an interim result). We should know more later this month. Alexbrn (talk) 08:24, 6 January 2021 (UTC)

A meta-analysis of randomised controlled trials you say is "unreliable", but a since-debunked anonymous-reporter's AP article criticising Prof. Kory is OK?

If "On October 12, 2020 Peru withdrew its authorization to use ivermectin and hydroxychloroquine as COVID-19 treatments." is a worthwhile inclusion here, then why is, "In December 2020 the Central American country of Belize announced that it had begun using convalescent plasma and Ivermectin to treat patients of Covid 19 with severe symptoms." [[17]] not also a worthwhile inclusion? AussiePete56 (talk) 16:07, 6 January 2021 (UTC)

This comment is in response to the last comment of Alexbrn:

"It's unreliable (and, as Hill sets out, based on poor quality data - which is why they are waiting for better data ..."

In fact the investigator on the meta-analysis of the ivermectin studies never states or implies that his work is based on "poor quality data". That is a false statement. The investigator gives two reasons for including additional studies. The first reason is that there is the potential for publication bias (at 9:09 in the video). The second reason is to match the number of total patients in a previous clinical trial of Remdesivir in Covid-19 (at 10:24 in the video). Neither reason is based on any known limitation of the current study, but just based on general prudence to include as many studies as is reasonable.

My suggestion is that the reference to this scientific presentation be reinstated in this Wikipedia article. If necessary, the wording can be changed to make it clear that the investigator recommends that additional study be completed before ivermectin use is adopted.--Vrtlsclpl (talk) 17:26, 6 January 2021 (UTC)

This video is not WP:MEDRS. You are aware of the general sanctions in effect for this topic. We need to wait for more reliable source(s) to appear, which should be soon. Alexbrn (talk) 17:37, 6 January 2021 (UTC)

Agree. I don't see how it is reliable. --Hipal (talk) 17:39, 6 January 2021 (UTC)

I modified the statement referring to the NIH guidelines on ivermectin in Covid-19 to be the following:

The National Institutes of Health recommend against the use ivermectin for COVID-19, in Covid-19 Treatment Guidelines released on August 27, 2020.

This edit was removed by Alexbrn who states: "Rmv. as gives false impression guideline is not current. The date is in the reference."

The date is of central importance for these guidelines and should not be disclosed in a reference that most readers will not view. Providing relevant factual information should not be considered controversial. Wikipedia should allow readers to decide for themselves if a given publication date is relevant.--Vrtlsclpl (talk) 19:35, 6 January 2021 (UTC)

What is your source for it being "of central importance"? It's very odd to pull bits of a reference into text. You are aware of the sanctions governing this topic. Alexbrn (talk) 19:44, 6 January 2021 (UTC)

Agreed. I don't see any reference supporting such emphasis. Am I overlooking something? --Hipal (talk) 19:47, 6 January 2021 (UTC)

There should not be a requirement to provide supporting documentation to disclose facts in a Wikipedia article. The relevance of the date is that the majority of clinical research in the use of ivermectin in Covid-19 was completed after the publication of the NIH guidelines.--Vrtlsclpl (talk) 19:52, 6 January 2021 (UTC)

There should not be a requirement But there are. --Hipal (talk) 19:57, 6 January 2021 (UTC)

Right.Wikipedia's sole purpose is to reflect the knowledge of reliable sources. There is a policy: WP:NOR. If you want to present something as WP:WEIGHTy, you need some source as a basis for your argument. Alexbrn (talk) 20:00, 6 January 2021 (UTC)

The use of the Neutral-Point-of-View policy to suppress a publication date from the body of a Wikipedia article is a perversion of the review process. --Vrtlsclpl (talk) 20:18, 6 January 2021 (UTC)

The point is the guidelines is current and such guidelines are under constant review. Without that context showcasing a date implies it has some special significance. Alexbrn (talk) 20:20, 6 January 2021 (UTC)

You do not have any evidence that the guidelines are under "constant review". That is the implicit bias in the article as it stands. There should not be any presumption about the inner workings of the NIH. Wikipedia should be simply reporting on the known facts.--Vrtlsclpl (talk) 20:39, 6 January 2021 (UTC)

I think we're getting into tinfoil hat land now. Like any major health organization, the NIH will of course update its guidelines. It's an explicit process.[18] Anyway, you have your answers. Alexbrn (talk) 20:45, 6 January 2021 (UTC)

Just a general philosophical comment. NIH is made up of men and women just like the rest of us with competing interests and biases. To be a little more concrete, consider the recent failures of review at Lancet and NEJM - what you might call "major health organizations". The NIH should not be somehow immune to criticism as Alexbrn would have it. --Vrtlsclpl (talk) 21:09, 6 January 2021 (UTC)

They're not immune from criticism but they do remain highly-regarded sources of information. The NIH guidelines are greatly respected and written by widely recognized experts. At this point, it's premature to say whether Ivermectin is effective or not. As Alex mentioned earlier, these are "live" guidelines that constantly evolve when new and compelling information arise. TylerDurden8823 (talk) 21:52, 6 January 2021 (UTC)

I will make this final comment. As it stands this Wikipedia article is deceptive as it leaves the Wikipedia reader with the impression that the use of Ivermectin in Covid-19 is a lost cause. --Vrtlsclpl (talk) 00:59, 7 January 2021 (UTC)

Wikipedia mentions dates for all sorts of things. Dates are facts. I don't see how there can be a policy-based reason for excluding such a fact. Teishin (talk) 01:29, 7 January 2021 (UTC)

What is the policy-based reason for EXCLUDING the fact of Belize adding Ivermectin to their list of approved treatments for Covid 19, but INCLUDING the fact of Peru discontinuing Ivermectin?

I support the comments of Vrtlsclp. Certain moderators here have abandoned the principle of a Neutral Point of View on this subject. Points against Ivermectin are deliberately emphasised and highlighted, while points in favour are suppressed and minimised. AussiePete56 (talk) 01:38, 7 January 2021 (UTC)

Small fix requested.

In the lede there is a very scary sentence that could do with some tiny adjustment so that the subject is clear. I am not getting involved but figured there are others who have the reference handy and can see if just adding the words "of the parasite" after the bold text would be an acceptable addition.

"It works by causing the parasite's cell membrane to increase in permeability, resulting in paralysis and death.[3]"

Idyllic press (talk) 09:46, 8 January 2021 (UTC)

 Done. Thanks for the spot - have edited. It should be clearer now. Alexbrn (talk) 10:16, 8 January 2021 (UTC)

The following discussion is an archived record of a request for comment. Please do not modify it. No further edits should be made to this discussion. A summary of the conclusions reached follows.

The addition of the publication date of the NIH Treatment Guidelines is no longer necessary. The addition of the date was intended to imply that changes to the NIH were outdated. That was confirmed today by an update to the NIH treatment guidelines on Ivermectin. — Preceding unsigned comment added by Vrtlsclpl (talk • contribs)

---

WP:VET

This is one of the most popular pages in Wikipedia:WikiProject Veterinary medicine's scope. Very few editors watch WT:VET's pages, which means that questions may not be answered in a timely manner. If you are an active editor and interested in animals or veterinary medicine, please put WT:VET on your watchlist. Thank you, WhatamIdoing (talk) 19:56, 11 January 2021 (UTC)

McCullough et al, Rev Cardiovasc Med

@Jdphenix: - Why did you remove the edit I made? The edit is below

Evidence of the effectiveness of Ivermectin for the treatment of Covid-19 is growing.

References

• I think it's okay to use this source to say something like "36 trials were registered for ivermectin, used alone or in combination, at the end of 2020". The text used "evidence is growing" isn't supportable. Alexbrn (talk) 20:59, 13 January 2021 (UTC)

The text you suggest is OK. Also, to avoid interpretation issues let's just add the text from the article itself:

"There are a number of randomized and prospective studies and all have shown efficacy [of Ivermectin for the the treatment of Covid-19] in clinical outcomes ..."--Vrtlsclpl (talk) 21:17, 13 January 2021 (UTC)

I provided the reason for my revert in the edit summary. Feel free to continue to add bulk to this article in a section that already has an open RfC on how that very section is presented. (Sarcasm should be duly noted. I don't support adding any mention of this source or related content.) Jdphenix (talk) 21:47, 13 January 2021 (UTC)

I do see now that you left a note: WP:MEDRS. Can you elaborate though? Also, the RfC was restricted to the question of whether a publication date could be added to the body of a Wikipedia article. There is no reason to lock down the editing of that entire section of the article for the duration of the RfC which may be 30+ days. --Vrtlsclpl (talk) 00:09, 14 January 2021 (UTC)

The mention of the RfC was sarcasm. Regardless, I'm unconvinced the additional is an enhancement to this article's goal to be part of an encyclopedia. I'm standing on established science, which has already been noted as questionable per earlier arguments in the RfC thread.

My stance here should be known. The section needs to be a short summary. I even think a brief mention of the drug's promise with COVID-19 treatment is fine. Anything beyond a couple of sentences belongs here.

Actually, thinking about it, why not? Let's move most of the content on Ivermectin#COVID-19 there to expand that article's content and keep this one sane. Regardless of the dubiousness of the science here, the research and furor around it is notable for sure. Take a look at Hydroxychloroquine for an example of what I'm afraid of happening here. Jdphenix (talk) 00:37, 14 January 2021 (UTC)

And there we go. The repurposing article has a new section for Ivermectin now. I want to make sure that my opposition and reason is clear; this is an article about an individual prescription drug. It's dry and boring. Jdphenix (talk) 00:50, 14 January 2021 (UTC)

I will take "yes" for an answer. I added a few words to the sentence in the revision to improve the clarity in the COVID-19 article. As it stands though, there is an incompatibility between the two articles. I don't have a strong position on the relative weight of the coverage of Ivermectin between the two articles. But if the subject is not covered extensively in this article, would there be a clear redirect to the other article? --Vrtlsclpl (talk) 02:43, 14 January 2021 (UTC)

@Vrtlsclpl:, made a big change because I think we're on the same page (or at least close to it, pun absolutely intended!). Let me know what you think. Jdphenix (talk) 03:31, 14 January 2021 (UTC)

I'm good with that. In the next thread down there another editor is working on revision related to COVID-19. There needs to be coordination there too - I would think their work could just be added to the sister Wikipedia article on COVID-19 drug repurposing.--Vrtlsclpl (talk) 05:14, 14 January 2021 (UTC)

I think this is better than it was a few days ago for sure. I'd advocate for letting this (single article) sit for a few days to see what other editors' takes on it are. There has been a significant amount of discussion on this one and letting others catch a breath and read up would be in order. Jdphenix (talk) 14:29, 14 January 2021 (UTC)

RfC about the style of the COVID-19 section

The Wikipedia article states that the National Institutes of Health recommend against the use of Ivermectin against COVID-19. Should the publication date of the NIH guidelines be included in the body of the Wikipedia article?--Vrtlsclpl (talk) 15:42, 8 January 2021 (UTC)

Survey

• No. Or at least, not without adding some background about how the NIH is regularly reviewing[19] its COVID-19 Recommendations. The push to include a date (to "allow readers to decide for themselves if a given publication date is relevant" as the OP argues on this Talk page) is to imply that the NIH is somehow out-of-date, which is a typical talking point among the ivermectin advocates "out there" on social media.[20] It's a detail, but Wikipedia doesn't want to be playing that game. This is the NIH guideline and it is current, not stale. Alexbrn (talk) 15:58, 8 January 2021 (UTC)

• No No reference is offered, so it appears to be WP:OR. The date is part of the reference, so in that sense the material is already there. --Hipal (talk) 17:59, 8 January 2021 (UTC)

• Yes I propose the following language that should address the concerns of the above Wikipedia editors:

"The National Institutes of Health recommend against the use of ivermectin for COVID-19. Changes to the NIH recommendation were considered by the NIH Treatment Guidelines Panel on January 6,2021. No date has been provided for making the determination."

--Vrtlsclpl (talk) 19:51, 8 January 2021 (UTC)

And why would Wikipedia want to link to a churned fringe press release from a zero-reputation website to try and query the NIH (which in Wikpedia terms is a strong RS) ?

@Vrtlsclpl: You're modifying the RfC already? Since it's only the three of us responding so far, I suggest clearly noting at the top of this RfC your new proposal, and not making any further proposals. Use the discussion section below to formulate and discuss any further suggestions, especially potential references. --Hipal (talk) 20:50, 8 January 2021 (UTC)

Fair enough. I propose this language instead: "The National Institutes of Health recommend against the use of ivermectin for COVID-19 that were published on August 27. 2020. Changes to the NIH recommendation were considered by the NIH Treatment Guidelines Panel on January 6,2021. No date has been provided for making the determination." The second and third sentences are responsive to Alexbrn's conditions. The goalpost here is resolution of the language and we can only get there through proposal and counter-proposal.--Vrtlsclpl (talk) 21:55, 8 January 2021 (UTC)

Making a stand against mentioning a straightforward fact like a date doesn't seem reasonable. Teishin (talk) 00:46, 9 January 2021 (UTC)

• Yes I agree with Vrtlsclp and Teishin. Adding a date gives more information which is inherently unobjectionable. The fact that the majority of research into Ivermectin was concluded after that date lends that information relevance.

AussiePete56 (talk) 04:57, 10 January 2021 (UTC)

• Make a stand for neutrality The COVID-19 section is duplicative with the Misinformation section as it is. I propose the following rewrite, citing international guidelines. Additionally, place a notice on this talk page indicating that on the topic of COVID-19 or ongoing research of ivermectin for this article, changes require discussion before they are published. This article is intended to be a descriptive read about the most mundane of topics; one of thousands of drugs.

=== Misinformation ===

Main article: Misinformation related to the COVID-19 pandemic

There is a false perception that ivermectin is more effective than current guidelines for the treatment of COVID-19. This has led to some countries adopting clinical guidelines for their use at the detriment to patient safety. Additionally, "Injectable ivermectin formulated for veterinary use has also wrongly been used for treatment of COVID-19." "Recommendation Regarding the Use of Ivermectin as a Treatment for COVID-19". Pan American Health Organization. 2020-06-22. Retrieved 2021-01-08.

