Talk:Ivermectin/Archive 3

Archive 1

Archive 2

Archive 3

Archive 4

Bryant, Lawrie, et al returns

In the American Journal of Therapeutics Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines.

"Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally."

This appears to refute "During the COVID-19 pandemic, misinformation was widely spread claiming that ivermectin was beneficial for treating and preventing COVID-19. Such claims are not backed by sound evidence." Comments? Thepigdog (talk) 05:42, 10 July 2021 (UTC)

This source has been discussed multiples times in many sections above. Alexbrn (talk) 06:03, 10 July 2021 (UTC)

My apologies. I thought that because it is recent, it wouldn't have been covered. I Should have checked. Thepigdog (talk) 03:50, 11 July 2021 (UTC)

Alexbrn, could I politely ask you to recuse yourself from this discussion. You only see one side of the argument. It is preprogrammed into your brain that the WHO, and Nature, and The Lancet represent the mainstream. There is overwhelming evidence that these parties represent a corrupt viewpoint that is working diligently to protect those involved in "Gain of Function" research. These parties support the "safe" covid 19 vaccination program. This is the most dangerous vaccine program in history and has done little to halt the spread of SARS_COV-2 in poor countries. The anti-Ivermectin lobby is motivated by the perception that Ivermectin is a threat to the vaccination program. Your continued presence in this dialogue can have no value as you have already made up your mind. Your mind is closed. Please step away. Get some air. Do something else.

Possibly Ivermectin is useful in the control of SARS-COV-2. Possibly it has no value. Either way, you cannot call it quackery. A more nuanced discussion is required than you can possibly understand. I thank you for your work. Thepigdog (talk) 11:41, 12 July 2021 (UTC)

From Kristian G. Andersen to e-mail to Fauci, Friday, January 21st, 2020, 10:32 PM from Fauci's e-mails, released under freedom of information.

• The unusual features of the virus make up a really small part of the genome (<0.1%) so one has to look really closely at all the features to see that some of the features (potentially) look engineered.
• Eddie, Bob, Mike, and myself all find the genome inconsistent with expectations from evolutionary theory.

From The proximal origin of SARS-CoV-2. Published: 17 March 2020. Authors Kristian G. Andersen, Andrew Rambaut, W. Ian Lipkin, Edward C. Holmes & Robert F. Garry.

We offer a perspective on the notable features of the SARS-CoV-2 genome and discuss scenarios by which they could have arisen. Our analyses clearly show that SARS-CoV-2 is not a laboratory construct or a purposefully manipulated virus.

So between the 21st of March and when the paper was submitted for publication, well before the 17th of March 2020 Kristian G. Andersen completely reverses his opinion.

I am making the argument that what your regard as a reputable source is demonstrably corrupted.

Are you so scared that you have rollback whatever I write? You win then, by the force of your power. Thepigdog (talk) 14:38, 13 July 2021 (UTC)

No, "it" is not quackery. What is quackery is the claim that it is a "miracle drug" that "obliterates COVID" or stops you getting sick, when the evidence does not support that. What is also quackery is the kind of moronic antivaxx bollocks you're spouting. Alexbrn (talk) 11:46, 12 July 2021 (UTC)

Ah, that one again. "You are in my way because you oppose me, so please go away so can get what I want without anyone refuting what I say." Pretty funny but not exactly new. Proponents of fringe theories have been trying that one for years. --Hob Gadling (talk) 12:32, 12 July 2021 (UTC)

Yeah.... This is gonna be really useful to preserve in the archive of this talk page. In the future, anyone arguing that "the WHO, Nature, and The Lancet" [do not] "represent the mainstream" is, in my humble opinion, either being disingenuous (and therefore WP:NOTHERE) or has a serious case of WP:CIR.--Shibbolethink ^{(♔ ♕)} 23:21, 12 July 2021 (UTC)

Good idea to preserve the archive of this talk page. Agreed that it is a very strange statement indeed to say that the WHO, Nature, and The Lancet do not represent the mainstream. And I can see why you admins (if that is the correct term) are so motivated to be strict gatekeepers related to conspiracy theories, etc, and how that could motivate you to err on the side of caution on pages like this. I can sympathize with that mindset. However, I believe when folks look back on this they will also see the strained and contradictory statements being made in the attempt to control the narrative. In the end, it will likely work against you, because all of the controlling certainly looks like censorship, and it fuels the fire of conspiracy theories. People will look back on this page and will judge the admins as well as the CT types, and will ask the question: "What were they thinking!?"--DavidM58 (talk) 05:29, 14 July 2021 (UTC)

There is a common trope in pseudoscience of the fantasy of future vindication. Assuming the evidence pans out like it looks its going to, what's likely to happen here is that people will either get bored and move on to some other "wonder drug" for COVID (fluvoxamine?), or else it will get established as a kind of amygdalin, with a long-term hard core of believers complaining about how "they" have suppressed it. For Wikipedia's purposes it's likely there will be some serious academic studies of COVID misinformation in coming years, which will then provide a good basis for improving the article. Alexbrn (talk) 05:41, 14 July 2021 (UTC)

My comment wasn't at all about science vs. pseudoscience. It was about gatekeepers such as yourself who make strained and contradictory statements (throughout this entire talk page) in an attempt to control the narrative. You have provided yet another example. Trying to control the narrative, and accusing those who disagree with you of peddling misinformation and pseudoscience only causes people to resist, solidify, and push back. Allowing reasonable discussion and reasonable conflicting opinions supported by reasonable evidence will more likely result in the truth coming out and being accepted.--DavidM58 (talk) 20:23, 14 July 2021 (UTC)

DavidM58, I would recommend the essays WP:1AM, WP:FLAT, and the policy WP:FRINGE to you. It seems they address many of the points you've made here. Good luck, I hope you find what you're looking for.--Shibbolethink ^{(♔ ♕)} 21:55, 14 July 2021 (UTC)

Ad hominem attacks on other editors won't help your case. MiasmaEternal^TALK 01:10, 13 July 2021 (UTC)

COVID-19

It is truly shocking the lengths taken to suppress information about this potentially life saving treatment for covid. The WHO and CDC have sat on this cheap safe potential treatment since August, meanwhile promoting an unproven expensive vaccine. Why? This is another tool in the toolbox, yet only negative articles are allowed on Wikipedia. When did Wikipedia become so politicized? Is this source good enough for mention? https://clinicaltrials.gov/ct2/show/NCT04668469 .2mg / kg is a low dosage proven to be safe, not the nonsense stated in this wiki

— Preceding unsigned comment added by 2601:603:4A80:5870:3910:DA7:2204:1AE2 (talk) 23:34, 25 December 2020 (UTC) 

Incoming edits due to https://www.news.com.au/lifestyle/health/health-problems/coronavirus-australia-ivermectin-antiparasitic-drug-kills-covid19-in-lab/news-story/615c435e56aefc4b704f4fd890bd4c2c for sure.... — Preceding unsigned comment added by 193.116.241.225 (talk) 14:15, 3 April 2020 (UTC)

Right now [48] and [78] are duplicate refs to the same COVID-19/invermectin article. Boud (talk) 23:38, 5 April 2020 (UTC)

Article incorrectly refers to SARS-COV-2 as a negative sense RNA virus. It is a positive sense RNA virus.

On December 8th 2020 Dr Pierre Kory, speaking as a representative of a group of doctors who together have published nearly 2,000 peer-reviewed publications appeared at a meeting of the Senate Homeland Security and Governmental Affairs Committee to plead that the NIH be forced to review the most recent evidence on the use of Ivermectin as a treatment and prophylactic for Sars-Cov-2 and Covid 19. He claimed that the use of Ivermectin on Covid 19 patients had a "miraculous impact", and this description was based on "mountains of evidence that has appeared in the last three months". He pointed out that the NIH's recommendation that Ivermectin not be used outside of controlled trials was made in August 2020, before the "mountains of data" that emerged subsequently. Dr. Kory presented a summary of this data, and the committee chairman Senator Ron Johnson promised to pass this on to the NIH for review.... <https://osf.io/wx3zn/> <https://www.youtube.com/watch?v=Tq8SXOBy-4w> AussiePete56 (talk) 02:46, 15 December 2020 (UTC)

It is okay to publish the truth about this drug now, and the results it has proven for Covid Treatment. Now that the marxists that control Wikipedia and all the internet have defeated Trump, the truth can come out. https://buffalonews.com/news/local/2nd-wny-hospital-ordered-to-treat-covid-19-patient-with-experimental-drug/article_f32339f0-5d01-11eb-b752-4f8966804581.html — Preceding unsigned comment added by 24.116.87.50 (talk) 11:39, 30 January 2021 (UTC)

I would delete this comment per WP:TPG, but perhaps it's instructive to leave it as an illustration of where the pro-Ivermectin boosterism is coming from. Alexbrn (talk) 11:48, 30 January 2021 (UTC)

Unreliable. Would need WP:MEDRS. Alexbrn (talk) 06:17, 15 December 2020 (UTC)

Here is some more reliable evidence on the effectiveness of Ivermectin in preventing and treating Covid-19 . https://covid19criticalcare.com/wp-content/uploads/2020/11/FLCCC-Ivermectin-in-the-prophylaxis-and-treatment-of-COVID-19.pdf .

https://c19ivermectin.com/ . AussiePete56 (talk) 05:40, 21 December 2020 (UTC)

Unreliable. Would need WP:MEDRS. Alexbrn (talk) 05:43, 21 December 2020 (UTC)

I dispute the claim of "unreliable" by Alexbrn since the two articles are secondary reviews of others' research and therefore qualify as reliable as per the WP:MEDRS guidelines. I notice that the "unreliable" tag was applied to this page three minutes after the links to the two review articles were published - three minutes isn't enough time to read even half of one of the reviews, let alone properly evaluate both. The charge of "unreliable" is therefore itself seemingly unreliable AussiePete56 (talk) 14:47, 21 December 2020 (UTC)

We need secondary sources in reputable medical journals (or medical textbooks, etc). These are obviously not that, and appear to be self-published web sites. Alexbrn (talk) 14:59, 21 December 2020 (UTC)

Using medical journals , textbooks etc is ideal, but as the guidelines state, "It is a generally accepted standard that editors should attempt to follow, though it is best treated with common sense, and occasional exceptions may apply." We are currently in a "war" with a virus which is currently killing nearly 14,000 people a day worldwide - a number which is increasing every day. Information which can save lives is desperately needed. As per guidelines, "Wikipedia's articles are not meant to provide medical advice. Nevertheless, they are widely used among those seeking health information." I maintain that this is clearly a time where an exception to the normal stringent editorial standards should apply. Ivermectin has been taken 3.7 billion times over 40 years and its safety is not in dispute - the only unknown is its efficacy. There is after all, no alternative medicine for Covid 19, and even ventilation in hospital will allow about 23% of patients to die. Surely the "mountains of evidence that Ivermectin works miraculously on Covid 19" that Dr Kory and his team refers to should be mentioned on these pages to allow access to as many medical professionals as possible the information they need to make their own assessments on how to best treat their patients. AussiePete56 (talk) 15:53, 21 December 2020 (UTC)

The current situation is all the more reason why we used the best quality sources, which is why general sanctions apply for this topic requiring WP:MEDRS, of which you have been notified. What you're proposed to add is dodgy (as the word "miraculous" should clue you in to at once). We already cite high quality WP:MEDRS: PMID 33227231. I shall not respond further unless new sources are proposed as this is a clear-cut case. Alexbrn (talk) 16:03, 21 December 2020 (UTC)

My point is that the information being presented in these reviews IS the "best quality source" available - ie, the very latest real-world studies demonstrating life-saving treatments. Alexbrn didn't even read these studies. 6% hospital deaths versus 23% are the results achieved. Some of these studies lack peer-review which typically takes months - time that these 14,000 people who are dying daily no not have. To give priority to ideological purity over thousands of daily deaths is insane and inhumane. To repeat a point that Alexbrm ignores - 3.7 billion doses of Ivermectin has been taken over 40 years. It is safe. There is only potential benefits to using it and strong and growing evidence supports such use. Allowing this information to be available, together with suitable disclaimers, is the appropriate and responsible decision. AussiePete56 (talk) 23:26, 21 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. [1] AussiePete56 (talk) 05:40, 25 December 2020 (UTC)

Alexbrn The actual meta-analysis linked as reference is much more positive as to the effectiveness of Ivermectin that what is stated in this wiki: There is only very weak evidence of ivermectin's benefit when used as an add-on therapy for people with non-severe COVID-19; there is no evidence for people with severe disease.[85]

Why not just quote the conclusion of the actual meta-analysis? Ivermectin is an established drug with a long history of clinical use and with minimal safety concern. Recent observational studies have reported the effectiveness of this drug as add-on therapy in patients with COVID-19. Our meta-analysis also supports this finding and suggests the modest utility of ivermectin in reducing all-cause mortality and improving clinical outcomes. Currently, many clinical trials are on-going, and definitive evidencefor repurposing this drug for COVID-19 patients will emerge only in the future. — Preceding unsigned comment added by Adriaandh (talk • contribs) 17:48, 31 December 2020 (UTC)

}}

"The National Institutes of Health recommend against the use of ivermectin for COVID-19". In the interests of full disclosure, I propose amending this to, "The National Institutes of Health recommended against the use ivermectin for COVID-19 in August 2020". Since then, dozens of research reports on Ivermectin and Covis 19 have been released. Putting a date on the recommendation flags for the reader that it does not necessarily encompass the most recent research. AussiePete56 (talk) 17:36, 1 January 2021 (UTC)

This would be possible is it was also added "... and is still current as of 2021", because of course such guidelines are under constant review. And we wouldn't want to give the false impression that the NIH is somehow outdated, now would we? Alexbrn (talk) 17:41, 1 January 2021 (UTC)

I would accept your suggestion on a "better than nothing" basis. Do you really think that the NIH's position is not outdated Alexbrn? You always exude the attitude that conformity to authority equals virtue. Do you have any theories on why the NIH, CDC and FDA allocated zero public funds to the investigation of re-purposing existing drugs against Covid 19, and instead went "all-in" on developing novel vaccines? I'm not cynical, but cynics would say, "Because that's where the money is." Many billions of dollars. And the vaccines don't work on patients who already have the virus. And it will take about a year for 80% of first-world countries to get vaccinated, and many more years for third-world countries.

So we're up to 15,000 people per day dying from Covid 19 at the moment, most of whom could be saved on the evidence of dozens of studies that the NIH ignores.... AussiePete56 (talk) 14:37, 2 January 2021 (UTC)

Please do not use Talk pages to push conspiracy theories. As multiple editors have now advised you, WP:FOC. Alexbrn (talk) 14:46, 2 January 2021 (UTC)

We should try to avoid turning this into a discussion board, and try to focus on reporting what our sources say. Since regulatory bodies routinely change their positions, their prior positions by their own admission were outdated. Teishin (talk) 14:51, 2 January 2021 (UTC)

Alexbrn, you have repeatedly referred to the 28 studies which each independently found that Ivermectin works to alleviate Covid 19 illness as "fake" - that sounds like a conspiracy theory to me. AussiePete56 (talk) 14:50, 3 January 2021 (UTC)

Something trying to pass itself off as a journal article, when it's just a self-published web site, is a "fake" journal article. As noted, people sharing it on Facebook get banned. Maybe Wikipedia should do the same. Alexbrn (talk) 14:55, 3 January 2021 (UTC)

I have no skin in this game. I just saw this chart stating far lower cumulative deaths from COVID-19 in the Mexican state of Chiapas compared to all the others and how that correlates with it being alone amongst them in using Ivermectin: https://twitter.com/Covid19Critical/status/1347721731272830976 (That mention of Ivermectin brought me here.) The correlation may be something which can be readily verified or disproved as it claims to be from public official data and the outcome mentioned on the main page. ― Ralph Corderoy (talk) 12:08, 10 January 2021 (UTC)

I'm late for this discussion. c19early, c19study, c19legacy, c19ivermectin, ivmmeta, c19hcq, hcqmeta, and others, use grossly incorrect methodology, producing biased results with bizarre p-values. They are still being used as "evidence" by political groups in Brazil to spread medical disinformation. (talk) 01:23, 26 April 2021 (UTC)

Does the recommendation from the ministry of health of India count as a reliable source ? https://www.icmr.gov.in/pdf/covid/techdoc/COVID19_Management_Algorithm_22042021_v1.pdf I hear also IVM is used in Mexico city now https://mexicobusiness.news/health/news/ivermectin-controversial-covid-19-drug-used-mexico-city Isn't it enough to say at least that there is no consensus on efficacy? We don't live in Disneyland, health agencie's recommendations in rich countries account for billions in drug purchasing.How could there be no influence when there are choices like $1000 remdesivir vs $5 hcq or ivermectin ? In countries with lower financial resources there are also bright people, but less pressure not to reuse existing drugs.— Preceding unsigned comment added by Pweltz (talk • contribs) 15:34, 28 April 2021 (UTC)

Reliable for their view, but since the Indian govt. is a busy hive of quackery and pseudoscience not reliable for any rational assertion about reality. Alexbrn (talk) 15:50, 28 April 2021 (UTC)

Could we just remove the "misinformation" claim? "A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness" https://pubmed.ncbi.nlm.nih.gov/33278625/ HaraldTheBlue (talk) 23:32, 6 June 2021 (UTC)

Hospitalized patients only, says the study. Not for mild disease, at home. And it concludes with Larger trials will be needed to confirm these preliminary findings. 72 participants is quite a small sample indeed. --Fernando Trebien (talk) 03:47, 7 June 2021 (UTC)

The link shows that it isn't misinformation and the source for the 'misinformation' claim comes from a patient group on social media. The reference to 'misinformation' needs to be removed if this page is to conform to the neutrality rule.

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Note the imprecise wording of the Invermectin COVID-19 Wikipedia entry: "As of January 2021, the U.S. National Institutes of Health COVID-19 Treatment Guidelines state that the evidence for ivermectin is too limited to allow for a recommendation for or against its use." This wording does not make clear that ivermection is now a treatment option for COVID-19. In fact, the “neither for nor against” NIH classification is the "recommendation given to monoclonal antibodies and convalescent plasma, both widely used across the nation." [2] Unfortunately, this clarification can not be made because the COVID-19 section is locked down for edits even from autoconfirmed users--which is contrary to the edit notification for that section. I hope this is just a mistake and not a tragic example of "cancel culture" impacting Wikipedia. — Preceding unsigned comment added by Swisswiss (talk • contribs) 18:48, 20 January 2021 (UTC)

Concerns about reporting of study results:

This statement is false: 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. I quote directly from the study: the median viral load for both genes was lower at days 4 and 7 post treatment in the ivermectin group with differences increasing from 3-fold lower at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) to around 18-fold lower at day 7 (p = 0·16 for gene E; p = 0·18 for gene N)

The study DID find a difference - it was just not statistically significant based on the threshold chosen. Even the PCR found a difference - RR 0·92. If you want to write something negative based on the results of this extremely small study, then write that it was underpowered to find statistically significant difference. Because every single endpoint found a difference showing benefit of Ivermectin use.Adriaandh (talk) 09:53, 10 February 2021 (UTC)

• I found the same error. It is interesting that the one paper cited in support of ivermectin's ineffectiveness actually does a pretty good job selling its beneficial effects - note that, on top of the difference in viral load that did not meet the significance threshold, it did find a significant reduction of symptoms. Whether or not the experimental design designated this as a "primary finding" would seem to me to have no bearing on the scientific merit of the finding, or its relevance to the text of this article. 2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:08, 18 May 2021 (UTC)

• • Not to worry, the editors simply deleted all mention of this study rather than reckon with their error.2600:1700:7CC0:4770:C47C:4E3C:EC7D:831 (talk) 20:34, 18 May 2021 (UTC)

The section on Covid seems to be highly subjective

The section on Covid seems to be highly subjective and possibly inaccurate. I believe it should be changed to more neutral and objective as Wikipedia standards dictate - removing the word "misinformation" and to change "no reliable evidence exists" to "no large scale studies have been done."

All research that has been performed to my knowledge has shown that ivermectin is effective at treating Covid. A meta-analysis of four papers, accessible through the NIH, shows a .02 p value that adding ivermectin to a treatment regimen leads to improved clinical outcomes.

While they do stipulate that the quality of the individual papers included in the meta-analysis is "very low," they go on to say "currently, many clinical trials are on-going, and definitive evidence for repurposing this drug for COVID-19 patients will emerge only in the future."

As far as I am aware, all subsequent papers have all found that ivermectin was effective in treating Covid. This website that performs a real time meta-analysis of all papers (as of comment, 55 studies) shows a p value of disproving the clinical results as p = 0.000000000000043.

While there are no large scale studies of ivermectin as of yet, there is nothing but positive research (again, as far as I know) that show that it is effective. Therefore, "misinformation" does not objectively apply to this situation. It should only be applied when we have reliable information that the claim is false. On the contrary, the only reliable information we do have is that the claim is true, though I grant that it is far from settled science due to lack of large scale studies.

Further, while any of the smaller studies on their own might not be considered "reliable," surely a meta-analysis of 55 studies demonstrating a remarkably small p-value, could arguably considered reliable. Notwithstanding the lack of a large scale study, the meta-analysis data should disqualify the descriptor "not reliable" from being used by an objective source such as Wikipedia. 2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 08:45, 16 May 2021 (UTC)

ivnmeta.com is not a reliable source. This article cites several reliable sources. Alexbrn (talk) 08:57, 16 May 2021 (UTC)

I believe my overall point stands even with only the first source. The authors find a statistically significant beneficial effect in their meta-analysis of 4 papers (though they stipulate the individual papers to be of very low quality) and say only time will tell when there is more of a body of evidence shown.

As others have pointed out, since the publication of that paper, many other papers have shown significant results in favor of ivermectin, even if not all 55 papers included in the website you mention are legitimate (I wonder, which aren't? I genuinely don't know).

My argument against the use of the word disinformation therefore stands, as this is an active ongoing area of research (and I might add, the overwhelming body of evidence, however inconclusive, points to its efficacy).2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:09, 16 May 2021 (UTC)

Things have moved on since November, but in fact we already cite that review (actually, at COVID-19 drug repurposing research#Ivermectin which is transcluded here). The line from ivermectin proponents was for a long time that high-quality evidence of benefit was just around the corner. It hasn't appeared, and ivermectin advocacy has passed into the realm of quackery, antivax, COVID denial and conspiracy theorizing.[3] There's not much more Wikipedia can do than report the caution from our best (WHO, FDA, NHS, etc.) sources and the shame of the misinformation that's been spread. Alexbrn (talk) 09:15, 16 May 2021 (UTC)

Why is science based medicine deemed reliable here and not the other websites of individual physicians? Again, I am relatively new to this issue and am trying to understand the terrain here. As for "ivermectin advocacy has passed into the realm of quackery, antivax, COVID denial and conspiracy theorizing," this again reads as highly subjective.2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:24, 16 May 2021 (UTC)

We don't cite that SBM article (there's no need when we have top-level WP:MEDRS), but SBM is regarded as a reliable source for fringe medical claims (see WP:RSP). I'm not sure what you mean by subjective. If you want to read about the sociological aspects of ivermectin/COVID advocacy - which Wikipedia does not really cover - there's plenty of reading to be done, starting here maybe? As far as (lack of) evidence of efficacy goes, we have unimpeachable sources already cited. Alexbrn (talk) 09:32, 16 May 2021 (UTC)

Your linked source (New Statesman) does not address any of the points I am making RE subjective use of "disinformation." It reiterates that the papers have been included in meta-analyses are low quality, and that a large scale trial at Oxford is underway. Where is the sufficient objective basis to label this issue "misinformation?" 2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:46, 16 May 2021 (UTC)

The subjective/objective distinction, if meaningful anywhere, is not meaningful for the purposes of reflecting what reliable sources say. By any measure the claim that ivermectin is a "miracle cure" or indeed effective at all, is misinformation. Reliable sources contain that knowledge, Wikipedia reflects it. That is the function of an encyclopedia. There is more detail on the misinformation at the COVID-19 misinformation article. Alexbrn (talk) 10:10, 16 May 2021 (UTC)

"By any measure the claim that ivermectin is a "miracle cure" or indeed effective at all, is misinformation." According to the WHO, no conclusion has been reached on this question. Certainly an investigator who finds an effect, in an ongoing worldwide clinical effort, in not spreading misinformation by reporting their finding. Certainly the WHO's own analysis that no conclusive finding has been reached, should outrank a non-SME deeming ivermectin benefits to be "misinformation." I also question why the European Medicines Agency recommending against its use, is being cited over the WHO, which does not recommend either for or against.2600:1700:7CC0:4770:D89C:66EE:D017:775B (talk) 21:06, 16 May 2021 (UTC)

From the New Statesman article linked above by Alexbrn as a reputable source - "at the moment the only scientific response is to withhold judgement." This language far more accurately describes the current state of the science as far as I can tell. I remain confused as to why "misinformation" is an accurate characterization of the potential benefits of ivermectin, and further why it should be included in a single-sentence synopsis on the topic - seems to me that something more akin to the official WHO language would serve to inform readers better, rather than arbitrarily shepherd them towards adopting a subjective opinion RE misinformation. 2600:1700:7CC0:4770:D89C:66EE:D017:775B (talk) 00:04, 17 May 2021 (UTC)

The WHO is already cited. Claims that ivermectin is an effective COVID treatment are misinformation. A statement that we should "withhold judgement" would not be; but that's not what the advocates are saying. That's the reality according to the sources. Alexbrn (talk) 05:48, 17 May 2021 (UTC)

Surely, under your definition, misinformation is spread about every drug known to humanity. The question is, what is the most informative way to present the relevant information in a one-sentence synopsis? Is it to debunk a notion that the reader may or may not have prior to reading the article, in a manner that easily could lead others to a false understanding of the scientific record - ex. "Wiki says Ivermectin being effective against Covid is misinformation, so this must mean it is not effective!" Or is it to provide a simple summary of the science - "research to ascertain effectiveness is underway"? In my opinion, the current language creates a false impression in the reader and endeavors to "correct" rather than inform. If use of "misinformation" is strictly necessary, then more specificity as to what is misinformation and what is not would seem to me to be of the utmost importance.2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 18:51, 17 May 2021 (UTC)

"There is no evidence it is effective" obviously means just that. We are not responsible for any misunderstandings by people who cannot read. There are people out there who tell you it works against COVID, and Wikipedia needs to tell you that those people pulled that information out of their own ass. I don't know what is so difficult about that. --Hob Gadling (talk) 05:39, 18 May 2021 (UTC)

That is not an accurate characterization of my argument. Allow me to point out what exactly I find misleading: "During the 2020 COVID-19 pandemic misinformation was widely spread claiming that ivermectin was beneficial for treating and preventing COVID-19. No reliable evidence exists to back up such claims." Notwithstanding the fact that a paper cited in the body of the article (deemed reliable) does offer evidence that ivermectin is beneficial in the treatment of Covid, labeling the claim "misinformation," which indicates that the information is false, could indeed lead a careful reader to conclude that the information is not simply unsubstantiated (again, I would argue against that claim as an aside) but indeed that it has been falsified (incontrovertibly not the case). The word "misinformation" in the context of this sentence simply is not merited in my view. 2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 05:56, 18 May 2021 (UTC)

We assume our readers are reasonably intelligent. Any reader who was provoked into imagining something nonsensical about the falsifiability of a drug's efficacy would not be a "careful reader", they'd be daft. You seem to be pursuing some kind of Truth™ but Wikipedia's purpose is to reflect reliable sources. Alexbrn (talk) 06:05, 18 May 2021 (UTC)

Nonsense. Equivalence with a placebo could be easily determined by an experiment designed towards that end. 2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:14, 18 May 2021 (UTC)

I will also repeat an argument earlier for which I have heard no response. Why should a researcher, accurately reporting their findings, deemed to be spreading "misinformation?"2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:20, 18 May 2021 (UTC)

The is good evidence, or there is not. We're in the latter circumstance. It's likely that the True Believers will always find something in any experiment that they say supports their Truth™, no matter how unencouraging it is. Anyway, without new sourcing I think we are done here. Your question has no relevance to our article text. Alexbrn (talk) 06:22, 18 May 2021 (UTC)