=== COVID-19 ===

The efficacy of ivermectin against SARS-CoV-2 is under study by several researchers. "Ongoing Living Update of Potential COVID-19 Therapeutics: summary of rapid systematic reviews". Pan American Health Organization. 2020-05-08. Retrieved 2021-01-08.

Jdphenix (talk) 04:08, 9 January 2021 (UTC)

I oppose the proposal of Jdphenix. One of the reasons I oppose it is that the meta-analysis is out of date. It was published on May 8, 2020. Also, the comment does not properly belong under this RfC. This survey is limited to a more procedural question of whether a publication date should be included in the body of the Wikipedia article.--Vrtlsclpl (talk) 14:47, 9 January 2021 (UTC)

I am proposing an alternative to the yes/no question due to the extensive discussion that led to now. My goal is to get the article back to stritly descriptive and verifiable statements. Individual editors don't WP:OWN content on Wikipedia, including the format of an RfC.

I'll let others handle the debate on the weight of international guidelines versus newer but less reliable sources. Have a good one! Jdphenix (talk) 16:54, 9 January 2021 (UTC)

Oddly enough I share some of the frustrations of Jdphenix. I will emphasize that, to this point, none of my edits to this Wikipedia article have been allowed. That is why I raised such a narrowly defined procedural question. Again, the question was whether a publication date should be included in the body of a Wikipedia article.--Vrtlsclpl (talk) 18:27, 9 January 2021 (UTC)

Please add that the NIH has met with the specialists on Ivermectin use for COVID and has indicated that they will review the evidence provided and update their recommendation (from August 2020) in February 2021. Currently the statement makes it seem like the NIH recommendation is current and final and any talk about Ivermectin use can be equated to flat eatherism. The only studies cited are very old and seems to be cherry picked to have something that can easily be said against them. Adriaandh (talk) 02:39, 10 January 2021 (UTC)

I agree with Adriaandh and support his suggestion, which is similar to Vrtlsclpl's AussiePete56 (talk) 05:28, 10 January 2021 (UTC)

• trialsitenews.com is not WP:RS. Is this covered by any proper reliable sources? I noticed that MedPage Today published something.[21] Alexbrn (talk) 09:46, 10 January 2021 (UTC)

Two sources have been provided thus far that report on the meeting of the NIH COVID-19 Treatment Guidelines panel to reconsider the Ivermectin recommendation. Here is a third from Newswise.--Vrtlsclpl (talk) 17:21, 10 January 2021 (UTC)

That's more churnalism. To repeat, is there RS? Alexbrn (talk) 17:24, 10 January 2021 (UTC)

That is an unreasonable objection. Such a meeting is in itself an uncontroversial event, and if three separate medical-news outlets reported it, common sense [[22]] allows it to be accepted as fact. AussiePete56 (talk) 03:20, 11 January 2021 (UTC)

If you can find a recognized news outlet, then it can be considered. But not self-published websites / press-release mills mirroring dodgy material from the FLCCCCC, who are not trustworthy. WP:WEIGHT is a thing you know. The push to try and retro-fit crappy sources in support of a pre-decided POV is getting tiresome. Alexbrn (talk) 07:44, 11 January 2021 (UTC)

This meeting is akin to "business decides to have a business meeting, business matters were considered, but not adopted." The whole mess around COVID-19 repurposing research is worth inclusion somewhere, but not on this article. COVID-19 drug repurposing research#Hydroxychloroquine seems like a better place. I really don't see why individual drug articles need more than a couple of sentences noting that there is ongoing research related to COVID-19, with a link to the re-purposing article. Jdphenix (talk) 15:02, 11 January 2021 (UTC)

Suppose, hypothetically speaking, I categorically oppose all of your suggestions, JdPhenix. Where do we go from there? I think you are objecting to the dryness of the discussion. Since the Wikipedia editors of this page are not able to agree on the prospects for Ivermectin in Covid-19 we can only nibble around the edges.--Vrtlsclpl (talk) 16:46, 11 January 2021 (UTC)

Disagreements can be resolved by WP:DR. But disagreements needed to be argued from a WP:PAG basis. Jdphenix's arguments are reasonable (even if I don't quite fully agree). OTOH, it is absolutely not the job "to agree on the prospects for Ivermectin" one way or the other. The dull duty of editing an encyclopedia mainly involves (1) Accurately identifying relevant, quality sources and (2) Summarizing them. The problem here is that some editors evidently have got a personal opinion on the "prospects for Ivermectin" and so are askew of their basic editing duties. Alexbrn (talk) 16:53, 11 January 2021 (UTC)

If you're opposed to all of my suggestions with no counter argument that I can see, then no additional discussions need to be had (between the two of us on this particular topic). We're at an impasse and it wouldn't be resolved without a third-party. (Note - I actually came to this article in response to this being on the RfC list as such a third party.) Jdphenix (talk) 17:42, 11 January 2021 (UTC)

@Jdphenix: I'm not sure if you're addressing me but I'm not "opposed to all your suggestions"; I'm sympathetic. But I also think we need some "Culture & Society" / misinformation coverage, as this is warranted by the weight of sourcing. You could always try a WP:BOLD edit? Alexbrn (talk) 17:46, 11 January 2021 (UTC)

@Alexbrn: I was not addressing you. My apologies for the misunderstanding. I'm not going to edit the COVID-19 section or misinformation section during this discussion. It's clear there isn't consensus on how this article should be written, and I appear to be the lone voice in my desired style for it (at this moment in time). Jdphenix (talk) 17:48, 11 January 2021 (UTC)

Respectfully, I am going to summarize progress on this RfC to this point with the intent to close this discussion if there is no objection in the next day or so. Of course the general discussion can continue outside of the RfC. I thank contributors for their input. I count two explicit "NO" votes, three explicit "YES" votes. I note two contributors with comments but without explicit votes. I also note that one contributor, Alexbrn, has made a proposal, (paraphrased) that the date of the last meeting of the NIH COVID-19 Treatment Guidelines Panel can be included but with context. Hopefully there is consensus for the following: The date of the last meeting of that panel is added to the body of the Wikipedia article. If others prefer, they can add in context to accompany that date.--Vrtlsclpl (talk) 17:22, 11 January 2021 (UTC)

RFCs generally run for 30 days and need an independent closer, often an admin. An involved WP:NAC would be problematic and disruptive. You also misrepresent my position (which is why we need an independent closer). If the RFC runs to term it's likely more editors will stop by. Alexbrn (talk) 17:33, 11 January 2021 (UTC)

• Weak no on the one hand, including the date of a review is fine, and we do that with lots of meta-analyses in medical articles. However, our goal here is to give the reader an accurate impression of the mainstream view on a topic. We do that by summarizing what high-quality sources say about the topic. If folks feel the mainstream view is missing something, then that's a problem that should be brought elsewhere (we have a news-focused sister project that I know nothing about; perhaps that's a better place for living on the edge of the news). It seems the purpose of including the date here is to undermine the credibility of the NIH position by making it seem dated, and so I can't support it. If the NIH wishes to change its position, I'm sure it has the ability to do so, and we'll update our article accordingly then. Until then, I'd prefer we just state what the institutes' position is. Perhaps folks can add more detail at a more covid-centric article. But here, it seems somewhat undue. Ajpolino (talk) 18:02, 11 January 2021 (UTC)

The time course of an RfC is not constrained by Wikipedia but I will leave the RfC open. On the comment by Ajpolino that Wikipedia should represent the mainstream view. Agreed. Essentially, the question we are trying to resolve is "What is the mainstream view?". I think that editor may be equating the mainstream view with the view of the US government and the World Health Organization. Other governments view this issue differently. The government of Uttar Pradesh, a large province in India distributed this drug widely for COVID-19. There is also widespread use of this drug against Covid-19 in latin america with official government support in the Dominican Republic and Belize. The province of Chiapas in Mexico has distributed this widely to the population. The "mainstream view" should not be defined to be synonymous with the view of the most powerful organizations.--Vrtlsclpl (talk) 19:07, 11 January 2021 (UTC)

"I think that editor may be equating the mainstream view with the view of ... the World Health Organization"; that is an incorrect characterization of part of my argument. Based on WP:MEDRS, the WHO is definitely considered a high quality source, and my recommendation above is based on position statements from the same. Jdphenix (talk) 19:18, 11 January 2021 (UTC)

For better or for worse, I think the medical mainstream is more influenced by large nations' health regulatory bodies (or in NIH's case, health research bodies) than by smaller nations' or states' regulatory bodies. The fact that Uttar Pradesh, DR, Belize, et al. have distributed ivermectin widely for covid is interesting and important. It should probably be described here or (perhaps more appropriately) at some more covid-focused articles. But it's no reason to add a date to our mention of when the NIH's guideline is posted. Ajpolino (talk) 20:20, 11 January 2021 (UTC)

"at some more covid-focused articles"; this is a concise description of my view. Jdphenix (talk) 20:29, 11 January 2021 (UTC)

I agree we need to avoid a shopping list of countries (/states!?) that approve or ban ivermectin: that way madness lies. And if we do cover it somewhere, we need to be careful not to misrepresent it either by being partial (I notice the ivermectin boosters are quiet about Australia and South Africa), or by skewing what the sources say: in Belize, for instance, it seems Ivermectin is distributed in a bid to head off people dangerously self-medicating with veterinary supplies, not because they believe it's a miracle drug for COVID-19.[23][24] Alexbrn (talk) 21:13, 11 January 2021 (UTC)

• No The date of the NIH guidelines may never change, if the guidelines do not change. As a result, including this information may create a misleading impression that the underlying science informing the guidelines is becoming more and more outdated. In actual fact, the guidelines can be considered entirely up to date, and research conducted since their initial publication has not been sufficient to warrant publishing any different guidelines subsequently. Awoma (talk) 20:46, 11 January 2021 (UTC)

The comment above states that the government of Belize authorized the use of Ivermectin to "...head off people dangerously self-medicating..." That is not supported by their second reference. Here is an extended quote from the reference in that comment:

"But the medical response team along with our Ministry of Health team here we sat down and we revised the research papers, all the articles, everything that we could to look at Ivermectin and its use in other countries and its use in protocols in other countries and we found that it had significant evidence that it has been beneficial in reducing the viral replication – so the multiplication of the virus in your body and some studies have also shown that it has helped with prophylaxis as well. So when we look at the pros and cons with using Ivermectin a decision was made to put it on our protocols for many reasons. It has a significantly high safety profile, it is effective, it is accessible and it is cost effective as well."[25]

Regarding the inclusion of a statement on use in different countries: I hate to drop such a strong card - to include a date in a Wikipedia article is almost the definition of verifiable and relevant. However, if there is consensus around exact language that's fine with me. --Vrtlsclpl (talk) 21:04, 11 January 2021 (UTC)

" we need to avoid a shopping list of countries (/states!?) that approve or ban ivermectin... (I notice the ivermectin boosters are quiet about Australia and South Africa)" - Alexbrn.

I heard that for quite some time, South Africa had an official policy that AIDS was not caused by the HIV virus, so their recent decision to ban ivermectin for Covid 19 treatment is perhaps not surprising. As far as Australia is concerned, doctors here are already free to prescribe ivermectin to treat Covid 19, as it is the right of every doctor to treat their patients as they see fit, taking into account the most recent medical evidence.  [[26]] If doctors in the USA are more hesitant to venture away from the official policies of the NIH, CDC, FDA etc, it could be less about concern for patient welfare and more about America's notorious litigious culture. If Wikipedia's official policy regarding medical issues is to report "official" guidelines while ignoring latest research, it could be just following down the rabbit-hole this culture which has resulted in the highest per-capita spend on medicine in the world, whilst delivering vastly inferior results compared to many other countries. [[27]]

Apparently you have an aversion to comparing countries, let alone states, on their decisions about ivermectin and Covid 19, but this one example illustrates why your anti-ivermectin position is so very wrong. Only one of Mexico's dozens of states used ivermectin to treat Covid 19 - see if you can guess which line in this chart represents that state... [[28]]

AussiePete56 (talk) 16:20, 12 January 2021 (UTC)

• No. Wikipedia is by definition behind the ball. We cannot introduce language that could read as potentially middling. If the recommendation changes, then the information will change at that time. Until such as time, this is the current recommendation. Ajpolino mostly already summarizes my view on this. Kingofaces43 (talk) 17:11, 12 January 2021 (UTC)

It is a slippery slope to exclude relevant facts from a Wikipedia article. The only real meter stick is whether something is true and relevant. The "...could read as potentially middling." (meddling?) is not a Wikipedia standard and would be impossible to apply uniformly. --Vrtlsclpl (talk) 17:44, 12 January 2021 (UTC)

Relevance of this particular meeting is this discussion. I remain unconvinced it's relevant. Jdphenix (talk) 18:49, 12 January 2021 (UTC)

A metaphor if you will - a company considers Java to build it's great new product, but decided something different. Does that company's consideration of Java get included on Java (software platform)? No, it wouldn't. Jdphenix (talk) 18:54, 12 January 2021 (UTC)

A better metaphor would be, that if dozens of studies suddenly confirm that Java users are discovered to have a dramatic level of immunity to an otherwise deadly pandemic sweeping through the world - would that fact get included on Java (software platform? Yes it would.