The article text improperly uses the word misinformation. That is the relevance of my question. As for whether there is good evidence or not, do you now believe the paper that is currently cited by the article is no longer "good evidence," now that you have been informed that it contains significant evidence of benefits of the use of ivermectin in treating Covid?2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:25, 18 May 2021 (UTC)

Per WP:GEVAL we need to make sure misinformation (e.g. "wonder drug") is properly identified. This is policy. There is no good evidence per the WP:MEDRS sources we cite; this is a the sourcing standard for biomedical information on Wikipedia. If you have a specific proposal, make it, but this is just looking like a prolonged waste of time so I shall not respond further if no concrete policy-based proposal is made. Alexbrn (talk) 06:33, 18 May 2021 (UTC)

I feel I have (more than) adequately detailed my concerns over the term "misinformation" as it is deployed currently in the summary of ivermectin vis a vis Covid. Certainly specifying what is misinformation (ex. "miracle cure" has clearly been established by the research not to be accurate) and what is not (the open prospect that it might be deployed as a beneficial treatment and/or preventative measure) would be a good way to begin addressing these concerns.2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:46, 18 May 2021 (UTC)

No, because your "open prospect" narrative is a WP:PROFRINGE one out of alignment with the way in which decent sources refer to the matter. Alexbrn (talk) 06:52, 18 May 2021 (UTC)

It aligns perfectly with the language within the paper currently cited in the article (I was not the one who deemed this paper reliable). Regardless, if the term "misinformation" must be used (I wonder why this is the case), it certainly should be directed at a specific target. What exactly is misinformation?2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 07:01, 18 May 2021 (UTC)

You have no idea how ironic what you're spouting is. 2402:B801:2867:E200:C5E8:96E4:1417:F9CC (talk) 09:36, 23 May 2021 (UTC)

Miracle Cure or Cruel Hoax (May 6th 2021).Moxy- 21:52, 18 May 2021 (UTC)

If the term "miracule cure" indeed is what is referred to by "misinformation" in the introductory sentence, then that should be specified. As it stands, the vague application of misinformation appears to be directed towards the idea that ivermectin is beneficial in treating covid - a conclusion which by no means is reflective of the current state of the science. Further, I would question why fact checking the "miracle cure" claim would warrant "lede" status, but I am not willing to die on that hill ;) 2600:1700:7CC0:4770:C47C:4E3C:EC7D:831 (talk) 22:14, 18 May 2021 (UTC)

MEDRS Dhama et al (2020) on Ivermectin and Covid

From p. 29 of this MEDRS in one of the best journals (Clinical Microbiology Reviews):

Recently, another FDA-approved drug, ivermectin, was reported to inhibit the in vitro replication of SARS-CoV-2. The findings from this study indicate that a single treatment of this drug was able to induce an 5,000-fold reduction in the viral RNA at 48 h in cell culture. One of the main disadvantages that limit the clinical utility of

ivermectin is its potential to cause cytotoxicity. However, altering the vehicles used in the formulations, the pharmacokinetic properties can be modified, thereby having significant control over the systemic concentration of ivermectin (338). Based on the pharmacokinetic simulation, it was also found that ivermectin may have limited therapeutic utility in managing COVID-19, since the inhibitory concentration that has to be achieved for effective anti-SARS-CoV-2 activity is far higher than the maximum plasma concentration achieved by administering the approved dose (340). However, ivermectin, being a host-directed agent, exhibits antiviral activity by targeting a critical cellular process of the mammalian cell. Therefore, the administration of ivermectin, even at

lower doses, will reduce the viral load at a minor level. This slight decrease will provide a great advantage to the immune system for mounting a large-scale antiviral response against SARS-CoV-2 (341). Further, a combination of ivermectin and hydroxychloroquine might have a synergistic effect, since ivermectin reduces viral replication, while hydroxychloroquine inhibits the entry of the virus in the host cell (339). Further, in vivo studies and randomized clinical control trials are required to understand the mechanism as well as the clinical utility of this promising drug

I propose we edit the article to acknowledge that this source says "ivermectin, even at lower doses, will reduce the viral load at a minor level.". Forich (talk) 02:40, 24 May 2021 (UTC)

[4].Moxy- 04:35, 24 May 2021 (UTC)

The source is old in comparison to later good ones, and a WP:REDFLAG flies. It does not raise confidence that the text about "immune response" is cited to a single letter, and misrepresents it (by boosting a "can" to a "will"). We already say why pre-clinical work gave rise to the notion that ivermectin might have utility as a treatment. Alexbrn (talk) 10:24, 24 May 2021 (UTC)

ivmmeta and all similar domain names linking to the same site

Tagging in user:Aaronmhamilton to this discussion about sites like ivvmeta.com. These are not MEDRS, and as has been discussed above several times, the findings on that site are not a legitimate reason for any edit on this page. To restate my reasons for this revert:

For 1, you can't change the wording and keep the same citation, that's misleading. Because the citation does not support that claim. For 2, there is actually a great deal to distrust about the website this editor linked. It is not a MEDRS. It is entirely anonymous, no one knows who runs the site or if they actually have any credentials to back up the ad-hoc analysis they're doing.

As a medical researcher and scientist, I can tell you they break a lot of the golden rules of meta-analysis. But you don't have to trust me on that, and you shouldn't, because that's not how wiki works! Trust the RS: There are peer reviewed articles (and several much more informal take-downs that themselves link to MEDRS) detailing exactly what is wrong with that website and how they do their systematic review, and where they go wrong. More than anything, they have cherry picked which outcomes to use from each study, which "informal" studies to include, which patients to include, and they have combined data that is in different settings, different types of patients, all in a way that makes the data look shiny and good for their preferred outcome. You will find that this site differs in conclusion from basically anything published in a reputable MEDRS. There's a reason for that. And it isn't a conspiracy, it's that the scientific community tends to agree on how systematic reviews are meant to be performed. this ain't it, chief. Overall it is a shame that site is so terrible in its methodology, because it has fabulous style. Style points, unfortunately, are not worth much in science. --Shibbolethink ^{(♔ ♕)} 02:15, 25 May 2021 (UTC)

When you bring an inappropriately sarcastic and derisive quip like "this ain't it chief" to the table, it is clear that it's personal to you, and honestly, that you haven't evaluated the specific claims of your citations on the matter. I guess I'll revisit this when there are more cold bodies. Aaron Muir Hamilton <aaron@correspondwith.me> (talk) 03:33, 25 May 2021 (UTC)

Hahaha, no no no, I apologize if it came off that way. I just am tongue-in-cheek about most things. I meant no harm by my comments, you are not the first and you will not be the last to find that site trustworthy, and I spend my time criticising data, not people. Like I said, it is visually very impressive. But I judge badly done science especially poorly, and that site needs some work in its understanding of the levels of evidence re: Greeenhalgh. It's particularly flawed methodology to group RCTs and non-RCTs together in a systematic review, as it degrades the quality of the conclusions you can draw from it. In evidence-based medicine, conclusions are drawn based on what the highest quality available evidence tells us, not the plurality of evidence. One million unblinded case reports do not surpass one RCT. And, as wikians, we are supposed to take what the most reliable highest quality systematic reviews of RCTs say, and restate it for the public. Anyway, when you're ready to come back and talk about it, there's always plenty of people around here to talk about it with! --Shibbolethink ^{(♔ ♕)} 05:10, 25 May 2021 (UTC)

Sources

Ah, yes. Saying one thing in the style of "this ain't it chief" invalidates all the solid reasoning by the same person. That way of thinking is similar to the fallacy fallacy, but not quite the same. If the way you judge an argument is that superficial, it's no wonder that you cannot tell that site is a bad source. It mimicks the style of science, and Shibbolethink did not, and style trumps content for you. Well, as Shibbolethink said, that is not how Wikipedia works. --Hob Gadling (talk) 09:04, 26 May 2021 (UTC)

Current clinicial trials

Currently there is a Principle trial being ran investigating the effectiveness of ivermectin in treating COVID in over-50s in the UK. The trial currently has over 5,000 volunteers.

It may be appropriate to include this in the lead of the article as the fact that such a large-scale study from a reliable organisation is currently taking place is very notable and will be an extremely useful and reliable source when the study publishes its results, whichever way it goes. Yeah, that's fine. (talk) 08:42, 23 June 2021 (UTC)

 Done Yes, that would seem appropriate as this is a BIG one that has gained mainstream attention. Updated at COVID-19 drug repurposing research. Alexbrn (talk) 13:42, 23 June 2021 (UTC)

Perhaps the paragraph "During the COVID-19 pandemic, misinformation was widely spread claiming that ivermectin was beneficial for treating and preventing COVID-19.[14] Such claims are not backed by sound evidence.[15][16][17][18][19]" should now be revised. It appears too harsh. The metadata study reported at , appears, at first glance, to show a benefit for treatment and prevention. K012957 (talk) 13:18, 13 July 2021 (UTC)

 Not done That source is not cited as it is not sufficiently reliable, as discussed in multiple locations on this Talk page. Alexbrn (talk) 13:23, 13 July 2021 (UTC)

Okay, I understand. Still, there is the new NIH-sponsored study (started in June 2021) at . There are no results yet. They are still recruiting. Perhaps a mention of the various NIH-sponsored studies would be appropriate? K012957 (talk) 13:49, 13 July 2021 (UTC)

Already are. Alexbrn (talk) 13:51, 13 July 2021 (UTC)

A study from Pasteur Institute on an animal model : --Mreg93 (talk) 10:58, 17 July 2021 (UTC)

Where is safely achievable level found?

> Based on this information, however, doses much higher than the maximum approved or safely achievable for use in humans would be required for an antiviral effect.

This statement links to the following sources, https://en.wikipedia.org/wiki/Ivermectin#cite_note-COVID-19_drug_repurposing_research_Bray_2020-95, https://en.wikipedia.org/wiki/Ivermectin#cite_note-96

I can however not find where the papers states that they are not "safely achievable". I just find that they base their statement on the maximum approved standard.

Roman et al: Ivermectin for the treatment of COVID-19

• Roman YM, Burela PA, Pasupuleti V, Piscoya A, Vidal JE, Hernandez AV (28 June 2021). "Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials". Clinical Infectious Diseases. doi:10.1093/cid/ciab591. ISSN 1058-4838. PMID 34181716.

Should be useful, at least until the big trials are complete and their results incorporated in newer reviews. Alexbrn (talk) 06:07, 29 June 2021 (UTC)

unsubstantiated COI accusations and off-topic discussions. We are not here to peer-review.-Shibbolethink (♔ ♕) 03:39, 15 July 2021 (UTC)

The new serious paper that discard ivermectine is from Clinical Infectious Diseases published by Oxford University Press, that is in no way linked to the Oxford–AstraZeneca_COVID-19_vaccine. Obviously his is not a WP:COI because the paper is not part of wikipedia, so I will take it as a joke. --Eloyesp (talk) 02:14, 30 June 2021 (UTC) ...huh? Are you saying that if we were to use this WP:BESTSOURCES systematic review in the article, you would consider it a COI? I'm sorry I'm just confused by the wording of your comment. You do think it's a COI? or not?--Shibbolethink (♔ ♕) 02:27, 30 June 2021 (UTC) I'm just saying that ignoring that Oxford is one of the interested parties on a conflicting subject and treating it as "unbiased research" (quoted from WP:BESTSOURCES) does not makes any sense. As far as I understand Oxford University depends on Ivermectine not being an accepted treatment on Covid to continue selling the Vaccine (as the emergency approval can only be allowed when there is no alternative treatment). As always, I may be missing something. Just to clarify, I didn't know about WP:BESTSOURCES, but clearly an Oxford published paper on Ivermectine is not one (just as a paper on their vaccine is not or a company paper about his product is not).--Eloyesp (talk) 02:59, 30 June 2021 (UTC) The authors ≠ Infectious Diseases Society of America ≠ Oxford University Press ≠ Oxford/Astrazeneca. This objection has to be one of the most ignorant pieces of tinfoilery I've yet seen on Wikipedia. As a reminder, some basic level of competence is required to edit Wikipedia. Alexbrn (talk) 06:23, 30 June 2021 (UTC) I would like to hear more voices, as you may be the one lack the social skills here as I feel you are making exceptions to WP:DNB on a regular basis. I feel that, while your Good Faith is clear, you might lack some social skills for dispute resolution like empathy and humility. --Eloyesp (talk) 11:49, 30 June 2021 (UTC) You need to WP:FOC. It helps nobody to indulge idiotic arguments. Alexbrn (talk) 11:52, 30 June 2021 (UTC) I forgot about civility on the list. I will refrain for more edits until next week to prevent WP:EUI, as I feel a little bit offended by your personal attacks and I think it is better to calm down a bit. Regards. --Eloyesp (talk) personally I agree that asserting this as a legitimate COI makes me question whether Eloyesp is WP:HERE. That's why I asked for clarification, because I didn't believe it at first. It's just obvious baloney. Have you read WP:FLAT? What were your thoughts?--Shibbolethink (♔ ♕) 12:21, 30 June 2021 (UTC) I think the broader concern of conflicts of interest in research, especially in biomedical research, is a valid overall concern, and especially so for a topic as controversial as ivermectin. However the above connection via Oxford University Press publisher is questionable at best. A more appropriate example of potential COI would be the Lopez-Medina RCT Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19 widely cited as an example of ivermectin's inefficacy for treatment, with disclosures of funding directly from pharmacautical companies: "Dr López-Medina reported receiving grants from Sanofi Pasteur, GlaxoSmithKline, and Janssen and personal fees from Sanofi Pasteur during the conduct of the study. Dr López reported receiving grants from Sanofi Pasteur, GlaxoSmithKline, and Janssen and personal fees from Sanofi Pasteur during the conduct of the study. Dr Oñate reported receiving grants from Janssen and personal fees from Merck Sharp & Dohme and Gilead outside the submitted work." Caprilyc (talk) 13:05, 30 June 2021 (UTC) As MEDRS says: "Do not reject a high-level type of source ... because of personal objections to the inclusion criteria, references, funding sources, or conclusions ..." Sources can only be questioned when there is some sourced legitimate basis for doing so. Alexbrn (talk) 13:10, 30 June 2021 (UTC) I don't think questioning a high-level source which openly discloses being funded by a Merck subsidiary as a potential conflict of interest is a stretch, or counts as a "personal objection." I didn't feel strongly enough to start up a thread about it in the first place, but as far as conflicts of interest go, that seems like a legitimate basis. If you disagree please elaborate on why you believe the authors of this study receiving funding from a Merck subsidiary does not represent a conflict of interest. Caprilyc (talk) 13:33, 30 June 2021 (UTC) It's a personal objection. Journals have editorial processes, require conflict of interest transparency, and use independent peer review to validate research, and are not discounted just because some random Wikipedia editor thinks their conspiracy-theory-fuelled sleuthing trumps all that; some external expression of concern are needed. The JAMA article is a primary source in any case and not usable here, so the question is moot. The objections to the Clinical Infectious Diseases are also personal objections, and absurd ones at that. Alexbrn (talk) 13:39, 30 June 2021 (UTC) I agree that the Clinical Infectious Diseases objections are dubious and that the Merck/Lopez-Medina connection would need further sources to be included. My point was that that is a direct connection not an extremely hypothetical chain for a possible COI. Caprilyc (talk) 13:48, 30 June 2021 (UTC) Conflicts of interest happen all the time, and are not necessarily a bad thing - in some sense they are inevitable because of the nature of specialism and expertise. What is bad is undisclosed and so unmanaged conflicts of interest that can taint work. Basically, you are indulging in a conspiracy theory with zero documentary support. Alexbrn (talk) 13:59, 30 June 2021 (UTC) I'm sorry can you elaborate on the exact conspiracy theory I am indulging? I am merely pointing out an openly disclosed potential conflict of interest. I don't see how this equates to indulging a conspiracy theory. As I stated above I believe that "Merck/Lopez-Medina connection would need further sources to be included." Caprilyc (talk) 14:12, 30 June 2021 (UTC) The conspiracy theory is that in some unspecified way pharma companies were responsible for results which are not reliable. Curious about this, I looked around a bit and see the ivermectin yahoos on the web have been trying very hard to discredit this research. Have you been drinking their koolaid? I notice an entire domain devoted to a letter (jamaletter.com) rejected by JAMA, and containing some of the usual suspects among the signatories, including Pierre Kory and Paul E. Marik, and spot checking another name at random it's the executive director of the Association of American Physicians and Surgeons - which shows we're entering the orbit of planet quackery here. Alexbrn (talk) 14:19, 30 June 2021 (UTC) I've seen the articles you linked to, and don't think any of them would count as a reputable source by Wikipedia standards. As I have said repeatedly I'm not certain that the connection between Merck and Lopez-Medina is conclusive enough to warrant further discussion unless it gets confirmed by other sources. But there are many well-documented cases of similar conflicts of interest with pharmaceutical industry and medical research in the past, for further on the reading see: Hidden conflicts? Pharma payments to FDA advisers after drug approvals spark ethical concerns, Merck Manipulated the Science about the Drug Vioxx, Academic Medical Center Leadership on Pharmaceutical Company Boards of Directors, Memorial Sloan Kettering Curbs Executives’ Ties to Industry After Conflict-of-Interest Scandals, Harvard Medical School in Ethics Quandary I don't think any of these sources count as conspiracy theorist or trying to promote a particular agenda. Caprilyc (talk) 15:33, 30 June 2021 (UTC) Yes, hidden conflicts of interest, as the Science piece points out, are unethical and problematic. But that is not the situation with the JAMA article which has COI disclosure. Ironically, the only documented hidden conflict of interest in this topic area is that SBM piece raises about the Bryant, Lawrie et al paper, which the ivermectin boosters are so incuriously keen on. Alexbrn (talk) 15:45, 30 June 2021 (UTC) Even non-hidden conflicts of interests can have effects... Per Pharmaceutical_industry#Controversies: "Meta-analyses have shown that psychiatric studies sponsored by pharmaceutical companies are several times more likely to report positive results, and if a drug company employee is involved the effect is even larger." Caprilyc (talk) 15:48, 30 June 2021 (UTC) Yes, and is precisely what the publication process and peer-review seek to deal with. Wikipedia follows reliable, published, reputable sources for this reason. If there's documented cause for concern that is one thing, but editors with a POV not liking something cannot be allowed to influence source choice, for obvious reasons. Alexbrn (talk) 15:54, 30 June 2021 (UTC) Wholeheartedly agree! Caprilyc (talk) 16:13, 30 June 2021 (UTC) also, wanted to say, it's important to identify when someone is attacking us, vs our arguments. and if multiple people think our argument is baloney, maybe it's time to reassess that argument and admit we were wrong. --Shibbolethink (♔ ♕) 12:23, 30 June 2021 (UTC) @Eloyesp: @Caprilyc: Someone stands to benefit from the continued instigation of such a conspiracy. If you follow the money, you can easily tell who it is; after all, its sale soared. Ivermectin has been tested at various locations by various healthcare professionals at various times during the last 15 months. Being cheap, if it really worked, governments would be scrambling to distribute it, as that would end the pandemic and save trillions of dollars. We don't see that happening, so clearly there is no basis for the claim that any of the existing studies supporting it are proving anything. Do you really think the UK government would be so stupid to let AstraZeneca make money at their expense? What about the US government? Are 600 thousand deaths and a recession worth the profit of some national big pharma company? What we do see rich countries investing in is lockdowns and monoclonal antibodies, the latter being too expensive for large scale use in developing countries. Ivermectin was used in India during last month's peak due to despair but not before that, and it is used in Brazil which is in the middle of a Senate inquiry to investigate corruption while handling the crisis. While ivermectin continues to be used in Brazil for that purpose, you can see in the data there is no significant effect in preventing deaths. --Fernando Trebien (talk) 17:41, 30 June 2021 (UTC) "Someone stands benefit from the continued instigation of such a conspiracy. If you follow the money, you can easily tell who it is; after all, its sale soared." - by this are you implying Merck would financially benefit if ivermectin was proven an effective treatment for COVID? As far as I am aware the drug is off-patent at this point. Were you implying Merck is promoting misinformation about effectiveness of ivermectin, in order to sell more of it? Caprilyc (talk) 17:54, 30 June 2021 (UTC) If it is off-patent, who is making money from the sales? Think. It's a group of manufacturers. --Fernando Trebien (talk) 18:33, 30 June 2021 (UTC) I read the fulltext Roman et al. paper and I am not sure I understand how their conclusions follow from the data. For all cause mortality they report risk with ivermectin 2 per 100 vs 6 per 100 with control; RR 0.37 (0.12 to 1.13) with very low certainty of evidence. This contradicts an earlier version of the paper where all-cause mortality was reported as RR 1.11 (0.16 to 7.65) - their conclusion of "IVM did not reduce all-cause mortality vs. controls (RR 1.11, 95%CI 0.16-7.65, very low QoE)" makes sense for the earlier version but the latest revision just does not make sense. "IVM did not reduce all-cause mortality vs. controls (RR 0.37, 95%CI 0.12 to 1.13, very low QoE)" Can someone please explain how a RR of 0.37 for all-cause mortality is not a reduction? I understand that the confidence interval is wide but based on my reading of the data they present, their conclusions do not follow from the data they present. Caprilyc (talk) 13:53, 6 July 2021 (UTC) This is WP:NOTAFORUM, and especially not for attempting amateur peer-review. I suggest you take these queries (incidentally, the talking points being pushed by pro-ivermectin disinformation sites) to a forum such as the comment section here, where such things get regularly aired. Alexbrn (talk) 14:00, 6 July 2021 (UTC) Alexbrn sorry if I am overstepping my bounds here, but I am merely pointing out the fact that even the abstract does not make sense. I don't think this constitutes trying to perform "detailed peer review." My understanding of relative risk and confidence intervals is that RR < 1 for all-cause mortality means a reduction in all-cause mortality. If the CI includes 1 the relative risk is not statistically significant. But "IVM did not reduce all-cause mortality vs. controls" is not an appropriate interpretation of the new data. "IVM reduced all-cause mortality, but the reduction was not statistically significant" would be an appropriate interpretation. Even the article you linked parrots this info: "Ten RCTs (n=1173) were included. Controls were standard of care [SOC] in five RCTs and placebo in five RCTs. COVID-19 disease severity was mild in 8 RCTs, moderate in one RCT, and mild and moderate in one RCT. IVM did not reduce all-cause mortality vs. controls (RR 0.37, 95%CI 0.12 to 1.13, very low QoE) or LOS vs. controls (MD 0.72 days, 95%CI −0.86 to 2.29, very low QoE). AEs, severe AE and viral clearance were similar between IVM and controls (all outcomes: low QoE). Subgroups by severity of COVID-19 or RoB were mostly consistent with main analyses; all-cause mortality in three RCTs at high RoB was reduced with IVM." If I have missed something in my interpretation please elaborate. Caprilyc (talk) 14:37, 6 July 2021 (UTC) WP:NOTAFORUM. The meaning of the source is perfectly clear. Alexbrn (talk) 15:19, 6 July 2021 (UTC) Not sure what you mean by WP:NOTAFORUM as I am not proposing original research, personal inventions, personal feelings on a topic. I am trying to contribute to the discussion by pointing out an apparent discrepancy in the abstract of a paper that is relevant to the assessment of ivermectin as a treatment for COVID. Relative risk is "the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group." If all-cause mortality RR for ivermectin-treated patients is 0.37 the conclusion of IVM not reducing all-cause mortality is false. From Relative_risk#Statistical_use_and_meaning "RR < 1 means that the risk of the outcome is decreased by the exposure, which can be called a "protective factor." Caprilyc (talk) 16:08, 6 July 2021 (UTC) You're trying to engage in amateur peer review. It's a waste of time. The conclusions the source drew are clearly expressed. The conclusions you might draw are completely irrelevant here. Alexbrn (talk) 16:12, 6 July 2021 (UTC) Caprilyc is quite legitimately pointing out a very flagrant error in the study, and it doesn't take a specialist in peer review to see it. This is the "Roman, et al" study which elsewhere on this talk page you proclaimed as “The best quality secondary review," and the one of four meta-analysis you allow to be linked on the ivermectin page. Therefore, it deserves consideration whether this is really meets such strict standards that you seem to insist on. The treatment arms in the study of Niaee1 were reversed, protested by Dr. Niaee himself -read the comments. This error was corrected in the revised version, but with no change to the conclusion in spite of dramatic change in the evidence. The correction shows a >60% mortality reduction in those that took ivermectin. Caprylic is just pointing out the obvious to any reader of the study that is paying attention: their conclusion of "IVM did not reduce all-cause mortality vs. controls" just does not continue to make sense after they corrected the data. See here for the long list of issues raised about "Roman, et al". Of the four published meta-analysis studies, I still believe Hill, et al is the strongest, and should be referenced in this WP page.--DavidM58 (talk) 05:03, 14 July 2021 (UTC) I know there are "concerns" among the broscientists on the web, and you're linking to a quackery site. But no concerns from real scientists. There is basically a concerted effort by ivermectin believers to "take out" an article they don't like. Likewise, your belief that a weak source, that Wikipedia would never normally use, is "the best" seems curious. Alexbrn (talk) 05:21, 14 July 2021 (UTC) Fine. Resort to ad hominems (" 'concerns' among the broscientists," "quackery," "real scientists," "believers"), or tell folks not to engage in "amateur peer review" when you cannot counter specifically named major errors in what you called "the best quality secondary review." Have you even read the two studies in question?--DavidM58 (talk) 03:03, 15 July 2021 (UTC) Of course, but there's no point trying to engage in amateur peer review. The supposed "major errors" are just canards in internet forums and quackery sites (and - seriously? - in the whole field this is the only quality concern the ivermectin fans have!?!) Wikipedia is built on reliable sources, not "trialsitenews". Alexbrn (talk) 03:28, 15 July 2021 (UTC)

Extended-confirmed-protected edit request on 21 July 2021

Please remove these lines:

By 1986, ivermectin was registered for use in 46 countries and was suministered massively to cattle, sheep and other animals.[62]

Ivermectin was approved for human use in 1988.[63]

Ivermectin earned the title of "wonder drug" for the treatment of nematodes and arthropod parasites, although this title can not be extrapolated for any off label uses of the drug.[64]

Ivermectin has been used safely by hundreds of millions of people to treat river blindness and lymphatic filariasis.[65]

and replace them with a single paragraph:

By 1986, ivermectin was registered for use in 46 countries and was administered massively to cattle, sheep and other animals,[62] and it was approved for human use in 1988.[63]  Having been used to treat hundreds of millions of cases of river blindness and lymphatic filariasis,[65] it earned the title of "wonder drug" for the treatment of nematodes and arthropod parasites, although this title cannot be extrapolated for off-label uses.[64]

The content's identical; it will just look better as a single small paragraph. (The only exception is replacing "suministered" with "administered" because it doesn't seem to be an actual word.) Thank you. 64.203.186.79 (talk) 19:11, 21 July 2021 (UTC)

 Done RudolfRed (talk) 01:51, 22 July 2021 (UTC)

New Cochrane report regarding Ivermectin does not support the use of ivermectin

Also here: I cannot add it, but a new Cochrane report (PMID 34318930) came to the conclusion that "the reliable evidence available does not support the use ivermectin for treatment or prevention of COVID-19 outside of well-designed randomized trials.".--Julius Senegal (talk) 08:21, 31 July 2021 (UTC)

Inserting unreliable sources to back up unfounded claims

Rickyjames, please take a look at the consensus template at the top of this page. Your edit adds content that is of a medical nature, declaring that a treatment is effective, but is not based on WP:MEDRS sources. This is why I reverted. Such content that is against scientific consensus (and editor consensus) must be based on extremely high quality sources. And ivmmeta, as the template at the top of this page describes, is not a reliable source for medical claims.--Shibbolethink ^{(♔ ♕)} 02:14, 5 August 2021 (UTC)

Jerusalem Post article

Just leaving this here if someone wants to use it as a source.] I don't know if the Post is enough to add some neutrality into that last lead paragraph, please have a look, thanks. Randy Kryn (talk) 04:22, 3 August 2021 (UTC)

 Not done. Source is not a WP:MEDRS, which is what is needed to make claims about the treatment of disease.--Shibbolethink ^{(♔ ♕)} 04:26, 3 August 2021 (UTC)

This isn't a request, leaving the source for others to use. Randy Kryn (talk) 12:16, 6 August 2021 (UTC)

American Journal of Therapeutics

Leaving a source here for someone to use. Randy Kryn (talk) 12:15, 6 August 2021 (UTC)

American Journal of Therapeutics, fringe? Randy Kryn (talk) 12:20, 6 August 2021 (UTC)

Discussed and rejected ad nauseam for good reason, also see the FAQ at the head of this page. Alexbrn (talk) 12:51, 6 August 2021 (UTC)

“[S]uch claims are not backed by sound evidence.”