AussiePete56 (talk) 01:26, 13 January 2021 (UTC)

I think you are referring to the meeting of the NIH advisory committee on Covid-19 treatments that was held last week to discuss the use of Ivermectin in Covid-19 (although some in this thread deny that it occurred.) It is significant because a major perception is that Ivermectin in Covid-19 is a conspiracy theory. The simple existence of that meeting dispels that notion. --Vrtlsclpl (talk) 19:14, 12 January 2021 (UTC)

That is the meeting I was referring to. Those in this discussion raising WP:MEDRS concerns are not doubting that the meeting itself occurred, but if it is worth mentioning. (If there is actual doubt that the meeting itself occurred, why are we burning time on this again?) Additionally, we're not trying to write a piece that corrects misconceptions are certain POVs on what is a conspiracy theory. We're just writing an encyclopedia. You already know my proposal for this article. Jdphenix (talk) 21:17, 12 January 2021 (UTC)

I disagree. I think the fact that an NIH Panel met last week to discuss changing their recommendation on Ivermectin for COVID-19 is important. To this point, there has been radio silence in the media on this topic. --Vrtlsclpl (talk) 21:50, 12 January 2021 (UTC)

And why do you think that might be? Alexbrn (talk) 21:54, 12 January 2021 (UTC)

Various reasons. Herd mentality. Deference to medical establishment. General lack of sophistication in medical research. Fundamentally, it is probably due to the opposition of pharmaceutical companies. --Vrtlsclpl (talk) 22:17, 12 January 2021 (UTC)

Facepalm Alexbrn (talk) 22:21, 12 January 2021 (UTC)

@Vrtlsclpl:, I'm not sure how an argument paraphrased as "this meeting was important because the worldwide pharma cabal is suppressing it" enhances your position here. Jdphenix (talk) 22:43, 12 January 2021 (UTC)

I agree. But the skepticism of the positive findings of Ivermectin for Covid-19 boils down to one single article of faith: the pharmaceutical industry would not commit such an atrocity.--Vrtlsclpl (talk) 01:06, 13 January 2021 (UTC)

I'll continue this discussion once provided with WP:RS with information about worldwide effort by pharma to suppress COVID-19 therapeutic treatments. Especially take a read over WP:FRINGE. Jdphenix (talk) 01:39, 13 January 2021 (UTC)

My point is the following: My viewpoint of Ivermectin in Covid-19 rests on a large number of scientific studies. Your argument rests on the belief in the basic goodness of the Pharmaceutical industry. Which of our views is more broadly accepted is probably besides the point and probably also unknown at this point. Vrtlsclpl (talk) 02:08, 13 January 2021 (UTC)

• No. I'm with Alexbrn on this one, based on the points provided. Idealigic (talk) 15:40, 13 January 2021 (UTC)

Discussion

FYI, we've made significant changes to the section in question for this RfC. This diff shows those changes. Jdphenix (talk) 14:32, 14 January 2021 (UTC)

References

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.

NIH COVID-19 Treatment Guidelines Panel’s Statement on the Use of Ivermectin

One week after Dr. Paul Marik and Dr. Pierre Kory – founding members of the Front Line Covid-19 Critical Care Alliance (FLCCC) – along with Dr. Andrew Hill, researcher and consultant to the World Health Organization (WHO), presented their data before the NIH Treatment Guidelines Panel, the NIH removed their previous guidance recommending against using Ivermectin, replacing it with neutral guidance which states "The COVID-19 Treatment Guidelines Panel (the Panel) has determined that currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin for the treatment of COVID-19." Thank you Alexbrn for removing the biased and inaccurate "Misinformation" section, but I believe it's appropriate to add the fact that the NIH issued updated guidance to the COVID-19 research section. The FLCCC Alliance characterized the situation by saying "Their recommendation has now been upgraded to the same level as those for widely used monoclonal antibodies & convalescent plasma, which is a “neither for nor against” recommen­da­tion. The significance of this change is that the NIH has decided to no longer recommend against the use of ivermectin in the treatment of COVID-19 by the nation’s health care providers. A consequence of this change is that ivermectin has now been made a clear therapeutic option for patients." A better summary of the state of COVID-19 Ivermectin research, including a mention of the best peer-reviewed RCTs and the observational studies in areas where Ivermectin is widely used would be appropriate (given that this section is labeled "Research", and that we would not be reaching any conclusions).Tvaughan1 (talk) 06:06, 15 January 2021 (UTC)

Per previous discussion any detail on this is now at COVID-19 drug repurposing research. Alexbrn (talk) 07:35, 15 January 2021 (UTC)

As Tvaughan1 seems to be stating, the update to the NIH guidelines is an extraordinary development. As Wikipedia editors, hopefully we can make a positive contribution by helping the public better understand this therapy. As always we would welcome further editors - especially those with more hard-core clinical expertise --Vrtlsclpl (talk) 15:43, 15 January 2021 (UTC)

I'd say it was a routine development. Guidelines get updated in response to changes in the underlying evidence all the time, and it has happened a lot during the pandemic. Anyway, the relevant page is now updated. Remember, although Wikipedia reflect accepted knowledge, it never gives medical advice. Alexbrn (talk) 15:51, 15 January 2021 (UTC)

I think the first appropriate step in response to the NIH decision would be to add a section to this article titled: "Medical Uses/COVID-19". Since there have been contentious discussions on editing this article I will first ask for consensus on addition of that section and also for some baseline text.--Vrtlsclpl (talk) 15:57, 15 January 2021 (UTC)

Haven't we just been through a long process of discussion that resulted in shifting this content to the repurposing article? I would strong oppose reversing that, especially since the sources say ivermectin has no clinical relevance for COVID-19. Alexbrn (talk) 16:01, 15 January 2021 (UTC)

There is absolutely no reason to add a COVID-19 subsection to Medical uses. As long as this is an investigational, off-label use, it belongs in the Research section and elsewhere (ideally, the repurposing article). If and when reliable evidence emerges and this use becomes established *and approved by regulatory agencies*, then addition would be appropriate. Fvasconcellos (t·c) 06:39, 16 January 2021 (UTC)

By the way, the editor mentions "regulatory agencies". The editor needs to be more specific. Which regulatory agency in which country? --Vrtlsclpl (talk) 06:52, 16 January 2021 (UTC)

Review articles for COVID content

These very recent articles might be helpful to people who are trying to get current information into the article:

• Kaur, Harpinder; Shekhar, Nishant; Sharma, Saurabh; Sarma, Phulen; Prakash, Ajay; Medhi, Bikash (2021-01-03). "Ivermectin as a potential drug for treatment of COVID-19: an in-sync review with clinical and computational attributes". Pharmacological reports: PR. doi:10.1007/s43440-020-00195-y. ISSN 1734-1140. PMC 7778723. PMID 33389725.
  • Notes: Proper peer-reviewed, secondary review article. The journal is MEDLINE indexed and ranked 67th percentile by Scopus (=better than two-thirds of pharmacology journals) with a five-year impact factor of 2.8 (good). This is a solid source, and the full text is available free online.
• Martin, Richard J.; Robertson, Alan P.; Choudhary, Shivani (January 2021). "Ivermectin: An Anthelmintic, an Insecticide, and Much More". Trends in Parasitology. 37 (1): 48–64. doi:10.1016/j.pt.2020.10.005. ISSN 1471-5007. PMID 33189582.
  • Notes: Proper peer-reviewed, secondary review article. The journal is MEDLINE indexed and ranked 96th percentile in parisitology and 95th percentile in infectious disease by Scopus (=one of the very best journals for this subject) with a 2019 impact factor of 6.9. This is a solid source from a highly reputable journal, but it appears to be behind a WP:PAYWALL.
• Kinobe, Robert T.; Owens, Leigh (2021-01-11). "A systematic review of experimental evidence for antiviral effects of ivermectin and an in-silico analysis of ivermectin's possible mode of action against SARS-CoV-2". Fundamental & Clinical Pharmacology. doi:10.1111/fcp.12644. ISSN 1472-8206. PMID 33427370.
  • Notes: Proper peer-reviewed, secondary review article. The journal is MEDLINE indexed and ranked 59th percentile in pharmacology by Scopus with an impact factor of 2.75 (good). This article is in a reputable journal, but the subject of the article is largely about non-human testing (which WP:MEDRS discourages), and it appears to be behind a WP:PAYWALL.

This is a complete list of all the MEDRS-compliant articles indexed at PubMed for the current month. In terms of what they say, a brief glance suggests that they converge on two key points:

1. There isn't enough evidence to know whether ivermectin produces a clinically significant benefit in people, but it is "promising" (to quote the last paper).
2. There are good reasons to worry that the (very high) dose necessary to produce the antiviral effects in the lab "could be toxic" to patients in real life (to quote the last paper again).

I think it would be a good idea to have this article reflect these recent research papers. This would probably be best done by having one or more of the interested editors sit down and read these papers in full, and then update the article. WhatamIdoing (talk) 02:18, 14 January 2021 (UTC)

I am supportive of adding references to this article. I took a look at the first two articles you proposed. They seem pretty reasonable. I wasn't able to access the third because of a broken link at the NLM. One thing, between the two articles I looked at, the emphasis is relatively pre-clinical. It might be good to add an article with a more clinical emphasis. Please consider adding this one:

• McCullough PA, et al. (2020). "Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)". Rev Cardiovasc Med. 21 (4): 517–530. doi:10.31083/j.rcm.2020.04.264.

Also, you may have noticed in another thread that there is interest, by other editors, in consolidating a couple of related articles on Ivermectin in Covid-19 but that shouldn't affect your proposal in general. --Vrtlsclpl (talk) 03:29, 14 January 2021 (UTC)

WhatamIdoing Thanks for that - those all look viable: I shall get reading. Vrtlsclpl The McCullough paper looks less useful - it's a very low impact journal for making claims about clinical efficacy and seems to be suggesting ivermectin as a fallback from HCQ (!?). Alexbrn (talk) 07:41, 14 January 2021 (UTC)

I took a closer look at Kaur et al cited above. It is fairly impressive. I would suggest just including an excerpt from their conclusion:

"Certain studies have highlighted the significance of ivermectin in COVID-19; however, it requires evidence[s] from more Randomised Controlled Trials (RCTs) and dose- response studies to support its use."

As far a McCullough et al, I would need to know more about the Wikipedia thresholds for inclusion/exclusion.--Vrtlsclpl (talk) 16:52, 14 January 2021 (UTC)

I don't advocate for any "magic numbers", but the journal that McCullough's paper appeared in is weak. Scopus ranks it as 23rd percentile in its field. It's impact factor is half the median (again, for that specific field). These are worrying because other research has indicated that journals at the bottom of the pack have a surprisingly high likelihood of plagiarism contents (including unsourced and known-to-be-incorrect content lifted copied from Wikipedia articles). We have stronger sources that are specifically focused on ivermectin; I would encourage us to use those instead. WhatamIdoing (talk) 20:34, 14 January 2021 (UTC)

Careful! There is so much activity in this area that it's important to always check for outdated information, which in the case of ivermectin for Covid is generally anything over a few months old. Any reviews used must include recent studies in its remit; WP:MEDDATE notes, "editors should try to find those newer sources, to determine whether the expert opinion has changed since the older sources were written" I just noticed the first source was written back in September, and accepted in November...

That rules out the first two sources WhatamIdoing found. Still reviewing...

Apropos removal of the controversy section:

--50.201.195.170 (talk) 22:22, 14 January 2021 (UTC)

References

break

Can I suggest this article published on the NIH's website, "A COVID-19 prophylaxis? Lower incidence associated with prophylactic administration of ivermectin" [[29]]AussiePete56 (talk) 01:28, 15 January 2021 (UTC)

@AussiePete56: that is primary research, and so not WP:MEDRS. Alexbrn (talk) 13:01, 15 January 2021 (UTC)

• Note PMID 33189582 is available in (legitimate) free-to-access form here. As probably our highest quality article source, it should be used. Money quote: "These observations are scientifically interesting, but ivermectin is not yet proven to be clinically relevant for Covid-19 treatment." Alexbrn (talk) 12:57, 15 January 2021 (UTC)

Alexbrn, that comment (from a parasitologist) was specifically related to the theoretical effectiveness of ivermectin against the virus itself, referring to the original research which used far stronger concentrations of ivermectin than has subsequently been found to be needed to be effective in practise. Also, the mode of death in Covid 19 is that the virus provokes an over-reaction from the body's immune system, creating a a cytokine storm which leads to sepsis, pneumonia, multiple organ failure, etc. [[30]] Ivermectin acts as a potent inhibitor of both cytokine production and the transcription of nuclear factor-κB (NF-κB), the most potent mediator of inflammation, so even if ivermectin was found to not kill the virus at normal dosage levels (which is not the case) it's anti-inflammatory benefits qualify it as still "clinically relevant" for Covid 19 treatment. AussiePete56 (talk) 04:15, 18 January 2021 (UTC)

So let's see. Given given a choice between:

1. A WP:MEDRS source which asserts ivermectin is not yet proven clinically relevant
2. A WP:SPA on Wikipedia who says it is

Which do you think Wikipedia is bound to reflect? Perhaps we needn't bother reading sources, but just say what we want? Alexbrn (talk) 05:52, 18 January 2021 (UTC)

RfC about the addition of a section entitled Medical_uses#COVID-19

The following discussion is an archived record of a request for comment. Please do not modify it. No further edits should be made to this discussion. A summary of the conclusions reached follows.