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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“During the COVID-19 pandemic, misinformation was widely spread claiming that ivermectin was beneficial for treating and preventing COVID-19.[14] Such claims are not backed by sound evidence.[15][16][17][18][19]”

This passage assumes that the only evidence of medical efficacy is the conduct of large scale, double-blind trials. This is incorrect. Clinically practicing doctors can detect the efficacy of treatments, and routinely do so. As an extreme example, surgeons generally do not conduct large scale, double-blind trials…people would die if they did. Yet we routinely consider the life-saving surgical practices of surgeons as “sound evidence”, because they demonstrably change the survival rates of patients with certain conditions or injuries. Let’s change this passage to be more accurate…there may not be large-scale double-blind trials, but I do hear compelling evidence that there are practicing physicians who are detecting a beneficial effect. Ivermectin is not known to have serious side-effects, therefore it seems a low-risk alternative that does no harm, and may do some good. We’re at vaccine saturation in the US…why not make a safe treatment acceptable for consideration by doctors, especially since it might pull in a portion of the vaccine skeptical public? Can we tone this down so it highlights that there is one very specific form of evidence that is lacking, while leaving open the question of emerging evidence from clinical practice? BleedingKansas (talk) 05:27, 7 July 2021 (UTC)

 Not done You are espousing a fringe view. Wikipedia's policy is to align to reliable, mainstream sources. Alexbrn (talk) 06:27, 7 July 2021 (UTC)

There is no evidence that BleedingKansas has espoused a "fringe" view. As a rule, wikipedia editors should refrain from base rhetoric such as labelling viewpoints by other editors "fringe". Rather, BleedingKansas has espoused a common sense viewpoint. Where a common sense viewpoint diverges with alleged mainstream sources, giving room for the common sense viewpoint should be considered. In this instance, the alleged mainstream sources have given no rationale for excluding ivermectin from the medical practitioner's toolbox insofar as it is considered a safe drug by the same sources. The line of thinking that the editor collective should rigidly parrot perceived "mainstream sources" would preclude us to inform readers in a Semmelweis moment, and is therefore false. Esperion (talk) 12:11, 14 August 2021 (UTC)

This page is in desperate need of correction. There is sound research demonstrating the efficacy of ivermectin in inhibiting viral replication in COVID-19[2], as well as in several other viruses[1]. It could be more correctly described as an anti-parsitic and selective antiviral. Note the last reference here is a double blinded randomised control trial[3]. Please make use of research search engines DevnullNZ (talk) 09:57, 9 August 2021 (UTC)

I would like to add my voice to the chorus of voices that have been asking for this paragraph to be toned down, at the very least. Does the new meta-analysis by Andrew Hill meet the standards for inclusion here? Hill is a researcher for the WHO. The peer-reviewed analysis is published by the Open Forum of Infectious Diseases, which has a journal impact factor of 3.835. The editorial accompanying the analysis (Mark J. Siedner MD MPH, Harvard Medical School), states the following: "The results are compelling. They identify a clinically significant benefit in pooled estimates for most of their selected outcomes. For example, they estimate a mean reduction in time to viral clearance of 3 days (95%CI 1-5), a reduction in time to clinical recovery of 1.5 days (95%CI 0.4-2.8), a reduction in duration of hospitalization of 4.3 days (95%CI 0.0-8.6) and 56% reduced risk of mortality. Notably, their estimates remain largely similar after excluding studies at high risk of bias. And, although the included studies do not overlap, their results are largely consistent with many (but not all 20) other meta-analytic evaluations of ivermectin conduct by other groups. Even the most ardent skeptic should be given pause by this data."

Clearly, this can no longer be considered only a fringe view, nor can we characterize it as misinformation that is not backed by sound evidence. Meta-analysis is here: https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab358/6316214 Editorial is here: https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab318/6298585

WP:CLEARLY? It's the same issue as the others: an ivermectin advocate publishing a review of low quality data that oddly comes out different to all the reputable medical organisations considering it. WP:REDFLAG applies. Alexbrn (talk) 20:53, 11 July 2021 (UTC)

So, a well regarded researcher who comes in unbiased and with no apparent conflict of interest, but forms a positive opinion after reviewing good evidence gets labeled "an ivermectin advocate," and is therefore eliminated from consideration when he presents the evidence in a respected peer reviewed journal from Oxford University Press? Are the journal editor and those doing the peer review now denigrated as well to "ivermectin advocate" status? This reasoning does not make sense. It's not just presenting an opinion (like the numerous links allowed, written by authors of questionable expertise), but rather is sharing results from "24 randomized clinical trials (3328 patients) identified through systematic searches of PUBMED, EMBASE, MedRxiv and trial registries."

Perhaps you can read the study and tell us where it goes wrong, and what the peer reviewers and the editor from Harvard missed? Then you can write a letter and inform them why they should retract the study. — Preceding unsigned comment added by DavidM58 (talk • contribs) 23:13, 11 July 2021 (UTC)

Please learn how to WP:SIGN and how to WP:INDENT.

This is an encyclopedia, not a science-journal monitoring center. When we judge a source not good enough for inclusion in an article, there is no compulsion to inform the publisher of the source of our decision. And if all studies which are not strong enough to overturn a consensus were retracted, all research would screech to a halt. --Hob Gadling (talk) 07:25, 12 July 2021 (UTC)

Quite. If we were going just by normal rules of thumb, the new piece is in a non-MEDLINE-indexed journal, which would rule it out for non-mundane claims. But since we're in a highly problematic field with sourced expressions of concern about ivermectin research, we can rely on the stronger sources (EMA, etc.) to ensure we aren't unduly boosting fringe science. WP:EXCEPTIONAL applies. Alexbrn (talk) 08:01, 12 July 2021 (UTC)

• Seriously? This treatment is still said to be invalid and fringe on the page? Maybe Wikipedia has missed the boat on yet another current topic. Randy Kryn (talk) 16:25, 13 July 2021 (UTC)

  As long as you do not supply WP:MEDRS sources, we have to assume that the boat is at the bottom of the ocean and it was a good idea to miss it. --Hob Gadling (talk) 18:42, 13 July 2021 (UTC)

• Sunken treasure. Randy Kryn (talk) 18:47, 13 July 2021 (UTC)

Wow. Reading this section was disheartening, to say the least, but reading the talk section about this section is much more so. Leaving aside the question of which position on Ivermectin for either prophylaxis or treatment of Covid19 turns out to be more accurate, the tone of this section is blatantly propagandistic, which should be rather the opposite of the style of writing used to address the factual basis for claims of a given substance's efficacy as disease treatment. The section starts with (heavily politicized) assertions and conclusions about Ivermectin and Covid19, then casts not only opposing viewpoints but opposing evidence (and, whether one considers it high quality evidence or not, said opposing evidence has been widely published in relevant [and reputable, fwiw] sources, including a number of medical journals) as, essentially, baseless conspiracy theories of the sort no doubt common to the writers' political opponents (yes, tongue firmly in cheek here). Wikipedia is an encyclopedia, one which I've usually appreciated in the past for its even handed tone on biochem/small molecule/drug articles when the 'Research Directions' section comes up. This entry should be no exception, and its far from unreasonable to expect editors and contributors to put aside their political motivations and adhere to this standard. Even if we don't admit that there is far from consensus on this issue, we could write it in a much more factual way, using neutral language (i.e. "Some clinicians have advocated for" "various political figures have drawn attention to" "this evidence has, as of X date, not been accepted by X, Y, Z") instead of using words like "erroneously" and "misinformation" and the like, which are claims that are no different than the ones purportedly being "debunked". This section is really off on the NPOV, which given the importance of the topic could possibly have serious (life and death) IRL consequences. Truth is always important, but seems especially important here. As for the data, a simple perusal of The Lancet, CHEST (one of the top Pulmonary/Crit Care Journals) and even Nature should show that from an clinical trial/research data perspective, Ivermectin efficacy is at least an open question, nevermind its widespread use in actual clinical practice in many different jurisdictions (which is EXACTLY how we landed at using Dexamethasone for severe covid when existing "Gold Standard" reviews of the evidence for/against corticosteroids in ARDS had created doubt it would be of much use - fast forward some months, and now its a Gold standard treatment for critical covid patients. Ditto IL-6 inhibitors like Toci - they were pretty fringe but achieved widespread acceptance as part of the toolkit in no small part because some clinicians experimented). This style of writing seems reminiscent of mask wearing being dismissed as "ineffective" and 'misinformation' during the pandemic's early days. Even the WHO made that mistake in their public health advice. Please let's remember that, not make the same mistakes here, and keep the language measured and precise, instead of strident. 108.175.233.87 (talk) 00:53, 23 July 2021 (UTC)

After reading the top 30% of this diatribe: So you disagree with the conclusions of our reliable sources, and you want the article to be more on the fence. And why exactly? You should be aware that empty reasoning like "Wikipedia is an encyclopedia, one which I've usually appreciated in the past for blah blah" does not help at all when deciding that specific question. You could say the same, and people actually do say the same, about Holcaust denial. See WP:YWAB. So, cut all the filler and try again, restricting yourself to reasoning that actually says anything about ivermectin, using reliable sources. Ideally, sources that have not been brought forward and rejected for a good reason before. --Hob Gadling (talk) 09:59, 23 July 2021 (UTC)

Shouldn't this count as a source? Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection Published by Oxford University Press on behalf of Infectious Diseases Society of America. Authored by

• Andrew Hill - Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, L73NY, UK
• Anna Garratt - Department of Infectious Diseases, University Hospital of Wales, Cardiff and Vale, University Health Board, UK
• Jacob Levi - Department of Intensive Care, University College London Hospital, ULCH NHS Trust, London, UK
• Jonathan Falconer - Department of Infectious Diseases, Chelsea and Westminster Hospital, Imperial NHS Trust, London, UK
• Leah Ellis, Kaitlyn McCann, Victoria Pilkington, Ambar Qav, Junzheng Wang, Hannah Wentzel - Faculty of Medicine, Imperial College London, UK

The 13th 4postle (talk) 13:41, 9 August 2021 (UTC)

Sources

The 13th 4postle, here is the important text of that meta-analysis: "Many studies included were not peer reviewed and a wide range of doses were evaluated." If this were the only source, then that would be one thing. But we have many other sources saying the opposite, that are more stringent and reliable and include only peer-reviewed studies. Indeed, the IDSA itself (which you reference) does not yet agree that the evidence is robust enough to recommend use. We must defer to the highest quality sources. See the consensus template at the top of the page. Thanks.--Shibbolethink ^{(♔ ♕)} 15:14, 9 August 2021 (UTC)

Shibbolethink The problem is the wikipedia article explicitly states "Such claims are not backed by credible scientific evidence." That's not true and you're basically admitting it. There is scientific evidence and you're admitting that IDSA says that their is. That the scientific evidence is not robust enough to recommend treatment does not equal that there is no scientific evidence. The article is not giving readers a true picture of the scientific debate around Ivermectin and it's use in treating Covid. And we as editors of Wikipedia should not seek to be the arbiters of truth. We should simply point out the evidence for and against and let the readers decided. That would be a true neutral point of view. These are high quality sources and the Wikipedia article is acting as if they are conspiracy theories. The Wuhan lab leak was also considered a conspiracy theory and evidence against it censored. The 13th 4postle (talk) 15:45, 9 August 2021 (UTC)

The Hill source has already been discussed. It's an article by an Ivermectin advocate in a low quality journal reliant on likely fraudulent research. When we have the EMA, Cochrane collaboration, etc. we're not going to undercut them with WP:EXCEPTIONAL claims from such a poor source. Alexbrn (talk) 06:47, 10 August 2021 (UTC)

The key word is "credible". You keep pretending that the article says "no scientific evidence", but it says "no credible scientific evidence". Before, there were other adjectives. --Hob Gadling (talk) 08:45, 10 August 2021 (UTC)

And now, inevitably.[5] Alexbrn (talk) 12:58, 10 August 2021 (UTC)

Here are 9! Double Blind Randomized Control Trials which suggest that Ivermectin has a positive effect in treating patients with Covid-19. How is this not considered "credible scientific evidence?"

The 13th 4postle (talk) 12:14, 11 August 2021 (UTC)

Wikipedia requires reliable sources per WP:MEDRS. Primary sources are generally prohibited because they require expertise to interpret. This job has been done by many reliable secondary sources which are cited. Alexbrn (talk) 14:18, 11 August 2021 (UTC)

Okay, sure, but the problem is with the specific language that "During the COVID-19 pandemic, misinformation was widely spread claiming that ivermectin is beneficial for treating and preventing COVID-19.[19][20] Such claims are not backed by credible scientific evidence.[21][22]". There is credible scientific evidence. Why can't we change the wording of the article to reflect that while there are some double blind randomized controlled trials that support that Ivermectin could be used as a treatment for SARS-COV-2, it has not been recommended for treatment by the WHO, FDA, etc... because many of the trials have been criticized for their lack of size, procedures, and accuracy." Or something along those lines. I just don't think the wording in the article is accurate of the true scientific discussion going on. This isn't a conspiracy theory. The 13th 4postle (talk) 14:57, 11 August 2021 (UTC)

There is no credible evidence that backs the preposterous claims made for ivermectin. Sorry, Wikipedia isn't going to indulge quacks and quackery. Alexbrn (talk) 15:01, 11 August 2021 (UTC)

Wikipedia would be doing a deep disservice to its readers if we included language like "some double blind randomized controlled trials" support the use of treatment X. There are almost no treatments so pseudoscientific that there haven't been primary trials showing positive evidence. Stating so in all cases would actually cause harm. Instead, we rely on WP:MEDRS-quality sources to review the primary evidence, and we report their conclusions. Firefangledfeathers (talk) 15:04, 11 August 2021 (UTC)

We go by what the bulk of RS say.Slatersteven (talk) 15:02, 11 August 2021 (UTC)

Please note, we comment on the content, not users. If you have an issue with user take it to their talk page or wp:ani.Slatersteven (talk) 13:13, 14 August 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.

Additional Pharmacokinetic Information And Contraindications

Peak levels from oral dosing in humans occur within 4 to 5 hours. Ivermectin is fat soluble and highly protein bound, with a terminal half-life of 57 hours in adult humans. Almost no original drug appears in the urine. It is Extensive metabolised by hepatic CYP3A4 to many different substances mostly hydroxylated and demethylated metabolites. Ivermectin is contraindicated in people with impaired blood brain barriers (head injury, CNS infections) due to its effects on GABA receptors.

Source: Goodmand and Gilman's Pharmacological Basis of Therapeutics, 11th edition, pages 1086-1087.

Updated information by Dr. Kylie Wagstaff about ivemectin "high dosage for COVID-19" claim

In an online presentation during the Ivermectin Global Summit, hosted by the site TrialSite News, uploaded to VIMEO on May 25, 2021, Dr. Kylie Wagstaff, Head of the Nuclear Therapeutics Laboratory, Biomedicine Discovery Institute, Monash University, Australia, and team leader for the group that published the ivermectin in vitro study using monkey kidney cells, indicated that the claim many have made, that while her research team's efforts showed that ivermectin does mitigate the COVID-19 virus, the dosage needed to accomplish this in humans would be "very high" and "toxic", is "a fallacy."

Dr. Wagstaff explained how monkey kidney cells are very different from human tissue and do not produce an immune response, nor do they produce interferon. She went on to point out that because ivermectin accumulates in human lung and other tissues, there is no need for a 1:1 ratio of drug to virus and, consequently, the IC50 of the original monkey-kidney culture does not carry over into humans. She pointed out that ivermectin works with the human immune system to produce a 6-8 fold increase in the IC50 using the 0.2 mg/kg of body weight dosing commonly found in protocols treating SARS-CoV-2, which is within the standard dosage range for treating parasites. --Bdmurrell (talk) 01:52, 26 August 2021 (UTC)

References

This is a primary source, which is not suitable for referencing or inclusion on wikipedia. We need secondary sources to discuss this claim and give it weight or lack thereof. Please see our policies on WP:PRIMARY and WP:NPOV, particularly WP:DUE and WP:RSUW. Her claim has also not been peer-reviewed. In particular, it fails PRIMARY pts 1, 2, and 4. As to the specific claim, as a scientist who studied antiviral compounds in the lab, she makes some claims here that are not scientific. For example, it is not easy to convert dosages from petri dishes in the lab to human treatments, and she makes it sound quite easy in that talk. Secondly, it is not easy to extrapolate immune system effects from cell culture studies, and so what she says is similarly misleading. And finally, she makes claims of efficacy in humans which are not substantiated by the epidemiological literature.— Shibbolethink ^{(♔ ♕)} 02:41, 26 August 2021 (UTC)

Request Wikilink to the COVID-19 misinformation article

There is a small paragraph discussing how this drug is not proven or certified to be safe and/or effective for treatment of covid-19. Currently it has links to the Covid-19 article and the Covid-19 pandemic, but I think that a link to the COVID-19 misinformation article would be useful as well, as that directly addresses this piece of misinformation. 2601:644:8B80:2690:7093:CDFE:71EE:6AF6 (talk) 04:47, 28 August 2021 (UTC)

 Done. Agreed, that is kind of a missed opportunity and a hole in our ability to educate readers. Will change. Thanks for the tip. — Shibbolethink ^{(♔ ♕)} 06:08, 28 August 2021 (UTC)

brand names section is problematic for footnotes

Several cn's are missing in the section below, as well as at least one misplaced footnote. In addition it would be nice to have in the history section reference to this link.

Brand names

Ivermectin is available as a generic prescription drug in the U.S. in a 3 mg tablet formulation. It is also sold under the brand names Heartgard, Sklice and Stromectol in the United States, Ivomec worldwide by Merial Animal Health, Mectizan in Canada by Merck, Iver-DT 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. The formulation for rosacea treatment is sold under the brand name Soolantra. While in development, it was assigned the code MK-933 by Merck.

Albertbelgium (talk) 11:29, 31 August 2021 (UTC)

Sources

That link (to the Merck program) is not a secondary, independent, reliable source, so we typically would not reference it. We could describe the program if it is covered by such sources.— Shibbolethink ^{(♔ ♕)} 19:34, 31 August 2021 (UTC)

PAHO/WHO source, a current source and frequently updated

[6] Ongoing Living Update of COVID-19 Therapeutic Options: Summary of Evidence. Rapid Review, 26 August 2021

--TMCk (talk) 18:28, 2 September 2021 (UTC)

Summary of findings:

"Although pooled estimates suggest significant benefits with ivermectin, included studies’ methodological limitations and a small overall number of events results in very low certainty of the evidence. Based on the results reported by the RCTs classified as low risk of bias, ivermectin may not significantly reduce mortality nor mechanical ventilation requirements, and probably does not improve time to symptom resolution. However, ivermectin may reduce hospitalizations in non-severe patients. Further research is needed to confirm or discard these findings."

--TMCk (talk) 18:33, 2 September 2021 (UTC)

That's very thin soup. Cullen³²⁸ Let's discuss it 04:25, 4 September 2021 (UTC)

Source for ivermectin not being beneficial for Covid

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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Slatersteven, you reinserted that the claim "ivermectin is beneficial for treating and preventing COVID-19" is misinformation (i.e. untrue), citing the BMJ. I don't see where the BMJ source says that ivermectin has been proven to not be beneficial for treating or preventing Covid. Could you maybe quote the specific sentence(s) in the source stating that? Than we could attach the source to the claim you reinserted in the article. --Distelfinck (talk) 15:04, 2 September 2021 (UTC)

"Misleading clinical evidence and systematic reviews on ivermectin for COVID-19" is its title. So yes it says its misinformation.Slatersteven (talk) 15:06, 2 September 2021 (UTC)

Also if POltifact is not an RS for the claim, it's not an RS for disputing it.Slatersteven (talk) 15:07, 2 September 2021 (UTC)

Sure. We don't use Politifact for that claim in the article. --Distelfinck (talk) 15:16, 2 September 2021 (UTC)

"ivermectin is beneficial for treating and preventing COVID-19" doesn't need to be untrue for it to be misinformation. Promotion of unproven medical claims is misinformation. Firefangledfeathers (talk) 15:16, 2 September 2021 (UTC)

Then we should change that part of the sentence from misinformation was widely spread claiming that ivermectin is beneficial for treating and preventing COVID-19. to misinformation was widely spread claiming that ivermectin has been proven beneficial for treating and preventing COVID-19. That's what reliable sources say -- the jury is still out if ivermectin is beneficial, but the claim that it has been proven beneficial is false. Would you be okay with me changing it in that way, Slatersteven? --Distelfinck (talk) 15:25, 2 September 2021 (UTC)

Yep, I can live with that.Slatersteven (talk) 15:27, 2 September 2021 (UTC)

Thank you --Distelfinck (talk) 15:29, 2 September 2021 (UTC)

I oppose that change, but no so forcefully that I'd revert it. Firefangledfeathers (talk) 15:30, 2 September 2021 (UTC)

The change seems to be splitting a very fine hair, in a way that misleads the reader. --Hipal (talk) 15:31, 2 September 2021 (UTC)

Maybe, but it seems to me a reasonable compromise.Slatersteven (talk) 15:35, 2 September 2021 (UTC)

The BMJ article's title ("Misleading clinical evidence and systematic reviews on ivermectin for COVID-19") doesn't specify what claim the "Misleading" is referring to. It could be about ivermectin being beneficial, but also could be about other information around that topic. Again, please provide a quote supporting the claim you reinserted into the article. A drug not being beneficial is a biomedial claim and needs a reliable source per WP:MEDRS --Distelfinck (talk) 15:16, 2 September 2021 (UTC)

It does not have to, it just has to say some claims are, which it does.Slatersteven (talk) 15:22, 2 September 2021 (UTC)

The OP is reversing the burden of evidence. The assumption is that a drug is ineffective unless evidence shows otherwise, and this is why no reliable source source says ivermectin has any benefit for COVID-19 (while many fringe/unreliable ones claim otherwise). To be neutral, Wikipedia frames the misinformation as misinformation. Alexbrn (talk) 16:23, 2 September 2021 (UTC)

"The assumption is that a drug is ineffective unless evidence shows otherwise". You can make that assumption, and conclude that Ivermectin is ineffective for Covid, but to put that conclusion into Wikipedia, you would need a reliable source that also makes that conclusion. See WP:Verifiability. Also, I would contend that your assumption is right about 99 times out of a 100, just because most candidate drugs don't turn out to be useful, but being right 99% of the time is not good enough for Wikipedia. We have to be right 100% of the time. --Distelfinck (talk) 16:35, 2 September 2021 (UTC)

That is the assumption of EBM, which is why sources say the ivermectin promoters are spreading information. To be neutral, Wikipedia reflects those sources. We don't want ingenious weasel wording which muddies the issue. Alexbrn (talk) 16:51, 2 September 2021 (UTC)

Alexbrn, the sources don't say that it's not beneficial against Covid. That's a conclusion you have drawn, and just seem to have admitted to have drawn. This is a textbook case of breaking the No original research policy . Please self-revert --Distelfinck (talk) 16:55, 2 September 2021 (UTC)

Please re-read my comment, as you seem to have misunderstood. Certain people are spreading misinformation about ivermectin; there is no credible evidence it is of any benefit for COVID-19. Wikipedia reflects this well-sourced knowledge to be neutral. OR doesn't come in to it. Alexbrn (talk) 17:15, 2 September 2021 (UTC)

You put back the claim that "misinformation was widely spread claiming that ivermectin is beneficial for treating and preventing COVID-19." into our article. Misinformation is by definition false information. None of the sources cited say that the claim that ivermectin is beneficial against Covid is false, or misinformation. That makes what you put into our article missing a proper source. Ergo you should revert your edit. --Distelfinck (talk) 17:22, 2 September 2021 (UTC)

At least one says "misleading".Slatersteven (talk) 17:26, 2 September 2021 (UTC)

Then let's change "misinformation" to "misleading claim" in the article. --Distelfinck (talk) 17:27, 2 September 2021 (UTC)

Promotion of misleading claims is misinformation. Firefangledfeathers (talk) 17:29, 2 September 2021 (UTC)

Talk about "splitting a very fine hair", sorry, but I really am not seeing why that change changes anything.Slatersteven (talk) 17:30, 2 September 2021 (UTC)

I don't see why we should stray from the wording used in the source (if the source really exists, I am trusting what you say here). Either way, the source still isn't added to the claim in our article, the claim currently has only two mainstream media articles attached to it, but no source that satisfies WP:MEDRS. As a first step, could you maybe add the source to the claim in our article? --Distelfinck (talk) 17:45, 2 September 2021 (UTC)

We have two medical sources, one saying "misleading". We have media sources that saying "misinformation".Slatersteven (talk) 17:51, 2 September 2021 (UTC)

Okay, I just looked at both medical sources. None of them calls the claim that Ivermectin is beneficial against Covid misleading. --Distelfinck (talk) 18:12, 2 September 2021 (UTC)

This is getting silly. It's a claim in our article without a source. This either gets reverted back to the okay version, or I will bring this to the reliable sources noticeboard --Distelfinck (talk) 18:21, 2 September 2021 (UTC)

Ivermectin has been researched for anti-Covid benefits, and found to be helpful. s1 s2 s3 s4 s5 s6 s7 Claims of anti-Covid efficacy are not misleading or misinformative. The article header should be updated to remove that statement. 🖖 ChristTrekker 🗣 15:05, 3 September 2021 (UTC)

See the FAQ at the head of the page. Alexbrn (talk) 15:07, 3 September 2021 (UTC)

Sorry, don't see anything labelled "FAQ". I did post a review of evidence (not primary source), and a media article covering a government statement. But the tone of the discussion here makes it sound like the types of secondary sources allowed is so narrowly constructed that any dissent, no matter how well-referenced, will be thrown out. 🖖 ChristTrekker 🗣 15:29, 3 September 2021 (UTC)

It's labelled "Treatments for COVID-19: Current consensus". Plenty of good sources referenced there, and there has since been a Cochrane review.[10] Alexbrn (talk) 15:32, 3 September 2021 (UTC)

I agree with you 100%, ChristTrekker, but I am not so bold as to attempt to make an edit that gets past the self-appointed anti-ivermectin police. I will restrict myself to observing that the article as currently written brings not only Wikipedia but also its "approved" sources (WHO, FDA, CDC and NIH) into disrepute. Piedmont (talk) 14:42, 6 September 2021 (UTC)

Alexbrn None of the sources in that paragraph that you edited state that the claim "ivermectin is beneficial for treating and preventing COVID-19" is misinformation, or untrue. Even though, you added this statement to our article with your edit. You added unsourced information. Unsourced information is against Wikipedia policy, in this case. A correction is in order, i.e. you should remove that statement. --Distelfinck (talk) 14:52, 6 September 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.

Is it verifiable?

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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Shibbolethink You are missing the point with your above close. Statements, even if true, if challenged, need a inline citatation (e.g. in a footnote). The statement that "ivermectin is beneficial for treating and preventing COVID-19" is misinformation doesn't have an inline citation supporting it. --Distelfinck (talk) 15:36, 6 September 2021 (UTC)

I really suggest you drop this now.Slatersteven (talk) 15:42, 6 September 2021 (UTC)

Some sources

https://www.digitaljournal.com/tech-science/no-ivermectin-is-not-a-drug-for-treating-the-coronavirus-says-the-fda/article

https://www.forbes.com/sites/roberthart/2021/09/02/internet-vigilantes-are-fighting-ivermectin-misinformation-with-memes-and-explicit-horse-cartoons/?sh=334f3f2215df

https://www.theguardian.com/australia-news/audio/2021/sep/03/covid-19-ivermectin-and-reporting-on-misinformation-in-australia-with-lenore-taylor

https://www.nationalgeographic.com/science/article/the-shaky-science-behind-ivermectin-as-a-covid-19-cure

All are variations on Ivermectin misinformation.Slatersteven (talk) 15:42, 6 September 2021 (UTC)

That statement is an encyclopedic summary of these sources: [11] [12] [13] [14] which are all directly attached to the statements in question.