This discussion was closed because it has a WP:SNOW chance of resulting in a meaningful change to the article. — Preceding unsigned comment added by Jdphenix (talk • contribs)

---

On January 14, 2021, the NIH changed their recommendation on the use of Ivermectin in COVID-19. The updated recommendation states "...currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19." This recommendation is now the same as for the widely used monoclonal antibodies & convalescent plasma. Is it appropriate to add a section entitled Medical_uses#COVID-19 ?--Vrtlsclpl (talk) 16:47, 15 January 2021 (UTC)

Maybe, although it unfortunately doesn't mean anything: not yet known to be harmful or beneficial for the treatment of COVID-19. It could be used to highlight that uncertainty, but the current sentence already says that it's under investigation. —PaleoNeonate – 20:08, 15 January 2021 (UTC)

I think some context is in order. For the vast majority of pharmaceuticals the NIH does not recommend for or against their use. And for the vast majority of the off-label uses of the pharmaceuticals, there is insufficient data to recommend their use. It would be good to hear from someone who has a more firm understanding of this issue, though.--Vrtlsclpl (talk) 21:26, 15 January 2021 (UTC)

Per WP:MEDRS:

Speculative proposals and early-stage research should not be cited to imply wide acceptance. For example, results of an early-stage clinical trial would not be appropriate in the Treatment section on a disease because future treatments have little bearing on current practice. The results might – in some cases – be appropriate for inclusion in an article specifically dedicated to the treatment in question or to the researchers or businesses involved in it. Such information, particularly when citing secondary sources, may be appropriate in Research sections of disease articles. To prevent misunderstanding, the text should clearly identify the level of research cited (e.g., “first-in-human safety testing”)

While this particular use is still in the early stages of research/clinical trials, it does not belong in the Medical uses section. If the NIH guidelines made a recommendation for use, that would be another beast entirely. A non-recommendation either way does not warrant mention. Fvasconcellos (t·c) 07:17, 16 January 2021 (UTC)

I agree with @Fvasconcellos. Non-recommendations should generally not be included. If we did include it, it should be written in plain language, which I believe would be the opposite of Vrtlsclpl's goal. We would have to say that the NIH says there no scientific proof that it works for COVID-19, and that the NIH does not recommend that people with COVID-19 take it, and that the NIH says you'd have to very large ("100-fold") amounts of the drug.

An overdose of ivermectin can permanently kill brain cells. Overdoses of ivermectin can kill people. Please, stop pushing this. The science isn't there, and Wikipedia shouldn't get behind this hype. WhatamIdoing (talk) 22:06, 16 January 2021 (UTC)

Overdoses of ivermectin can kill people - Indeed.[31] Alexbrn (talk) 15:40, 17 January 2021 (UTC)

We should metion overdose here as the amount being advocated is just nuts.--Moxy 🍁 16:05, 17 January 2021 (UTC)

Honestly? We need to stop opening RfCs every time a study comes out or something gets updated. We're not trying to be in sync with current events. We're not trying to provide a glossary of all studies done on this drug or any drug. We're just trying to be an informative neutral resource.

The round and round discussion that goes the same way, again and again, seems awfully pointy. Are we wikilawyering? I think we are. Jdphenix (talk) 03:51, 18 January 2021 (UTC)

Proposals

Per WP:MEDRS, the updated information does not warrant a new section in Medical Uses. A lack of a recommendation is not noteworthy. Additionally, there are sound concerns about the dangers of overdose and inappropriate administration of veterinary formulations of this medication.

As such, I propose that there are no changes made to imply that ivermectin has a medical use for COVID-19. Jdphenix (talk) 04:37, 20 January 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.

Semi-protected edit request on 20 January 2021

The 10,000 fold number mentioned in the COVID19 research section is incorrect. It should be 70-80 at most. The number is a miscalculation. The max lung concentration is about 0.082 micromolar, while the IC100 is 5.6 micromolar. 5.6/0.082 is 68.3. From: https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/cpt.1889 "Even with the high lung homogenate:plasma ratio, ivermectin is unlikely to reach the IC50 of 2 μM in the lungs after single oral administration of the approved dose (predicted lung concentra-tion: 0.0873 μM) or at doses 10× higher that the approved dose administered orally (predicted lung concentration: 0.820 μM; " 32.210.242.73 (talk) 03:43, 20 January 2021 (UTC)

Not sure when that figure was added, but I have removed it due to WP:SYNTH/WP:NOR concerns. It is unsupported by the currently cited sources (one of which fails WP:MEDRS, by the way). Fvasconcellos (t·c) 05:18, 20 January 2021 (UTC)

Removal of link: "Misinformation related to the COVID-19 pandemic § Ivermectin"

I removed a link from the COVID-19 section to an article on misinformation since it implies that the potential application of Ivermectin to COVID-19 is misinformation. @Fvasconcellos: stated that there was consensus to have a link from the COVID-10 section to an article on misinformation. We can survey again but I don't believe that there was consensus. In any case, the link is no longer appropriate since the NIH has just recently removed their recommendation against the use of this therapy in COVID-19.[32]--Vrtlsclpl (talk) 06:28, 16 January 2021 (UTC)

That link has nothing to do with the NIH guidelines. The corresponding section in the Misinformation article regards the Congressional hearings. There continues to be misrepresentation and misinterpretation of WP:MEDRS in this article and elsewhere. Fvasconcellos (t·c) 06:36, 16 January 2021 (UTC)

Can you be more specific? What congressional hearings are you referring to? Can you also be more specific about "misrepresentation and misinterpretation"? --Vrtlsclpl (talk) 06:43, 16 January 2021 (UTC)

Dr Kory of the FLCCC Alliance presented evidence on 8 December 2020 before the US Senate Homeland Security and Governmental Affairs Committee hearing on "Early Outpatient Treatment: An Essential Part of a COVID-19 Solution, Part II". It is here https://www.youtube.com/watch?v=Tq8SXOBy-4w&feature=youtu.be, and a longer and fuller version is here https://vimeo.com/490351508. Dr Kory asked the Hearing to request the NIH to review the data urgently. The NIH has done so and the link is not to the Congressional hearing but to a Press Release which reads that the FLCCC "presented their data before the NIH Treatment Guidelines Panel, the NIH has upgraded their recommendation on ivermectin, making it an option for use in COVID-19." Far from it being an "unreliable source" it is the very source {the FLCCC} upon which the NIH changed its recommendation to approve the use of Ivermectin. The sentence should be reverted, although it could have been better worded to read: "the NIH now approves Ivermectin as a therapeutic option." Ergateesuk (talk) 21:43, 16 January 2021 (UTC)

It's fine as it, with text properly WP:Verified. Wikipedia won't say "the NIH now approves Ivermectin as a therapeutic option" because it would be blatant misinformation. Alexbrn (talk) 21:47, 16 January 2021 (UTC)

Alexbrn it seems to me that you have misinterpreted "approves" to mean "recommends". Ergateesuk (talk) 14:20, 21 January 2021 (UTC)

The recent update to the NIH COVID-19 Treatment Guidelines could be described as a "neutral" recommendation. It is also important to understand it's significance. As I have explained in the Talk section at Coronavirus disease 2019, the significance of the update to the NIH COVID-19 treatment guidelines can be accurately summarized as follows: "NIH has removed its recommendation against the use of Ivermectin in COViD-19". That is a fair description because the recommendation confers on Ivermectin the same status as two other therapies in wide use in the US: Baricitinib and Convalescent Plasma. All have US FDA approval. Most importantly, this is an earth-shattering development for those who have insisted that Ivermectin for COVID-19 is the domain of fringe conspiracy theorists. --Vrtlsclpl (talk) 15:49, 17 January 2021 (UTC)

Content on Wikipedia needs to be sourced, and Wikipedia is not going to adopt the unsourced framing and narrative of those touting this stuff: the ivermectin-as-miracle-cure quackery is still widespread out there on the webs, as are the conspiracy theories. Ivermectin is not approved by the FDA for anti-viral applications, so saying it has "FDA approval" in the context of COVID-19 treatment would be misleading. Alexbrn (talk) 16:03, 17 January 2021 (UTC)

Your word against Peter McCullough's, Vice Chief of Internal Medicine, Baylor University Medical Center. I interviewed him by email and I share that below without editing except to remove contact information and to highlight one sentence. He was aware that the purpose of the interview was for updating this article so there is not a problem with sharing it publicly. I am disclosing my name so that there are less concerns about conflict of interest and that I stand behind my views in a real sort of way.

Snipped private communication
Removed private communication from talk page. To paraphrase, it was a private exchange between a Wikipedia editor and the author or a source from this article.

— Preceding unsigned comment added by Vrtlsclpl (talk • contribs) 17:15, 17 January 2021 (UTC)

You should have asked him why his review was so crappy! In any case, letters are not reliable sources. Alexbrn (talk) 17:20, 17 January 2021 (UTC)

And posting it without permission could be a both a copyright violation and a breach of trust. You did ask first, didn't you? WhatamIdoing (talk) 17:59, 17 January 2021 (UTC)

No copyright/disclosure issues. Please focus on the issue at hand.--Vrtlsclpl (talk) 21:07, 17 January 2021 (UTC)

So you got permission to publicise this on Wikipedia? Please confirm, clearly. Alexbrn (talk) 21:11, 17 January 2021 (UTC)

There are now two published statements that explicitly recommend that physicians should now consider prescribing Ivermectin for patients with COVID-19: [33] and [34]. Wikipedia is now taking an extraordinarily controversial position to imply that Ivermectin use in COVID-19 is misinformation and elsewhere has made the decision to exclude Ivermectin from the COVID-19 treatment options. Here are minimal remedies:

• Remove the link to misinformation from this article. At the least it is outdated.
• Add Ivermectin to the treatment section at Coronavirus disease 2019.

OR

• Remove the "Medications" section at Coronavirus disease 2019 entirely.

In general, Wikipedia tries to stay away from giving medical advice. The absence of Ivermectin from the COVID-19 medicatons list might suggest to the reader that this medication is less acceptable than those that are on the list. To be a little more specific, in the comparison between Ivermectin and Baricitinib, two medications with the same NIH recommendation: why is Ivermectin is excluded from the medications list while Baricitinib is included? I am agnostic about the latter two options but obviously the current state is not neutrality. It is full blown advocacy.--Vrtlsclpl (talk) 22:04, 17 January 2021 (UTC)

You're linking to junk sources again: that self-published promo site, and McCullough weak review. And you didn't answer the question about permission - which could become a serious issue. You need to answer. Alexbrn (talk) 22:12, 17 January 2021 (UTC)

BTW, I noticed that the email interview with Peter McCullough I attached has been hidden. It appears as a collapsed green box. Is there any way to undo that?--Vrtlsclpl (talk) 11:32, 18 January 2021 (UTC)

I've removed the full text of the email interview. I echo concerns about copyright. There's no indication that Dr. McCullough agreed to contribute this material under WP's licensing. Jdphenix (talk) 04:28, 20 January 2021 (UTC)

Pardon my dust

Hi all, I'm hoping to go through this article to update it and smooth out the writing in the choppier sections (i.e. it flows poorly now). I'll be working in small bursts as I can find some free time. In the meantime, pardon my dust. If you see any issues or have suggestions, feel free to bring them up here. Thanks and happy new year! Ajpolino (talk) 07:22, 11 January 2021 (UTC)

Speaking of which, any objection to me trying to trim the infobox a bit to make it more reader-friendly? I'd like to try moving the database links to a separate box in external links similar to how we split disease article links from {{Infobox medical condition}} to {{Medical condition classification and resources}} (for an example, see Buruli ulcer). The rationale is that I'd guess most readers at a major drug's article are probably not biologists/chemists and won't click through to these links. The infobox is intended to give readers a quick-glance summary of key facts from the article, not to store miscellaneous data on the topic (we have Wikidata for exactly that purpose!). If folks don't object, I'll draw up a draft table and we can see how it looks. Cheers! Ajpolino (talk) 07:34, 11 January 2021 (UTC)

Hi Ajpolino - in the "Misinformation" section of "Society and Culture", can I suggest replacing the word "erroneously" with "controversially"? Given the vagueness of the term "miracle" it seems wrong for an encylopedia to state that a claim of "miraculousness" is an "error" under any circumstances, let alone when there are at least thirty separate studies that support Professor Kory's claims of ivermectin's "miraculous" effect on Covid 19. [[35]] For the same reason, I suggest that the link to the Associated Press article with the clearly false headline, "No Evidence that Ivermectin is a miracle drug against Covid 19" should be removed as those thirty studies represent a lot of evidence. The article has received criticism for errors in argumentation and fact. [[36]]

 AussiePete56 (talk) 15:10, 12 January 2021 (UTC)

You have RS, saying it might truly be a miracle? Because that's what it'd take to make a "controversy" ... in fact we'd need a good source saying there was a controversy about that. "Erroneous" is factual & WP:Verified. Alexbrn (talk) 15:23, 12 January 2021 (UTC)

Unless you're claiming that "miraculous" MUST MEAN an actual "Jesus-level" miracle, then the word has to be arguably reasonable in the light of evidence that ivermectin results in an average 85% improvement in a supposedly untreatable illness, according to those THIRTY-ONE studies. Since you are the one making the claim of "an error", the onus is on you to prove that those studies are all wrong. Saying that the claim is "controversial" is being polite - your claim of an "error" is plainly an opinion and shouldn't be a part of an encyclopedia. AussiePete56 (talk) 16:35, 12 January 2021 (UTC)

Not those bloody studies again. They are not reliable. The onus is not on anybody to "prove" anything "wrong"; that is a reversed-burden of evidence (and, incidentally, a hallmark of quackery). We follow the reliable sources, none of which lead any credence to this drug being a "miracle cure", but - to the contrary - say that: there's only weak evidence to support it, and a bunch of maverick doctors touting it, a bunch of credulous believers boosting it. Alexbrn (talk) 16:42, 12 January 2021 (UTC)

Actually, the scientific method is exactly that... somebody proposes a theory and if nobody can disprove it, it is a valid theory. You should also provide a way to prove it wrong for it to be a good theory, in this case, one could prove it wrong with a double-blind placebo study. So far, nobody has been able to prove it wrong, to the contrary, it has been proven correct by a plethora of studies (even if they are small and from countries you might not consider should be part of the scientific conversation). You are showing your bias very clearly with this comment.Adriaandh (talk) 14:01, 16 January 2021 (UTC)

@Adriaandh, I invite you to read about Russell's teapot and then revise your view of the scientific method to the exact opposite of what you stated. WhatamIdoing (talk) 21:46, 16 January 2021 (UTC)

@WhatamIdoing, Really? The Russel's Teapot thought experiment merely emphasizes the importance of the test with which one can disprove the theory (ie. it must be falsifiable That is why it is important to provide a means to disprove your theory, or did you stop reading before that part? What is the scientific method in your mind then? Please explain how this exact opposite scientific method works. — Preceding unsigned comment added by Adriaandh (talk • contribs) 01:26, 17 January 2021 (UTC)