And additionally these sources also back up the claim: [15] [16] [17] [18] [19] [20] [21] [22] — Shibbolethink ^{(♔ ♕)} 15:46, 6 September 2021 (UTC)

Right, we are clearly paraphrasing a wide range of sources.Slatersteven (talk) 15:48, 6 September 2021 (UTC)

Wikipedia's verifiability policy requires inline citations for any material challenged or likely to be challenged, and for all quotations, anywhere in article space. (from WP:Citing sources).

None of the four sources cited in that intro paragraph support the statement that "ivermectin is beneficial for treating and preventing COVID-19" is misinformation.

Even if the statement is true, it is still against policy, because none of the inline citations support it.

--Distelfinck (talk) 15:47, 6 September 2021 (UTC)

You are incorrect, the sources we have provided do support the statement. I think we are approaching WP:IDHT territory. Please read WP:SATISFY.— Shibbolethink ^{(♔ ♕)} 15:49, 6 September 2021 (UTC)

Our Verifiability policy says:

any material whose verifiability has been challenged or is likely to be challenged, must include an inline citation to a reliable source that directly supports the material. and A source "directly supports" a given piece of material if the information is directly present in the source, so that using this source to support the material is not a violation of Wikipedia:No original research. You said "That statement is an encyclopedic summary of these sources: ...". But if it's not directly present in at least one ouf the sources, per our policy that's not sufficient.

So please provide a quote from one of the four sources used in that paragraph, that directly supports the statement.

--Distelfinck (talk) 15:58, 6 September 2021 (UTC)

In the early hours of New Year’s Eve, former Liberal MP Craig Kelly logged on to Facebook to make one of his regular contributions to the global network of misinformation about Covid-19 – this time, to promote the antiparasitic drug ivermectin as a treatment for the virus....For months, Kelly had faced increasing criticism from health experts for promoting the use of drugs such as ivermectin and hydroxychloroquine as coronavirus treatments, against scientific evidence...[23]

"There’s a lot of misinformation around, and you may have heard that it’s okay to take large doses of ivermectin. That is wrong," the FDA said... Currently, there are no "mountains of data" to show its benefit. The existing evidence is limited and documents mixed results. We rate the statement False. [24]

a general publication from the Pan American Health Organization (PAHO) stated that “…ivermectin is incorrectly being used for the treatment of COVID-19, without any scientific evidence of its efficacy and safety for the treatment of this disease.” [25]

False. There’s no evidence ivermectin has been proven a safe or effective treatment against COVID-19. [26]

Misinformation is false or inaccurate information. Our statement is an encyclopedic summary of these sources per WP:SYNTHNOTSUMMARY. Encyclopedic summary is absolutely allowed on wikipedia, in exactly the fashion we have with these statements here. — Shibbolethink ^{(♔ ♕)} 16:05, 6 September 2021 (UTC)

Its time to close this, and take it to other venues.Slatersteven (talk) 16:18, 6 September 2021 (UTC)

If the unsourced information doesn't get removed in the next 2 days, or this doesn't get reported at ANI in the next 2 days, then I will personally report this to ANI. --Distelfinck (talk) 18:11, 6 September 2021 (UTC)

It is entirely up to you who you report, how, and when. But from my perspective this is fundamentally a content dispute. ANI does not typically like having content disputes brought to the noticeboard. I would advise you against bringing it there. However, I have no intention of removing the well-sourced material. — Shibbolethink ^{(♔ ♕)} 18:15, 6 September 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.

AMA resource

[27] "Why ivermectin should not be used to prevent or treat COVID-19" from the American Medical Association

Is this something that ought to be used, or does it not count as a reliable medical source? It's a few months newer than the sources given at the top of this article, but it's a very different kind of source. 2600:1003:B862:A86D:29BF:4640:593:3900 (talk) 21:01, 4 September 2021 (UTC)

Yes this would count as a WP:MEDRS as a guideline from a professional body. Sorry I was thinking about the AMA statement I had just read, did not realize this was to a different link: [28]. Arguably both are "professional body statements" however. Similar to how the WHO statement for covid origins was an "international body statement." It is, in that way, useful to understand the scientific consensus.— Shibbolethink ^{(♔ ♕)} 21:03, 4 September 2021 (UTC) (edited 21:35, 4 September 2021 (UTC))

Re correction: sure.--TMCk (talk) 21:54, 4 September 2021 (UTC)

Since when is a news article a professional guideline??????--TMCk (talk) 21:22, 4 September 2021 (UTC)

The above link is indeed to a news piece. We may want instead to discuss this link, a statement by the AMA and others. Firefangledfeathers (talk) 21:25, 4 September 2021 (UTC)

That's done with one sentence: Don't take medication meant for animals or order them online but get a prescription from your doc if you have one.--TMCk (talk) 21:30, 4 September 2021 (UTC)

@TracyMcClark: This is not a discussion page so please leave your personal beliefs elsewhere. There are cited uses of Ivermectin in humans linked directly in this article. --24.113.44.75 (talk) 03:09, 9 September 2021 (UTC)

I added the AMA statement to the misinformation section along with others from the FDA, CDC and WHO. I'm not sure if Merck's press release is reliable enough to use here, although it is mentioned by the AMA for what it's worth. It's not our job to steer folks away from bad medical decisions but I think it serves the reader well to say up front that use for COVID-19 treatment is specifically advised against, rather than using uncertain terms like "no evidence". –dlthewave ☎ 02:25, 5 September 2021 (UTC)

Possible issue with NPOV and "right-wing" allegation

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.

---

See: WP:NPOV & MOS:TERRORIST

In the Ivermectin#COVID-19_misinformation section the seond paragraph states "Ivermectin became a cause célèbre for right-wing figures promoting it as a supposed COVID treatment." Upon clicking the reference I find no mention of anything related to the "right wing". Can this sentence be reworded or removed altogether? --Skarz (talk) 01:49, 9 September 2021 (UTC)

References

The first line of the article: "The efficacy of a drug being promoted by rightwing figures worldwide for treating Covid-19 is in serious doubt..." Firefangledfeathers (talk) 01:55, 9 September 2021 (UTC)

"Conservative" AKA "right-wing" in US parlance, and this article is written from an american perspective. From that source: The conservative Australian MP Craig Kelly, who has also promoted the use of the anti-malarial drug hydroxychloroquine to treat Covid-19 – despite World Health Organization advice that clinical trials show it does not prevent illness or death from the virus – has been among those promoting ivermectin....Lawrence said what started out as a simple university assignment had led to a comprehensive investigation into an apparent scientific fraud at a time when “there is a whole ivermectin hype … dominated by a mix of right-wing figures, anti-vaxxers and outright conspiracists” — Shibbolethink ^{(♔ ♕)} 01:56, 9 September 2021 (UTC)

So if I understand this corretly, the original editor used the singular quotation from Lawrence, without citing his research, to extrapolate that Ivermectin is a cause celebre? That violates WP:NOR and WP:V. Nothing in that linked article, other some random quote from some random person references the right wing / ivermectin connection. --Skarz (talk) 02:39, 9 September 2021 (UTC)

Your comments about the linked article are incorrect. Firefangledfeathers (talk) 04:51, 9 September 2021 (UTC)

Ok, please explain why - because you disagree with me or because my understanding of Wikipedia guidelines is incorrect? --24.113.44.75 (talk) 05:26, 9 September 2021 (UTC)

Because Feathers found, and quoted above, that mention of anything related to the "right wing" you say you failed to find - in the very first sentence of the source. Why does this need explaining? --Hob Gadling (talk) 07:04, 9 September 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.

Claim about sterilization in men

Recently found this claim. The validity of this claim needs to be tested. Sharing the links to the claims on some news portals below.

https://www.wfla.com/community/health/coronavirus/ivermectin-causes-sterilization-in-85-percent-of-men-study-finds/

https://illinoisnewstoday.com/ivermectin-causes-sterilization-in-85-percent-of-men-studies-find/367625/

https://twitter.com/lymanstoneky/status/1435422132884881411

https://www.reddit.com/r/politics/comments/pko3zz/ivermectin_causes_sterilization_in_85_percent_of/

-- Dr. Abhijeet Safai (talk) 04:54, 9 September 2021 (UTC)

Since this is a medical claim, we need WP:MEDRS quality sources to support its inclusion in this article. (e.g. a review published in a reputable topic-relevant journal). These news sources unfortunately do not cut it. — Shibbolethink ^{(♔ ♕)} 11:20, 9 September 2021 (UTC)

So you now suddenly think WP:MEDRS is important? In the above discussion, you found it perfectly fine to back up your view that ivermectin has been proven to be not beneficial against Covid with The Verge, Fox News and the website of an obscure radio station --Distelfinck (talk) 11:31, 9 September 2021 (UTC)

That's because we already have numerous WP:MEDRS to back up the claim that "ivermectin has not been proven effective" (important distinction from what you just said). See the consensus banner at the top of this talk page. — Shibbolethink ^{(♔ ♕)} 11:33, 9 September 2021 (UTC)

That's not what I'm talking about. I suggest you reread what I just wrote --Distelfinck (talk) 11:38, 9 September 2021 (UTC)

Nowhere in the article does any sentence claim what you just wrote. — Shibbolethink ^{(♔ ♕)} 12:10, 9 September 2021 (UTC)

@Shibbolethink: Agreed. The currently discussed study in fact is a WP:PRIMARY one.[29] Even Forbes jornos are skeptical about such research.[30] AXONOV (talk) ⚑ 07:16, 11 September 2021 (UTC)

It turns out that the articls were redacted. Is inclusion of the fact these claimes were made WP:DUE?—blindlynx (talk) 14:53, 11 September 2021 (UTC)

@Blindlynx: Personally, I don't think so. If one were to search for "Ivermectin" in various engines, scholarly databases, etc. It doesn't come up very often, if at all. It seems to be a minor blip in a long saga of this drug. I don't feel particularly strongly about this, however, and I'd be happy to change my mind if presented with evidence of the DUE nature of this controversy... See:
Find sources: Google (books · news · scholar · free images · WP refs) · FENS · JSTOR · TWL
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL — Shibbolethink ^{(♔ ♕)} 13:42, 12 September 2021 (UTC)

Minor copyedit about the EMA

There's a sentence in the article that reads "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"." Would somebody with the ability to edit the page please add the full name of the EMA in something like 'European Medicines Agency (EMA)' and/or a link to the EMA page? The words 'European Medicines Agency' currently don't appear anywhere in the text of the article. Thanks in advance. Joe (talk) 08:38, 12 September 2021 (UTC)

 Done. Unfortunately that part of the article is actually a transclusion of another article. But I added the EMA to an earlier sentence, and I'll go fix it in the transcluded article as well. Thanks for the heads up — Shibbolethink ^{(♔ ♕)} 13:39, 12 September 2021 (UTC)

Thanky! Joe (talk) 06:46, 13 September 2021 (UTC)

Request Edit to Mechanism of Action Section

Pleaase change "In mammals, ivermectin cannot cross the blood-brain barrier" to "In mammals, glutamate-gated chloride channels only occur in the brain and spinal cord, and ivermectin cannot cross the blood-brain barrier".

The "Mechanism of Action" section currently notes that "In mammals, ivermectin cannot cross the blood-brain barrier", but omits the reason why this is important. After all, mammals also have nerve cells and muscle cells outside the blood-brain barrier. The sentence in the original source referenced is "However, mammals only possess glutamate-gated chloride channels in the brain and spinal cord and as the avermectins have a low affinity for other mammalian ligand-gated channels and do not usually cross the blood–brain barrier, they are very safe for mammals." This may be too much information, hence the suggested correction. It still leavs open the question of why ivermectin does not affect the spinal cord in humans (or perhaps it does?), but that is a problem in the original reference, and thus needs to be left for expert correction. Urilarim (talk) 00:07, 7 September 2021 (UTC)

 Done RFZYNSPY ^talk 00:47, 14 September 2021 (UTC)

 Note: Diff of my edit.

I altered your suggested sentence slightly. I replaced the old one with:

"In mammals, however, glutamate-gated chloride channels only occur in the brain and spinal cord and avermectins cannot cross the blood-brain barrier. Therefore, recommended doses of avermectins are unable to kill mammals via tissue paralysis."

Let me know your thoughts on my changes to your edit. Feel free to use my tale page or leave a message here. If you respond here, please ping me using the {{Talkback}} template on my talk page. RFZYNSPY ^talk 00:55, 14 September 2021 (UTC)

Reliable sources and "current consensus"

It is disingenuous to caution against websites that are anonymous (see above “Current consensus”, #3), since WP itself is proud to be anonymous. Niemandsbucht (talk) 20:42, 19 August 2021 (UTC)

We are fairly consistent on the point: WP:Wikipedia is not a reliable source. Firefangledfeathers (talk) 21:37, 19 August 2021 (UTC)

General philosophizing on the point of the encyclopedia, unrelated to this article. Try WT:Wikipedia is not a reliable source.

Respectfully, what is the point of an encyclopedia, or any ostensible reference or repository for and of information that categorizes itself as an unreliable source? This seems like a liability and accountability measure and it undermines the very nature of the site itself. I say this as a frequent user, paying donor, and someone who is considering a more active role in the editorial process. Zebraboy24 (talk) 12:21, 14 September 2021 (UTC) A moment's thought should reveal that if Wikipedia could use itself as a source, chaos would follow. The purpose of Wikipedia is to summarize accepted knowledge, and that is generally found in high-quality third-party publications. Alexbrn (talk) 13:02, 14 September 2021 (UTC) This would be a great point if at any time I had said that Wikipedia should use itself as a source. What you are essential doing is arguing that Wikipedia is a library and not an encyclopedia; or that libraries are nothing more than third-party stores of information. You understand that there is a difference in say, an auto manufacture stating that their vehicles are reliable forms of transportation and that same manufacture saying that due to internal polling our vehicles are the best forms of transportation available anywhere, correct? An encyclopedia is intended to be a place that localizes information, it is a sum of its parts. How can the information it provides be reliable yet it isn't reliable in and of itself? Wouldn't this same logic extend to any study, or report that uses the work or information of others and didn't rely solely on first person accounting? Zebraboy24 (talk) 14:02, 14 September 2021 (UTC) Because at any time an article may be vandalized or have POV inserted, a published work cannot.Slatersteven (talk) 14:09, 14 September 2021 (UTC)

Stromectol?