This isn't the forum for such discussions, but thinking that if someone cannot prove something then it's a valid theory is the opposite of the scientific method. --Hipal (talk) 02:03, 17 January 2021 (UTC)

Good thing nobody proposed that to be it.Adriaandh (talk) 19:06, 22 January 2021 (UTC)

Exactly. If "somebody proposes a theory and if nobody can disprove it" ...then nothing. Russell's teapot emphasizes that it's not everyone else's job to disprove the proposed theory. It's the proposer's job to positively prove it. WhatamIdoing (talk) 05:11, 17 January 2021 (UTC)

Science doesn't prove anything, you propose a hypothesis and the more evidence you can provide to support that hypothesis the more weight it carries. You can however disprove the hypothesis. So far Ivermectin has a huge amount of evidence that support the hypothesis that it is a viable treatment for COVID and there's no evidence to the contrary. It also has an even larger body of evidence that support the hypothesis that it is a safe medication.Adriaandh (talk) 19:06, 22 January 2021 (UTC)

You're sticking with this?! Please drop it. Your biases against science and for invermectin are very problematic and could result in a ban or worse. --Hipal (talk) 19:24, 22 January 2021 (UTC)

This is the "Society and Culture" section of the Ivermectin page. You are reporting what Professor Kory said at the Senate Committee meeting. His statement that Ivermectin has a "miraculous" effect on Covid 19 is undeniably controversial, but not "certainly" an error - therefore an encyclopedia should not report it as such. Very straight-forward. To accept that thirty-one properly conducted scientific studies provides significant corroborating evidence for his statement is reasonable. AussiePete56 (talk) 16:56, 12 January 2021 (UTC)

You'll need to bring some sources, rather than making an original argument. What we have is sourced fine. And per WP:PSCI Wikipedia needs to call out pseudoscience/nonsense when it's mentioned. Alexbrn (talk) 17:01, 12 January 2021 (UTC)

Here you go for a source of that, in the discussion section of this Meta analysis done by a respected scientist Ivermectin reduces the risk of death from COVID-19 -a rapid review and meta-analysis: Not only is ivermectin a safe, effective and well-known medicine, at an estimated cost of less than 10 pence per person treated with a 12 mg tablet, it does indeed seem like a miracle drug in the context of the current global COVID-19 situation.

The word "Miracle" us used colloquially, nobody is saying (or thinking that somebody is saying) that god came down to earth and did some magic to create a compound that he then told a doctor in a dream to use for COVID. The bar to clear for a drug to be miraculous during a pandemic killing thousands of people per day is not very high. To me, if it can save a single life, it is a miracle. Especially to that person who it saved and their family. Contrary to that, one can easily say that the media articles that push political views, saying doctors that are saving lives with their treatment are quacks, and anybody promoting and giving credibility to those articles as medical fact are evil.Adriaandh (talk) 14:01, 16 January 2021 (UTC)

Another source for an article where people call ivermectin a miracle drug after their mother survived covid https://buffalonews.com/news/local/after-judge-orders-hospital-to-use-experimental-covid-19-treatment-woman-recovers/article_a9eb315c-5694-11eb-aac5-53b541448755.htmlAdriaandh (talk) 14:41, 16 January 2021 (UTC)

"Pseudoscience" is defined by Wikipedia as, "an idea that is not broadly supported by scholarship in its field." It doesn't define it as "not reflecting the policy position of slow-moving bureaucratic Advisory Boards." Thirty-one properly conducted scientific studies all saying the same thing clearly constitutes, "an idea that is broadly supported by scholarship in its field." AussiePete56 (talk) 00:49, 13 January 2021 (UTC)

Hi AussiePete56 and Alexbrn, I haven't made it that far yet, so maybe my thoughts will change on this. My initial inclination is that this whole using-ivermectin-for-covid thing is of lasting importance and should be covered at this article in some way. But the fact that one time a US Senator held a hearing and a physician said some questionable things is probably not of lasting importance to this topic (though perhaps it has a place at some other article). Certainly if all the sources on ivermectin and covid mention this hearing as a turning point in folks' interest in ivermectin for covid, that'll change my tune. I realize that wording is important, so I'll ping you both when I draft something. Sorry for the slow movement; busy times in real life. My hope for this week is to update the other worm uses for ivermectin, the arthropod uses for ivermectin, and then the fact that it's often given as part of mass drug administration campaigns (rather than targeted treatment for those diagnosed with a disease). So I may not get to covid stuff until next week. I certainly have no holy lock on this article, so no need to wait for me for anything y'all wish to add/change. Ajpolino (talk) 17:12, 12 January 2021 (UTC)

Thanks Ajpolino. Actually, I have been unable to get Alexbrn to allow any changes to this page - even the addition of a factual date is too "misleading" to allow. You seem confident, so best wishes! AussiePete56 (talk) 00:38, 13 January 2021 (UTC)

Another thing Ajpolino... I agree with others that the main place for discussion of Ivermectin's role in treating Covid 19 should be the Covid 19 pages themselves... I notice that there is very little mention of Ivermectin there, even on the "Covid 19 Drug Repurposing Research" page, despite appearing to be far and away the most promising candidate to date for such effective repurposing. I could write something myself but I'm confident that it would be removed. Do you think you could come up with a contribution yourself? AussiePete56 (talk) 01:07, 13 January 2021 (UTC)

I propose removing the link the the wiki about misinformation with regard to Ivermectin and COVID since it contains misleading information without medical sourcing. For promoting the false claims of misinformation it seems to be allowed to use any type of reporting, but no counter points are permitted. Thus it will remain purely an archive or purported claims of misinformation without any discussion or validation of these claims. The first thing people reading about COVID and Ivermectin on the Ivermectin page sees is this link to misinformation which creates a totally false narrative without scientific backing around it.Adriaandh (talk) 17:42, 20 January 2021 (UTC)

It's a relevant article, so a link seems merited. There obviously is a load of misinformation/conspiracism, etc. out there about ivermectin ("miracle cure", "obliterates COVID-19", etc.), while scientific support is lacking. If there's a problem on reporting on that kind of misinformation, raise it at the target article. Here, it seems good! Alexbrn (talk) 17:54, 20 January 2021 (UTC)

HAHA, you play a good game! You know full well that you also control that section and that you are keeping it one-sided also. I have added a reference to an article in the Financial Times with a statement from a respected researcher about the fact that Ivermectin has everything aligned to be exactly as effective as the FLCCC claimed it to be, to show how biased the claims of "fake news" are there, which you promptly deleted. So, here, for any other links, you have been saying it requires Wikipedia:MEDRS , but this hogwash regurgitate false statements of "fake news" is ok to link to without any medical information/references or backing. The section on fake news you are controlling there should really be about how the APNews article it links to IS fake news, and how political rhetoric from a democratic senator is now being used as commentary on medical treatment that trumps the opinion of a group of highly regarded doctors treating patients.

For sure you have political (and who knows, perhaps financial) motivations for your moderation of these pages.Adriaandh (talk) 19:29, 20 January 2021 (UTC)

Looks like trolling; time to ignore. Alexbrn (talk) 19:32, 20 January 2021 (UTC)

Correction warranted

Please change “Common side effects include red eyes, dry skin, and burning skin” to => “Common side effects when used externally for head lice include red eyes, dry skin, and burning skin” to match source. --50.201.195.170 (talk) 09:35, 14 January 2021 (UTC)

 Done Fvasconcellos (t·c) 16:04, 16 January 2021 (UTC)

I note the effort, but now it's worse. The so called side effects are caused by die-off of parasites in the infected. As it's primarily used on a treat-the-whole-population, most of whom is not infected, and thus are not at risk, they REALLY don't belong in the lede. And they don't belong in the lede - we don't normally put side effects in the lede of Rx articles. Please remove them from the lede. --50.201.195.170 (talk) 00:59, 24 January 2021 (UTC)

???

:Could you link or quote the exact source you're referring to? I couldn't find anything on head lice after glancing at the two sources directly above. TimSmit (talk) 01:24, 15 January 2021 (UTC) The template I used says describe the change you’re requesting ... that’s what I did. I quoted the original text and what I think it should say now. What is there to not understand? what madness! The first quote is an exact exact quote from the article ... the second is what it should say ! Source is the source used in the article to support the quoted text!  ???--50.201.195.170 (talk) 14:34, 16 January 2021 (UTC) Ah! You confused yourself by putting the word ‘above’ on the end of my sentence. --50.201.195.170 (talk) 14:41, 16 January 2021 (UTC)

Semi-protected edit request on 20 January 2021

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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Remove "Based on this data, however, doses much higher than the maximum approved or safely achievable for use in humans would be required for an antiviral effect". Fails WP:MEDRS. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30464-8/fulltext is a better source for WP:V info on ivermectin. The Lancet. --50.201.195.170 (talk) 09:14, 23 January 2021 (UTC)

Also, at https://www.ft.com/content/e7cb76fc-da98-4a31-9c1f-926c58349c84, the WHO-funded ivermectin stats researcher is quoted:

“ “The purpose of this report is to forewarn people that this is coming: get prepared, get supplies, get ready to approve it,” Dr Hill said. “We need to be ready.” ”

That's apropos https://assets.researchsquare.com/files/rs-148845/v1_stamped.pdf.

6 meta analyses, 53 studies - listed at https://c19ivermectin.com/ - and all have positive findings - but we're still calling claims that it stops covid-19, "misinformation". Tantamount to mass murder - more and more so the longer this goes on. Even the NIH has changed its view to say ivermectin use against covid is acceptable - even though it appears to me it had to lie about the data in order to avoid coming out even more strongly in favor of ivermectin.--50.201.195.170 (talk) 09:14, 23 January 2021 (UTC)

I am procedurally answering this to note that the content in the COVID-19 section is being piped in from COVID-19_drug_repurposing_research#Ivermectin, so you need to make your edit request at that Talk page.

As for the Chaccour trial, thank you for the link. I will add it to the relevant section. Fvasconcellos (t·c) 11:17, 23 January 2021 (UTC)

Ah, the {{Excerpt|COVID-19 drug repurposing research#Ivermectin|nohat=y}} code. You still could have handled the request. Obstructionist, it feels. --50.201.195.170 (talk) 01:20, 24 January 2021 (UTC)

Not obstructionist. You made an administrative request; I am WP:INVOLVED in content issues on both pages. I am trying to maintain objectivity. An uninvolved admin should assess this. Fvasconcellos (t·c) 13:23, 24 January 2021 (UTC)

Regarding the Chaccour trial, wording "patients who received ivermectin" should be rewritten as "patients who received a single dose of ivermectin"; most other studies administer several doses of ivermectin. Then, why do you write "no difference in PCR-positive nasal swabs nor in viral load", while they observed lower viral load actually? "A marked reduction of self-reported anosmia/hyposmia, a reduction of cough and a tendency to lower viral loads and lower IgG titers". And finally, the authors conclude "This pilot points towards a potential use of ivermectin in COVID-19" but this section impresses quite the opposite. Is it some anti-ivermectin prejudice or what? Vlpast2 (talk) 20:01, 23 January 2021 (UTC)

A tendency, i.e., not statistically significant. Fvasconcellos (t·c) 13:23, 24 January 2021 (UTC)

Please create a new edit request, with what exactly should be changed with rationale. Jdphenix (talk) 20:33, 23 January 2021 (UTC)

There's adequate specificity. I.e. Regarding the Chaccour trial, wording "patients who received ivermectin" should be rewritten as "patients who received a single dose of ivermectin"; most other studies administer several doses of ivermectin.--50.201.195.170 (talk) 01:20, 24 January 2021 (UTC)

In the Covid 19 section the last sentence reads, "the government of Peru rescinded a previous recommendation for the use of ivermectin (alongside azithromycin and hydroxychloroquine) in hospitalized patients." A couple of days ago, it was reported that the government of Peru decided to reverse its position and once again include ivermectin in its kit for patients with Covid 19 [[37]] AussiePete56 (talk) 15:03, 23 January 2021 (UTC)

Are we going to start a list of every government action related to Ivermectin across the world? Should be "fun". Jdphenix (talk) 15:50, 23 January 2021 (UTC)

Well, it would undermine the falsehood that ivermectin is only being used in research at the moment - aren't we supposed to publish truth without bias? AussiePete56 (talk) 00:31, 24 January 2021 (UTC)

Aparrently not, some think. Anyway, please remove. Doesn't meet MEDRS. --50.201.195.170 (talk) 01:10, 24 January 2021 (UTC)

 Not done:

Wikipedia isn't a list. The fact that a doctor decides ivermectin is a good idea for COVID-19 treatment isn't notable by itself. This Extra source itself states that the doctor's opinion is that evidence by reputable studies is weak, but Leonardo Inga mentioning studies without references to which ones were used as a basis for his opinion.

One procedural note. The content we're discussing is included from COVID-19 drug repurposing research#Ivermectin, so the discussion probably is best suited there. Thanks! Jdphenix (talk) 01:23, 24 January 2021 (UTC)

It wasn't "a doctor" making the decision, it was the collective decisions of the Peruvian Ministry of Health and the Peruvian Government's Social Health Insurance Scheme. Jdphenix's decision to leave the reference to the original outdated since-reversed decision is obviously preposterous. Since certain editors here have an ideological commitment to never mentioning any positive association between ivermectin and Covid 19 treatment, I suggest just remove the entire sentence. The mistake needs to be corrected both here and in the "drug-repurposing" area. AussiePete56 (talk) 08:14, 24 January 2021 (UTC)

The text is clear that the rescinded recommendation refers to hospitalized patients. The "reversal of position" (actually nothing of the sort) refers to outpatient use. Fvasconcellos (t·c) 13:25, 24 January 2021 (UTC)

The headline of the article clearly indicates a "reversal of position" [[38]] so I propose that the sentence which currently reads, "and the government of Peru rescinded a previous recommendation for the use of ivermectin (alongside azithromycin and hydroxychloroquine) in hospitalized patients" should have added to it, "although ivermectin is still prescribed for outpatient use." AussiePete56 (talk) 16:00, 24 January 2021 (UTC)

Go here COVID-19 drug repurposing research#Ivermectin, be bold, and remember WP:BRD. I'd expect to see some back and forth before anything about this is included, but it's literally not in this article. Jdphenix (talk) 16:59, 24 January 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.

COVID-19, spread-out discussion, and conflicting content

We now have multiple concurrent discussions on ivermectin in COVID-19 across the talk pages of multiple articles, and conflicting information in each of those articles. While this use remains experimental, the core of our content should remain at the Ivermectin section of COVID-19 drug repurposing research. I have thus transcluded that content into the Research section of the present article in the hope of centralizing discussion and avoiding duplication of efforts/information conflicts. Fvasconcellos (t·c) 07:16, 18 January 2021 (UTC)

Please remedy your ignorance of the reality that it's standard practice, not experimental, in much of the world.--50.201.195.170 (talk) 07:48, 25 January 2021 (UTC)

Anti-covid use edits

Also, folks, its use against covid is already standard practice, not experimental, in much of the world, though clearly that makes some people angry and even in denial. Don't be US-blindered.

And I'll add: I'm not here to edit an article on the topic of misinformation related to the COVID-19 pandemic to the encyclopedia, or a section of this article on that topic. So don't tell me I have to. Don't tell me I have to anything - that's not how we are supposed to talk to each other.

The idea that animal use is primary is absurd. About 3.7 billion human doses. Prevents millions of cases of river blindness, malaria (partially), covid (according to people who aren't ignorant)... Please revert Fvasconcellos last edit.

--50.201.195.170 (talk) 08:03, 25 January 2021 (UTC)

 Not done No source given, and content here is transcluded from the COVID-19 drug repurposing research article in any case. Alexbrn (talk) 09:01, 25 January 2021 (UTC)

Inconsistency

"A randomized controlled trial (RCT) of 24 patients with non-severe COVID-19 and no risk factors found no difference in PCR-positive nasal swabs nor in viral load between patients who received ivermectin and those given placebo, thus failing the primary outcome of the study.[75]"

This addition was recently added to the Covid 19 section of the ivermectin page. When I have proposed mentioning other Randomised Controlled Trials investigating ivermectin's potential use in treating Covid 19, I have been reminded that it is against Wikipedia's ban on Original Research [[39]]. What is the difference here? . AussiePete56 (talk) 08:10, 29 January 2021 (UTC)

I'm in two minds whether we should have this. Any use of primary sources must be careful. In particular, they need to be consistent with secondary sources and not be used alone for any kind of strong claim (treatment benefits or harms, e.g.) Since this source is consistent with the secondary sourcing, and makes no surprising claims (no effect is, after all, the default assumption) this use is not problematic. Alexbrn (talk) 08:16, 29 January 2021 (UTC)

"consistent with the secondary sourcing...". What "secondary sourcing" are you referring to? The meta-analysis which found "weak evidence of benefit"? How is "no effect" consistent with "evidence of benefit"?

Also, the phrase, "no difference found in viral load" is not supported by the study, which says, "the ivermectin group had non-statistically significant lower viral loads at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) and day 7 (p = 0·16 for gene E; p = 0·18 for gene N) post treatment as well as lower IgG titers at day 21 post treatment (p = 0·24)." This was repeated in the "Interpretation" - "(the ivermectin treated group showed) a tendency to lower viral loads and lower IgG titers" as well as "a marked reduction of self-reported anosmia/hyposmia, and a reduction of cough" . AussiePete56 (talk) 17:35, 29 January 2021 (UTC)

Seems well-summarized to me, and consistent with the secondary source (essentially: "meh, probably doesn't work"). As I say I'm on the fence about this. Let's see what others say. Please WP:INDENT your posts. Alexbrn (talk) 17:39, 29 January 2021 (UTC)

When I suggested this study [[40]] for mention on this page, you didn't invite others' input - your reply was blunt and uncompromising - "@AussiePete56: that is primary research, and so not WP:MEDRS. Alexbrn (talk) 13:01, 15 January 2021 (UTC)" - Now all of a sudden, you have discovered philosophical flexibility regarding the use of Original Research. There are at least 17 other Randomised Control Trials which show strong statistically significant efficacy for ivermectin's use against Covid 19 which you ignore, but you want to cherry-pick and highlight the one with the smallest sample size, and the only one with no statistically significant outcomes of any kind. Why? AussiePete56 (talk) 13:32, 30 January 2021 (UTC)

Per MEDRS, you can't use primary sources to go against secondary ones. As for consensus, well, it can change. I'm all for that. Alexbrn (talk) 13:35, 30 January 2021 (UTC)

Could you please explain, why your secondary source is "meh, probably doesn't work" and not [[41]] eg.? By definition, "A secondary source summarizes one or more primary or secondary sources to provide an overview of current understanding of the topic, make recommendations, or combine results of several studies". How come "meh, probably doesn't work" is this thing and meta analysis of 35 studies is not? Vlpast2 (talk) 11:28, 1 February 2021 (UTC)

Some faked up document from a bunch of Maverick doctors is not a reliable source. The systematic review we cite, by contrast, is. Alexbrn (talk) 12:37, 1 February 2021 (UTC)

It's not a "systematic review" - it's original research. THIS is a systematic review... [[42]] (pg. 15)" This review and meta-analysis confirms that ivermectin substantially reduces the risk of a person dying from COVID-19 by probably somewhere in the region of 65% to 92%. The only uncertainty in the evidence relates to the precise extent of the reduction, not in the effectiveness of ivermectin itself.... This is a profoundly effective COVID-19 treatment." AussiePete56 (talk) 07:48, 7 February 2021 (UTC)

PMID 33227231 is a systematic review. The PDF you post is another faked up document, apparently coming from a one-director Ltd company "consultancy" in the UK. The increasing use of dodgy documents, Youtube, etc. by the Ivermectin cult is increasingly make this look like full-on woo. Alexbrn (talk) 08:09, 7 February 2021 (UTC)

Everything that contradicts your prejudices is labelled "fake". The Evidence-Based Medicine Consultancy is a highly regarded organisation which counts the British National Health Service and the World Health Organisation among its clients. Its director's peer-reviewed publications have received over 3,000 citations and her ResearchGate score is in the top 5%. This is a perfectly legitimate meta-analysis and is far more qualified to be included in Wikipedia than your tiny 24 person trial which fails WP:MEDRS AussiePete56 (talk) 14:27, 7 February 2021 (UTC)

See WP:RS and WP:MEDRS for what constitutes reliable sources. Alexbrn (talk) 15:01, 7 February 2021 (UTC)

Yes - primary sources don't qualify AussiePete56 (talk) 17:16, 7 February 2021 (UTC)

Mechanism of action? Stimulant effect? Lacking GABA neurotoxicity because of P-glycoproteins?

There is this statement

      Ivermectin, although still an investigational drug, has become the drug of choice for onchocer-ciasis (river blindness). Ivermectin intensifies GABA-mediated neurotransmission in nematodes and causes immobilization of parasites, facilitating their removal by the eticuloendothelial system. Selective toxicity results because in humans GABA is a neurotransmitter only in the CNS, and ivermectin does not cross the blood-brain barrier.

Im wondering regarding the recent large-scale human use of Ivermectin in central europe: where are the patient reported rejuvenating/stimulant effects coming from? Is it the action of Ivermectin on the intestines or other body parts, or is it a direct action of a minute/trace amounts acting in the brain? Since some other antihelminthic was being metabolised to amphetamine, and is added to all south-american cocaine production, is it possible that Ivermectin has a similar effect on a selected group of patients? How can it make some people feel better, stronger? Or is it just because they have slept better, because of the effect on GABA?

     Another barrier is due to membrane transporters, which actively export drugs from the cellular or tissue compartment back into the blood (Chapter 5). A well-known example is the P-glycoprotein. Although the octanol-water partition coefficient would favor lipophilic molecules to transverse across cell barriers, P-glycoprotein exports structurally unrelated amphiphilic and lipophilic molecules of 3-4 kDa, reducing their effective penetration. Examples of antimicrobial agents that are P-glycoprotein substrates include HIV protease inhibitors, the antiparasitic agent ivermectin, the anti-bacterial agent telithromycin, and the antifungal agent itraconazole.

There are notes on other pages saying that ivermectin is severely neurotoxic to mice that have some genes knocked out, and on another page that the lack of neurotoxicity in humans may be precisely because of the P-glycoprotein membrane transporters, which would mean that some of it WILL exhibit GABA action in humans. You can find those by searching in the 2108-page pdf for ivermectin. — Preceding unsigned comment added by 90.64.19.60 (talk • contribs) 17:38, 4 April 2021 (UTC)

References section

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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• 12:44, May 14, 2021 - «Restored revision 1023063928 by DMacks talk): Let the software do the work; forcing width mucks up the appearance»
• 10:27, May 14, 2021 - «Undid revision 1023063928 by DMacks talk) At 100% width references are completely unreadable. Let's make it more consistent with the rest of Wiki.»
• 04:15, May 14, 2021 - «Making the columns 50% narrower than standard makes this worse and not better. Undid revision 1023014905 by Alexander Davronov talk)»
• 20:35, May 13, 2021 - «‎References»

I propose to change the width of the {{reflist}} to 20em. Currently it's unreadable. Some good examples: Egalitarianism#References, Dendrite#Notes, Gdańsk#References --AXONOV (talk) ⚑ 19:37, 14 May 2021 (UTC)

The default/standard of {{reflist}} is 30em, not 100%. That specific width has consensus as default on enwiki, so presumably that's what generally is most usable for most readers. If your window is just slightly too narrow for two 30em columns, you get one column. But that's unusually narrow. Try adjusting your window. Setting 20em makes lots of nonstandardly-narrow columns for most readers. Obviously "50%" is not the right math. DMacks (talk) 21:17, 14 May 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.

Misinfo: Pierre Kory

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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• 09:21, May 15, 2021 - «‎COVID-19 misinformation: Witnesses making statements at the hearing - the context makes this sufficiently clear.»
• 07:51, May 15, 2021 - «‎COVID-19 misinformation: Reword and cite EMA per talk.»
• 09:50, May 15, 2021 - «‎COVID-19 misinformation: See Talk:Ivermectin#Misinfo: Pierre Kory»
• 10:03, May 15, 2021 - «Undid revision 1023252048 by Alexander Davronov talk) Let's do it in a right way.»

@Brunton: See WP:DONTREVERT and WP:DETAG. The problem is that Pierre Kory is not mentioned in the NYC article cited before so I'm going to place failed verification tag if you don't mind. Please provide a quote if you can so I can remove it. Thanks. --AXONOV (talk) ⚑ 09:49, 15 May 2021 (UTC)

That's not the cited source. I am beginning to suspect a WP:CIR issue here (or, with the PA in the template, maybe something worse). Alexbrn (talk) 09:54, 15 May 2021 (UTC)

@Alexbrn: The source cited in the first statement about hearing. I'm beginning to suspect that WP:CIR is an issue here because you don't catch that two unrelated statements coexist next to each other. AXONOV (talk) ⚑ 09:59, 15 May 2021 (UTC)

@Alexbrn: I have clarified what I'm talking about, take a look. NYC article is paywalled but I have access to it. I don't see Pierre Kory mentioned. --AXONOV (talk) ⚑ 10:07, 15 May 2021 (UTC)

He’s mentioned in the source placed after the statement referring to him (the one you placed the “failed verification” tag against), which would be the usual place to find the reference. If you want a quote, it says, “Dr. Pierre Kory, a pulmonary and critical care specialist at Aurora St Luke’s Medical Center in Milwaukee, described ivermectin as a “wonder drug” with immensely powerful antiviral and anti-inflammatory agents at the hearing before the Senate Homeland Security and Governmental Affairs Committee. Clips of Kory’s comments on ivermectin during the hearing were shared widely on social media with one clip receiving more than 1 million views on YouTube.” I think that adequately supports the content it is being used for. He doesn’t need to be mentioned in a reference supporting the previous sentence, because that sentence doesn’t refer to him. Brunton (talk) 10:18, 15 May 2021 (UTC)

@Brunton: You don't mind I cite the following to prove that he has participated in hearings?: LINK AXONOV (talk) ⚑ 10:21, 15 May 2021 (UTC)

No, because it's fringe junk. I don't know what you're playing at here, but it isn't good. Alexbrn (talk) 10:28, 15 May 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.

Wikipedia should not be used for crusades

The lead paragraph has this sentence tacked on to it :

> There exists no evidence that the drug works for COVID-19.

Now I'm not interested in arguing the case regarding Ivermectin and Covid at all. What is wrong with this sentence being in the lede is that it is completely out of place. We do not summarise a drug by saying what diseases and afflictions it has so far not shown evidence to treat. So why is this sentence here? I suspect that, as is increasingly the case on Wikipedia, certain ppl want to push an agenda.

Yes, I have not written this dispassionately but I am getting really tired of faux 'enlightened' individuals pushing agendas on wikipedia. Please treat this project as an encyclopedia, not a place to push agendas. This is directed at the person who just reverted my edit removing this rubbish and to all others who can't leave well enough alone. Oska (talk) 04:07, 12 May 2021 (UTC)

It might be better to say something like "During the 2020 COVID-19 pandemic misinformation was widely spread claiming that ivermectin was beneficial for treating and preventing COVID-19. Such claims are not backed by evidence". This is an odd case where the "what it doesn't do" aspect has become part of the knowledge.[43] However, before this we would really need something in the "Society and culture" section about this misinformation phenomenon, summarizing the content at COVID-19 misinformation. Alexbrn (talk) 04:40, 12 May 2021 (UTC)

Readers are fully capable of scanning the table of contents and jumping down to the section on research into its possible use against Covid, if that is what interests them. It does not need to be in the lead. The reason that that sentence was added to the end of the first paragraph is, I very strongly suspect, because agenda pushers know that just the first paragraph is what Google quotes when it presents a grab from the wikipedia article in search results. Hence the contamination of a lot of 'controversial' articles with agenda-pushers trying to stuff the agenda they are pushing into the first paragraph. As disinterested & dispassionate editors we shouldn't care how Google uses wikipedia articles and it certainly should not influence how we write them. Oska (talk) 04:50, 12 May 2021 (UTC)

Then why do you care? Ledes should summarize bodies, and a sentence or two to reflect the multiple paragraphs on this in the body is not unreasonable, surely? Alexbrn (talk) 04:56, 12 May 2021 (UTC)

I care because it is completely moronic to tack that sentence on to the end of the first paragraph. I'm trying to read an article on an important drug and I get stopped in my tracks by idiotic faux do-gooders pushing an agenda on wikipedia. "Here's information about a drug and wait, did we tell you that 'no evidence has been found' that it 'works for' one of 10 million afflictions that humankind can suffer from. And we'll ignore that absence of evidence is not evidence of absence because no, it's very important that we dispel any ideas that you might have that Ivermectin might have a use case against Covid. So we're going to do it right in the first paragraph so that Google quotes us. Because this is a very important agenda that enlightened people like us know is the correct one to push."

And I would not be in a minority in feeling like this. Wikipedia is becoming unusable to casual readers of controversial articles who just want information, not an agenda pushed at them. Oska (talk) 05:03, 12 May 2021 (UTC)

I've just removed the sentence for a second time. I think the lead three paragraphs read much more naturally now. Imagine, just for a minute, that you're coming to this article without any controversy about Covid and Ivermectin in mind. Shouldn't be that hard to imagine really; Ivermectin is an important drug that has been in continual use around the world for the last 40 years, being taken by literally billions of people. So for those readers they can now just read the lead-in without topical controversy being pushed in their face. And if they are interested in research around Covid and Ivermectin then yes, we have a section discussing that that they can scroll down to. Oska (talk) 05:17, 12 May 2021 (UTC)

Calling the sentence "completely moronic" and calling the people who are in favor of the sentence "faux do-gooders pushing an agenda" does not help your cause. I could just as well say that removing the sentence is completely moronic and that you are a faux do-badder pushing an agenda, with as much justification. So, just stay on the factual level.

At the moment, the stuff is pushed as a COVID cure, so it needs to be mentioned that it isn't. That you do not want the information is not a reason for omitting it - you are not the only customer, and for others, it is relevant. Alexbrn's suggestion about spreading misinformation is good. After this virus fest is over, we can drop it from the lede again. --Hob Gadling (talk) 07:46, 12 May 2021 (UTC)

Hob Gadling I hope you are not purposefully misquoting me. I did not call the sentence 'completely moronic'. I said that tacking it on to the end of the first paragraph (in a disjointed and breaking the flow way) is completely moronic. Please refer back to what I actually said and I would hope that you can see that there is a large difference between the two positions. I don't have any issue with the article documenting the controversy around Covid and Ivermectin. What I do have an issue with is ppl pushing agendas and making articles worse through their crusading. That's my complaint and hence the section title I chose "Wikipedia should not be used for crusades". I don't have a bee in my bonnet about Ivermectin and Covid, despite people trying to colour this discussion that way (but often it seems that crusaders see everything through the prisms of their personal crusades.) I'm just trying to keep wikipedia articles useful and informative to ordinary readers. And readers turn off and become dubious of a source when they feel that they are getting preached to, or that an agenda is being pushed.

Further, I find your suggestion that we promote some statements while an event is happening (in this case the pandemic) and then drop them later concerning. That is an agenda; I do hope you can see that. This is an encyclopedia, not a public health warning service. Readers should be able to come to an article and get information presented dispassionately and not coloured by current events. Oska (talk) 10:16, 12 May 2021 (UTC)

I should have written Calling putting the sentence at this place "completely moronic", but that looked clumsy to me, and I did not expect you to make such a drama about such a minor difference. It does not change my point one bit. My point was "it does not help that you are doing this", and, surprise, surprise, calling putting the sentence at that place "completely moronic" is every bit as disingenious as calling the sentence itself "completely moronic" would have been. I don't know why I expected a drive-by ranter like you to be reasonable enough to recognize this as a non-difference.

I don't have a bee in my bonnet about Ivermectin and Covid, despite people trying to colour this discussion that way Nobody did. Look carefully at what Alexbrn and I wrote. You are the only person here who is colouring anything.

So, my point whooshed right by your head, and instead, you invent motivations and people coloring stuff. You want to continue blaming your fellow users for your woes. You do not want this to be a discussion about how the article should look, you want this to be a jeremiad about crusaders pushing agendas. You have no objective reason against the existence of such a sentence, your real beef is with the hypothetical sinister motivation you smell out behind it.

Alright, then you should be treated the same way we treat all the other ranters: we, or at least I, will ignore you, and if you continue whining about other users supposedly having non-encyclopedic intentions, instead of working constructively, you will probably be blocked. Don't ping me. Bye. --Hob Gadling (talk) 11:19, 12 May 2021 (UTC)

I do not find the response above by Hob Gadling at all substantive. Most importantly, after betraying that they had an agenda and my criticism (in my second paragraph) of that agenda pushing (and how it worsens wikipedia generally and this article specifically) was not addressed at all. In my view they are dodging the main issue which was my impetus for my removal of that sentence and opening this discussion. Wikipedia articles should be written dispassionately and with no view to 'getting a message out', whatever is currently happening in the wider world. There are other channels for that. Oska (talk) 11:54, 12 May 2021 (UTC)

Your perception is crooked. You smell "agendas" behind everything. The "main issue", your original "impetus", by your own reasoning on this Talk page, was that you did not like what you believed to be the reason behind the sentence. But "I don't like what I believe to be the reason why people wrote this" is not a valid reason for removing something. Unless you come up with something that does not mainly consist of you pointing at other people and squealing, like Donald Sutherland at the end of The Body Snatchers, that sentence will stay in. --Hob Gadling (talk) 07:46, 13 May 2021 (UTC)

And ironically, the "crusading" that has been in evidence around ivermectin on Wikipedia, has been from users trying to push the "it's a miracle cure for COVID-19, not the vaccines THEY are deploying" line, as the roster of banned users attests. Alexbrn (talk) 08:02, 13 May 2021 (UTC)

What's ironic Alexbrn is that you are blind to crusading from your own 'side'. As someone who has stood completely outside the controversy, that is obvious to me. Propagandists often rationalise their own dubious actions as necessary in the fight against others propaganda. Neutrality and dispassionate documentation in this encyclopedia project loses out. Oska (talk) 10:06, 13 May 2021 (UTC)

I've spent a little time now reviewing Alexbrn & Hob Gadling's activity and they are both heavily involved in editing Covid related articles and active crusading on wikipedia in this area. Their talk pages include various back-slapping messages enthusing the valiant to keep up the good fight and sneering at their enemies. And as soon as I entered their orbit - not pushing any Covid related agenda but simply decrying how agenda stuffing had badly affected the lead of an article on an important drug - Alexbrn swung into passive aggressive attempt-to-intimidate mode and whacked an inappropriate warning message on my talk page, which I am still waiting for him to properly justify. Such bullying behaviour (motivated by the desire to 'fight the good fight') is unfortunately what drives a lot of less experienced editors away from the project. Oska (talk) 10:21, 13 May 2021 (UTC)

Bravo! you've identified the sterling work of active editors like me! If you have any substantive complaint (though I suspect this is just trolling, so I doubt it), then take it to an appropriate forum with your evidence. Otherwise, you should probably abide by our behavioural policies, unless you want to join the roster of miscreants the Project has needed to block. You have been warned. Alexbrn (talk) 10:55, 13 May 2021 (UTC)

@Oska: Calm down mate and stay focused. It's better to concentrate on sources rather than continuing this never-ending conversation. See below. AXONOV (talk) ⚑ 20:33, 13 May 2021 (UTC)

• I support the proposals by Alexbrn and will be happy to help in drafting something useful. TrangaBellam (talk) 11:10, 13 May 2021 (UTC)
• I would just add my two cents here and say that the Covid 19 pandemic situation is nowhere near its resolution and we should be very humble about what we know and what we don't know. I don't believe an objective source like Wikipedia should be involved with sheparding public opinion as to what is true information and what is misinformation, *if we do not have the facts* about that particular issue. Given that there is an ongoing large scale trial on the efficacy of ivermectin at Oxford, and a large body of evidence does exist (albeit, not strong evidence) as to its benefits, I *strongly* believe an objective summary needs to demonstrate more humility and acknowledgement of the uncertainty of the developing situation that is Covid 19 more generally and ivermectin's role in it. 2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 10:03, 16 May 2021 (UTC)

  The Wikipedia rules, such as WP:SOURCE and WP:FRINGE, directly contradict your opinion. When reliable sources say "it's like this", we say it's like this. You are free to start your own encyclopedia without those rules. Suggestions for the name: "OnTheFencePedia", "IHaveNoIdeaPedia", "SomeSayThisSomeSayThatPedia". --Hob Gadling (talk) 15:24, 16 May 2021 (UTC)

  • ”when reliable sources say ‘it’s like this,’ we say it’s like this.” Great, then how about changing the article to reflect the far more neutral and accurate language used by WHO: “The current evidence on the use of ivermectin to treat COVID-19 patients is inconclusive. Until more data is available, WHO recommends that the drug only be used within clinical trials.“2600:1700:7CC0:4770:D1B7:CD9:6351:3A39 (talk) 19:06, 16 May 2021 (UTC)

    "Inconclusive" means that if there is an effect, it is so small it could not be measured conclusively. That is what will happen when something does not have an effect: statistical noise will ensure that the measured effect size is not zero, but somewhere around zero. Sometimes, in 5% of all studies, it will even be statistically significant; that is the very definition of statistical significance. But those results will not be replicable.

    This is the minimum amount of evidence which is mathematically possible, also called "no evidence" by people who know how measurements work. If they are generous, they call it "inconclusive", but it's the same thing really. --Hob Gadling (talk) 06:05, 17 May 2021 (UTC)

    • As far as I am aware there was one study that is being widely cited that had an inconclusive result which had some sampling issues that contributed to an insignificant result. If a massive body of evidence had been compiled, all of which show "inconclusive" results, then your argument RE statistical noise would certainly be relevant. As it stands, I don't believe this is anywhere close to a resolved question.2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 18:57, 17 May 2021 (UTC)
      • The matter as it stands now is that there is no good clinical evidence of benefit, but most big health organisation have no objection to continued research. The way "questions" are "resolved" in medicine is for good evidence to be produced. Meanwhile, despite the lack of evidence, a number of quacks and fools are falsely promoting ivermectin as a silver bullet. All this is clear from good sources, which we cite. If the situation changes, Wikipedia will change too. We cannot change reality as reported by reliable sources. Alexbrn (talk) 19:29, 17 May 2021 (UTC)
        • Again, I must disagree with your subjective conclusions that are not supported by factual evidence. You deem anyone with a belief that ivermectin is beneficial to treating or preventing Covid as a "quack" or "fool." This might be a valid position to take, if this were a long standing issue with a substantial body of research which in summation finds no evidence to support the use of ivermectin. It seems to me you repeatedly conflate that hypothetical scenario with the actual current status of the issue - an unquestionably insubstantial body of research leading us to be unable to ascertain whether or not ivermectin in fact has any beneficial effect. This conflation is, in my opinion, reflected in the misleading text of the article.2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 20:41, 17 May 2021 (UTC)

  I would support adding an info on Covid-19 treatment effectiveness but the problem is that a significant share of the research is mostly WP:RECENT. So it's best wait for a certain amount of critical weight to gain. I also disagree with Hob Gadling on that WP:FRINGE is applicable here. See discussion below (#Sources on effectiveness against Covid-19). AXONOV (talk) ⚑ 21:31, 17 May 2021 (UTC)

  You think claims that ivermectin is a miracle cure, that eliminates the need for vaccination/lockdown etc, and has been covered-up by Big Pharma, doesn't take us into WP:FRINGE territory? That's ... something. Alexbrn (talk) 06:49, 18 May 2021 (UTC)

  I don't believe anyone said it did not apply to those claims. Please be careful of WP:TALK RE: mischaracterizing comments. 2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 07:50, 18 May 2021 (UTC)

Sources on effectiveness against Covid-19

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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Before discussion gets out of hand I got some sources to discuss. Both are reviews but a bit contradictory. The first review finds that Ivermectin brings down morbidity rates. I propose to adopt them in relevant subsections (lead/research). Please checkout:

1. Kory, Pierre; Meduri, Gianfranco Umberto; Varon, Joseph; Iglesias, Jose; Marik, Paul E. (April 22, 2021). "Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19". American Journal of Therapeutics. 28 (3): e299–e318. doi:10.1097/MJT.0000000000001377. ISSN 1075-2765. PMC 8088823.
2. "EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials". March 22, 2021.{{cite web}}: CS1 maint: url-status (link)

--AXONOV (talk) ⚑ 20:30, 13 May 2021 (UTC)

The "American Journal of Therapeutics" does not look good on SCImago. --Fernando Trebien (talk) 23:47, 13 May 2021 (UTC)

Yeah WP:REDFLAG, especially since this article was previous rejected by a Frontiers (a Frontiers!) journal, with a statement that it was bollocks[44]. We have very good sources on this and we shouldn't undercut them with marginal ones. Alexbrn (talk) 05:35, 14 May 2021 (UTC)

@Alexbrn: ...a Frontiers! ... Frontiers claims that the article didn't review controlled trials meanwhile there were 18 controlled ones (I've checked at least 2).[45]

As a fun fact, the Frontiers in Life Science and Frontiers of Medicine journals are rated lower than AJT by SJR.[46][47]. AJT has 59 points: [48] vs junky 35/33. And what about second source by EMA?

BTW, I wonder now what you would say about Nature as it's rated very highly[49]. AXONOV (talk) ⚑ 09:01, 14 May 2021 (UTC)

EMA is always good. As is Nature. Assuming all the usual WP:MEDRS boxes are ticked. If we stick to high-quality sources all shall be well. Alexbrn (talk) 12:42, 14 May 2021 (UTC)

@Ftrebien: Hardly an issue. I think we are obliged to mention it. Probably also worth to mention Frontiers's rejection. It seems baseless though. AXONOV (talk) ⚑ 19:31, 14 May 2021 (UTC)

According to WP:MEDRS, it surely is an issue. WP:MEDRS exists to prevent Wikipedia from spreading deadly false hopes. If this kind of "good news" was published by a trusted source like Nature, it would have a huge impact on the entire planet. 14 months into the pandemic, with tons of resources invested in research on drug repurposing for a long time in many countries, I'm sure that the EMA and the WHO (as well as the other regulatory agencies already mentioned in the article) have seen this paper and are most interested in changing their current stance if they think they now have better evidence. As there is a lot of potential profit involved, there has been a lot of sophisticated disinformation around ivermectin, particularly in Brazil (currently politically polarized with a denialist president promoting unproven cures), which is the main source of the information in this meta-analysis. Given this political context, Wikipedia should not suggest, by providing what looks like a credible scientific source to lay readers, that taking ivermectin offers any level of protection against COVID-19, unless we see a change in the consensus reported by the most trusted sources. --Fernando Trebien (talk) 22:35, 14 May 2021 (UTC)

@Ftrebien: ... WP:MEDRS exists to prevent Wikipedia from spreading ... Don't cite guidelines arbitrarely. Reviews are acceptable as they are secondary. Considering that WP:MEDRS is highly abused guideline I would like to see exact provisions (WP:BMI?) forbidding the first source above.

... which is the main source of the information in this meta-analysis. ... Are you saying that the first source is somehow compromised by Brazilian or any other govt? I'm fully aware of politicization over Covid-19 drugs over here but given WP:RS I don't think this opinion has a great weight. Review in Nature says that Ivermectin is promising in treating Covid-19 and should be investigated.[50]

... Wikipedia should not suggest, by providing what looks like a credible scientific source to lay readers, ... You oppose to cite both and let the readers to decide which they trust the most? It would be nice to balance each other per WP:NPOV/WP:WEIGHT. AXONOV (talk) ⚑ 07:37, 15 May 2021 (UTC)

WP:MEDRS isn't an abused guidelines, so much as the basis of the quality of Wikipedia's well-respected medical content. Granted, we have occasional problem editors trying to undermine it who don't like Wikipedia's quality requirements, but that's the same for pretty much all topic areas on Wikipedia. Per WP:REDFLAG this new review is not suitable for use. If in doubt, raise a query at WT:MED where experienced editors can offer further guidance. (BTW, you have not cited any review in Nature, so I'm not sure what is going on.) Alexbrn (talk) 07:43, 15 May 2021 (UTC)

@Alexbrn: WP:MEDRS isn't an abused guideline ... " Whatever. Unless it turns out in provision - it's clear abuse.

... you have not cited any review in Nature. Nature which says that the drugs poses some effectiveness in combating viruses, including COVID-19 (second paragraph in conclusion section): NATURE ARTICLE. In light of this I don't think the WP:REDFLAG makes up a case here. We are obliged to mention the first source under WP:WEIGHT I think. I propose to put it under COVID-19_drug_repurposing_research#Ivermectin section. AXONOV (talk) ⚑ 08:08, 15 May 2021 (UTC)

That's not in Nature; You seem confused. Please do not put quackery in Wikipedia, you could end up sanctioned. Alexbrn (talk) 08:11, 15 May 2021 (UTC)

@Alexbrn: My mistake. It's The Journal of Antibiotics . AXONOV (talk) ⚑ 08:19, 15 May 2021 (UTC)

@Alexbrn: Stop citing policies, guidelines and essays arbitrarily or you may end up sanctioned for excessive abuse.

... Please do not put quackery ... There is no evidence for that. SCImago rates it higher than Frontiers: [51] AXONOV (talk) ⚑ 08:22, 15 May 2021 (UTC)

The promotion of ivermectin is misinformation per multiple RS (see COVID-19 misinformation#ivermectin). As I said, if you want to widen consensus ask at WT:MED. You are now aware of the general sanctions in effect for this topic. Alexbrn (talk) 08:32, 15 May 2021 (UTC)

Review in Nature says that Ivermectin is promising in treating Covid-19 and should be investigated. June 2020. Research has come a long way since then. We can write at the top of Review / Evidence something like "In June 2020, a review suggested that ivermectin was promising. However, later results found weak evidence." This presents the information (which in fact I find relevant when narrating how the controversy started and unfolded) in the appropriate tone.

Are you saying that the first source is somehow compromised by Brazilian or any other govt? Very likely. If it were in fact neutral, reliable and of high quality, it would have been sent for review by a more reputable publisher, such as Nature, and we would see interest from other important health organizations such as EMA and WHO. But that is not happening at all.

You oppose to cite both and let the readers to decide which they trust the most? Yes, because there is no evidence, because WP:MEDRS exists to prevent the relativizing truths and facts in ways that could harm laypeople, and because the debate around it is currently tainted by economic and political interests, especially in Brazil. If it can cause injury by incorrectly modulating risky behaviours, leave the debate to experts and trusted health organizations.

Simply put, the article already says that ivermectin is being studied and I think that is sufficient because its sources are better than the one you propose. --Fernando Trebien (talk) 12:30, 15 May 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.

Semi-protected edit request on 22 May 2021

Since May of 2021, a paper on Ivermectin was Peer Reviewed by The American Journal of Therapeutics and published, Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. Pierre Kory, MD,1* Gianfranco Umberto Meduri, MD,2 Joseph Varon, MD,3 Jose Iglesias, DO,4 and Paul E. Marik, MD5. Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. Now Scientific Fact that Ivermectin is a Preventative & Treatment for Covid 19. Also, see the FLCCC ALLIANCE https://covid19criticalcare.com/ for further details and the latest updates. Also, see Dr. Tess Lawrie, https://medicalupdateonline.com/speciality/Dr-Tess-Lawrie/ Johnlark2095 (talk) 23:25, 22 May 2021 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. ScottishFinnishRadish (talk) 01:07, 23 May 2021 (UTC)

Semi-protected edit request on 22 May 2021 (3)

n March 2021, both the FDA and the European Medicines Agency (EMA) issued guidance that ivermectin should not be used to treat or prevent COVID-19.[79][80] After reviewing the evidence on ivermectin the EMA said that "the available data do not support its use for COVID-19 outside well-designed clinical trials".[80] Ivermectin is not authorized for use to treat COVID-19 within the European Union.[80] In the United Kingdom, the national COVID-19 Therapeutics Advisory Panel determined that the evidence base and plausibility of ivermectin as a COVID-19 treatment were insufficient to pursue further investigations.[81] The WHO says that ivermectin should not be used to treat COVID-19 except in a clinical trial.[82]

Since May of 2021, a paper on Ivermectin was Peer Reviewed by The American Journal of Therapeutics and published, Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. Pierre Kory, MD,1* Gianfranco Umberto Meduri, MD,2 Joseph Varon, MD,3 Jose Iglesias, DO,4 and Paul E. Marik, MD5. Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. Now Scientific Fact that Ivermectin is a Preventative & Treatment for Covid 19. Also, see the FLCCC ALLIANCE https://covid19criticalcare.com/ for further details and the latest updates. Also, see Dr. Tess Lawrie, https://medicalupdateonline.com/speciality/Dr-Tess-Lawrie/. Johnlark2095 (talk) 00:00, 23 May 2021 (UTC)

 Not done WP:REDFLAG for fringe work in marginal journal, or self-published websites. Wikipedia adhere to reputable sources. Alexbrn (talk) 06:07, 23 May 2021 (UTC)

Mischaracterization of the results of Chaccour et al

The characterization of the Chaccour et al study appears to be an example of the subjective and selective point of view currently conveyed by this article. I will not question the methodology, findings, or relevance of the paper here, as it has already been deemed relevant and reliable enough for inclusion in the article.

For reference, the text I am responding to is as follows:

"A randomized controlled trial (RCT) of 24 patients with non-severe COVID-19 and no risk factors found no difference in PCR-positive nasal swabs nor in viral load between patients who received ivermectin and those given placebo, thus failing the primary outcome of the study." — Preceding unsigned comment added by 2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 23:23, 17 May 2021 (UTC)

Point 1: Omission of symptom reduction as a finding of the paper

The study itself, entitled "The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial", finds a strong significant difference in symptom reduction in the patient group using ivermectin vs placebo group. While the procedure did specify a negative PCR test as the primary pass/fail metric, a significant symptom reduction is relevant to the substance of the Wikipedia article, and was seemingly relevant enough to the authors of the paper for them to include the subject in the title.

Point 2: Inaccurate claim of no difference in viral loads

The Wikipedia article states that the study "found no difference...in viral load." This is directly contradicted by the paper itself, which states "the ivermectin group had non-statistically significant lower viral loads at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) and day 7 (p = 0·16 for gene E; p = 0·18 for gene N) post treatment as well as lower IgG titers at day 21 post treatment (p = 0·24)." The paper did not find "no difference," it found a non-statistically significant difference. To be clear, these findings are closer to "significant difference" than "significant no difference."

Point 3: Overall mismatch between tone of study and characterization of it in article

The authors characterize their study as a "pilot [that] points towards a potential use of ivermectin in COVID-19 which warrants further exploration under larger trials." This is not communicated by the Wikipedia article, which portrays it as one data point of many which illustrate ivermectin's ineffectiveness.

2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 23:08, 17 May 2021 (UTC)

We shouldn't really be citing a primary source per WP:MEDRS, but using it in any way to contradict or undercut the better sources we do cite is absolutely verboten. I wouldn't mind removing this. Alexbrn (talk) 05:35, 18 May 2021 (UTC)

The question that remains is, which primary sources *don't* contradict or undercut the better sources? ;) 2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:10, 18 May 2021 (UTC)

One reliable source trumps an infinity of unreliable ones. We have ample good sourcing. Again, is any actual proposal being made? Alexbrn (talk) 06:35, 18 May 2021 (UTC)

Amending the factual inaccuracies would be a start.2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:40, 18 May 2021 (UTC)

Which ones are those? --Hob Gadling (talk) 09:10, 18 May 2021 (UTC)

The ones that were deleted entirely. I wasn't aware the purging of the pro-ivermectin study had already occurred when I made that commment. 2600:1700:7CC0:4770:C47C:4E3C:EC7D:831 (talk) 20:34, 18 May 2021 (UTC)

The reliable sources are based on primary sources, and they judge the quality of the primary sources to draw conclusions from the high-quality ones. A high-quality primary source would be a primary source that doesn't undercut the better sources. --Hob Gadling (talk) 09:10, 18 May 2021 (UTC)

Exactly. Concur with Hob Gadling. Wiki is not about doing your own research, there's plenty of other websites (of much lower quality and reliability) where you can do that. Wiki is about depicting the consensus of the experts. And the consensus is shown in the secondary sources, not the primary ones. --Shibbolethink ^{(♔ ♕)} 21:04, 22 May 2021 (UTC)

I believe you missed the thrust of my original comment, which was to point out that the source the Wiki editors had all verified and deemed reliable enough for inclusion, was mischaracterized in a number of ways, including cherry picking and outright misstatements. I understand the value of citing secondary sources - in fact I believe if the text of this article were to hew more closely towards respected secondary sources such as the WHO, it would be in better shape. As it stands, the level of bombast (summarizing ivermectin vis a vis covid with a report of non-specific "misinformation") is unearned and bordering on misinformation itself. 2600:1700:7CC0:4770:24D7:680E:7793:A321 (talk) 02:40, 23 May 2021 (UTC)

If you have actual evidence of misbehaviour take it to an appropriate noticeboard (e.g. WP:AIN) as complaining here is inappropriate and can achieve nothing. Alexbrn (talk) 06:10, 23 May 2021 (UTC)

Right. But even there, you will need to give people more than the rewordings of "you are wrong" we heard from you here. You will need to say what is wrong and in what way. --Hob Gadling (talk) 06:27, 23 May 2021 (UTC)

"You will need to say what is wrong and in what way." I don't believe this is a good faith engagement with my argument per WP:TALK. Please read the three points listed in the original comment titled "Mischaracterization of the results of Chaccour et al." If you have any questions as to anything that is unclear, or still believe anything to be a rewording of "you are wrong," please let me know and I can clarify any of the three substantive points made.2600:1700:7CC0:4770:7CAD:F4C3:E926:52A4 (talk) 18:16, 24 May 2021 (UTC)

Oh, all those IPs are the same person? If you keep using changing IPs instead of an account, no one can tell. Anyway, Alexbrn already told you we should not use primary studies, so that point is moot. --Hob Gadling (talk) 09:14, 26 May 2021 (UTC)

I certainly don't have evidence of malfeasance on any editor's part, nor is it my intention to accuse any one of this. My intent is for the article, which currently reads as being written from inaccurate and subjective viewpoint, to be edited to properly reflect the current status of the science behind ivermectin and Covid. From my understanding the talk page is the proper venue to do this as I am not authorized to edit the article myself.2600:1700:7CC0:4770:7CAD:F4C3:E926:52A4 (talk) 18:29, 24 May 2021 (UTC)

To all editors: This page is not available for general discussion. It is subject WP:GS/COVID19 and an uninvolved administrator such as myself should prevent meandering conversations that waste time and energy of other editors. Any further comments should contain an actionable proposal to improve the article based on WP:MEDRS. Other comments may be removed and anyone repeatedly restoring them will be blocked. Johnuniq (talk) 02:12, 25 May 2021 (UTC)