Why does "Stromectol" get top billing at the top of the article? Is this not pure commercial promotion?

200.68.169.188 (talk) 18:16, 24 August 2021 (UTC) baden k.

• No idea. It doesn't even appear to be the dominant brand. Changed. Black Kite (talk) 18:23, 24 August 2021 (UTC)

I think it is because in pharmacology text book like lippincott that brand is given as an example. Who ever made this may have simply copied it, I do not think there was any malicious intent.— Preceding unsigned comment added by 116.68.96.247 (talk) 20:38, 19 September 2021 (UTC)

Extended-confirmed-protected edit request on 20 September 2021

the claim is made that the use of ivermectin to treat covid is misinformation and theirs no data to backup the claim that ivermectin can be used to treat covid Because of the mechanism of action of ivermectin we know that it will be beneficial to symptoms and certain mechanisms of covid 19 and SARS-CoV-2 Ivermectin acts by inhibiting the host importin alpha/beta-1 nuclear transport proteins, which are part of a key intracellular transport process that viruses hijack to enhance infection by suppressing the host’s antiviral response.In addition, ivermectin docking may interfere with the attachment of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein to the human cell membrane. Not to mention a study from the American journal of therapeutics Witch concluded that Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/ I would like for the the page to be edited to remove the claim that misformation about the effectiveness of ivermectin was spread with no studies to back the claim Their is many studies that show the effectiveness of ivermectin thou as stated above not enough conclusive data for the approval of ivermectin as a covid 19 medication

Thank you for your time and I hope you will view the information given and actually check the relevant information instead of spreading deliberate misinformation 166.182.252.190 (talk) 20:29, 20 September 2021 (UTC)

 Not done for now: please establish a consensus for this alteration before using the {{edit extended-protected}} template. It will help to bring more reliable sources. Please also review the talk page archives for prior discussion about the American Journal of Therapeutics source. Firefangledfeathers (talk) 20:36, 20 September 2021 (UTC)

Reason why the page has not been updated with relevant info?

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996102/
• https://pubmed.ncbi.nlm.nih.gov/33065103/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195608/
• https://pubmed.ncbi.nlm.nih.gov/32533071/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203399/
• https://pubmed.ncbi.nlm.nih.gov/33723507/
• https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/
• https://covid19criticalcare.com/wp-content/uploads/2020/11/FLCCC-Alliance-I-MASKplus-Protocol-ENGLISH.pdf from https://covid19criticalcare.com/covid-19-protocols/i-mask-plus-protocol/

Is there a reason why these studies are excluded from the consensus and what about the FLCCC Alliance? 41.13.254.135 (talk) 07:29, 22 September 2021 (UTC)

Yes. Wikipedia requires reliable sources. See WP:MEDRS and WP:EXCEPTIONAL and review the statement at the head of this page. Alexbrn (talk) 07:36, 22 September 2021 (UTC)

And to add, we need new studies of proper clinical trials. Not analysis of anecdotal data from a few months ago.Slatersteven (talk) 10:57, 22 September 2021 (UTC)

Living organism...

Hi @Al-Andalus: just a note here because I reverted your edits and the rollback tool doesn't allow an edit summary. If I understand correctly, I think you were trying to make clearer the distinction between what ivermectin is approved and widely used for (treating worms and mites) vs. what it is not approved for (treating viruses), since we currently use the word "parasite" which could encompass both? Is that correct? If so, I think we could make that clearer in the article with less clunky wording. Maybe something like "Ivermectin is a medication used to treat worm and arthropod infections in humans and animals"? Though I suppose arthropod is also somewhat jargony... Anyway happy to hear others' thoughts on AA's proposed wording and/or on the idea of "parasite" being imprecise here. Ajpolino (talk) 13:53, 25 September 2021 (UTC)

Maybe add "and not for treating viral infections"?.Slatersteven (talk) 13:55, 25 September 2021 (UTC)

AA's attempt was much too wordy. If it can be done pithily to summarize something in the body, then - good. Alexbrn (talk) 13:57, 25 September 2021 (UTC)

Extended-confirmed-protected edit request on 26 September 2021

Add:

As of September 26, 2021, there is 79 clinical studies of Ivermectin as listed at the clinicaltrials.gov website.

https://clinicaltrials.gov/ct2/results?term=ivermectin&cond=covid%2C+covid19%2C+covid+19&Search=Apply&age_v=&gndr=&type=&rslt= Shawn.rsa (talk) 12:54, 26 September 2021 (UTC)

 Not done Undue/meaningless without secondary sourcing. Alexbrn (talk) 12:56, 26 September 2021 (UTC)

Also it does not matter hoe many there are. What matters is what they say, and if they have been rejected/withdrawn from publication.Slatersteven (talk) 14:00, 26 September 2021 (UTC)

Extended-confirmed-protected edit request on 1 October 2021

Your information on Ivermectin efficacy for early treatment of covid is not factual. See Uttar Pradesh and how they have contained the virus and reduced hospitalizations. When most of the world does not have vaccines or monoclonal antibodies you do the world a disservice by promoting misinformation due to the influence of for-profit pharmaceutical companies. These companies are coming out with their own new early treatments. Some are very similar in chemical composition to Ivermectin. 47.183.226.192 (talk) 03:29, 1 October 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. Firefangledfeathers (talk) 03:33, 1 October 2021 (UTC)

Additionally, this change would need reliable sources and consensus from other editors. Firefangledfeathers (talk) 03:34, 1 October 2021 (UTC)

Extended-confirmed-protected edit request on 1 October 2021 (2)

"Ivermectin has been pushed by right-wing politicians and activists promoting it as a supposed COVID treatment." This passage needs to strike the partisan political editorial content. People from across the political spectrum have "pushed" this drug. Putting this kind of partisan political editorializing into this article ruins the credibility of this site and feeds conspiracy theories. DanBoomerman (talk) 15:32, 1 October 2021 (UTC) DanBoomerman (talk) 15:32, 1 October 2021 (UTC)

See the upteen talk page threads about this.Slatersteven (talk) 15:38, 1 October 2021 (UTC)

Misleading Mechanism of Action

The page currently states:

   In mammals, however, glutamate-gated chloride channels only occur in the brain and spinal cord and avermectins cannot cross the blood-brain barrier.

This "cannot" should be changed to "does not usually". The claim that it cannot is misleading, inconsistent with the cited paper, and underplays the risks associated with this drug.

Wyatt Childers (talk) 18:31, 3 October 2021 (UTC)

 Done Zetana (talk) 21:22, 3 October 2021 (UTC)

Thanks for the catch, I've additionally partially rewritten that section to better reflect what the cited sources are saying. Zetana (talk) 21:35, 3 October 2021 (UTC)

Extended-confirmed-protected edit request on 8 October 2021

Ivermectin must be capitalized. Below and other places it is not.

"Despite the absence of high-quality evidence to suggest any efficacy and advice to the contrary, some governments have allowed its off-label use for prevention and treatment of COVID-19. Countries that have granted such official approval for ivermectin include the Czech Republic,[120] Slovakia,[120] Mexico,[121] Peru (later rescinded),[122][123] and India[124][125] (later rescinded).[126]" 2600:6C4E:200:BFE0:F8CF:7219:C5CA:756F (talk) 04:52, 8 October 2021 (UTC)

 Not done per WP:NCMED. Alexbrn (talk) 06:45, 8 October 2021 (UTC)

Extended-confirmed-protected edit request on 10 October 2021

Ivermectin is used globally as a broad base antiparasitic, antibacterial, and antiviral medicine based on its cell replication inhibition properties. With respect to SARS-CoV2 (COVID-19) Ivermectin has been shown to be absorbed into the lung tissue for long duration (half-life between 81-91 hours) which allows longer duration antiviral activity which can help reduce respiratory disease duration and patient recovery. The developing and third world areas have the highest use of Ivermectin based on its low cost (5 day course is US$0.60 to US$1.80) and high safety levels for humans with over 3.7 million human patients treated with with 5693 adverse reactions when administered for the various diseases it can be used to treat.. Cschlise (talk) 23:49, 10 October 2021 (UTC)

References

 Not done please see the consensus banner at the top of this page.— Shibbolethink ^{(♔ ♕)} 00:00, 11 October 2021 (UTC)

Extended-confirmed-protected edit request on 16 October 2021

• Under 'COVID-19 Misinformation': "Public discussion over ivermectin has been characterized by wrong attitudes regarding the interpretation of the evidence.[86]"; should either be supported with new evidence, or removed.

• Reason: The article linked is to an opinion piece, which in turn gives some examples or experts disagreeing with parts of public discussion. This is anecdotal at best. There should at least be and indication of 'characterized by whom'. If we mean only 'characterized by _someone_', then it has presumably been characterized differently by all sorts of people, as evidenced by how controversial this topic has become.

We risk losing neutral tone without being more careful with our words here. ErrantPhilosopher (talk) 13:59, 16 October 2021 (UTC)

 Done I removed this sentence because it doesn't really make sense (it reads like a bad translation). This is without prejudice to something sane being added sourced to the same source. Alexbrn (talk) 20:23, 16 October 2021 (UTC)

AJT

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.

---

The article says "Such claims are not backed by credible scientific evidence." The two citations following this sentence - one from Politifact and the other from The Guardian - neither of which are peer reviewed medical journals, and also neither of which was written by doctors, appear to be "cherry-picked" to support a predefined conclusion. A paper in the American Journal of Therapeutics (link is below), whose editorial board consists of over two dozen doctors and cites 144 other papers and studies, suggests that this is false. It states "Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally."

https://journals.lww.com/americantherapeutics/fulltext/2021/08000/ivermectin_for_prevention_and_treatment_of.7.aspx

The papers written by actual doctors usually say that some studies suggest it is not useful in treating COVID, or that it has some benefit but more study is needed, or that the drug hasn't been approved for this off-label use. This article is at best misleading, and at worst deliberately lying to readers.

d — Preceding unsigned comment added by DavidCNorris (talk • contribs) 03:06, 25 October 2021 (UTC)

A valid point, we need MEDERS sources for this claim.Slatersteven (talk) 08:23, 25 October 2021 (UTC)

An invalid point, as the cited sources are the EMA and BMJ Evidence Based Medicine. Alexbrn (talk) 08:31, 25 October 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.

Pharmacokinetics

• Borst P, Schinkel AH (June 1996). "What have we learnt thus far from mice with disrupted P-glycoprotein genes?". European Journal of Cancer. 32A (6): 985–90. doi:10.1016/0959-8049(96)00063-9. PMID 8763339.

Can someone confirm that this source also covers the text of the section after the citation? I cannot access it and its placement should likely be adjusted, or a citation-needed tag added... Thanks, —PaleoNeonate – 10:54, 19 October 2021 (UTC)

Update: someone tagged it for now. Thanks, —PaleoNeonate – 08:19, 24 October 2021 (UTC)

The original text says "Ivermectin interferes with neurotransmission in several helminths, in insects and in the mammalian brain, but normally it does not reach brain synapses, because Pgp [P-glycoproteins] in the mammalian blood-brain barrier excludes it. In the Mdr1a (-/-) brain, ivermectin concentrations are 100-fold higher than in the brain of control mice and the tolerance of Mdr1a (-/-) mice for ivermectin is also reduced by 100-fold". However, what goes after (on tortoises, peak concentrations) is not present in Borst source. Szmenderowiecki (talk) 00:44, 26 October 2021 (UTC)

Sources redux

Take a look at the 4 links posted as "proof against ivmmeta.com", they are complete jokes. Vice news interviewing some unqualified idiot? No, the way science works is by using meta analysis/scientific reviews not opinion pieces, which there are many of ivermectin's dozens of trials, and they almost all show it is highly effective. The stupidity in suggesting that the scientific review of ivermectin is "flawed" and then linking a garbage vice article as proof of "consensus" just shows that the editors here are nowhere near following wikipedia's own policy. Only one single study has been widely criticized by El Gazzar, which in the context of a meta analysis doesn't remotely matter as the results are the same. There are 60+ other trials that still make the prophylactic, early and late treatment effect signal clearly effective against covid 19. From the early in vitro study which showed a 5000 fold reduction in covid 19 within 48 hours, to the dozens of trials, many peer reviewed and published, many double blind rcts, to the population wide studies to the thousands of testimonies of people on deaths door suddenly making a full turnaround, ivermectin is unequivocally proven and anyone saying otherwise is either: a) stupid or b) paid to lie. Reading some random shill who has no credentials vs hundreds of studies from people with zero potential for conflict of interest, gee which is more likely to be true?

Collapse list of weak sources

Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study https://pubmed.ncbi.nlm.nih.gov/33592050/ Effects of Ivermectin in Patients With COVID-19: A Multicenter, Double-Blind, Randomized, Controlled Clinical Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101859/ https://naturalselections.substack.com/p/on-driving-sars-cov2-extinct Favorable outcome on viral load and culture viability using Ivermectin in early treatment of non-hospitalized patients with mild COVID-19 – A double-blind, randomized placebo-controlled trial https://www.medrxiv.org/content/10.1101/2021.05.31.21258081v1 Effects of Ivermectin in Patients With COVID-19: A Multicenter, Double-Blind, Randomized, Controlled Clinical Trial https://www.sciencedirect.com/science/article/pii/S0149291821002010 Real-World Evidence: The Case of Peru. Causality between Ivermectin and COVID-19 Infection Fatality Rate https://www.researchgate.net/publication/344469305_Real-World_Evidence_The_Case_of_Peru_Causality_between_Ivermectin_and_COVID-19_Infection_Fatality_Rate Sharp Reductions in COVID-19 Case Fatalities and Excess Deaths in Peru in Close Time Conjunction, State-By-State, with Ivermectin Treatments https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3765018 Use of Ivermectin Is Associated With Lower Mortality in Hospitalized Patients With Coronavirus Disease 2019 The Ivermectin in COVID Nineteen Study https://journal.chestnet.org/article/S0012-3692(20)34898-4/fulltext A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness Note: this study was funded by https://pubmed.ncbi.nlm.nih.gov/33278625/ https://www.jcdr.net/articles/PDF/14529/46795_CE[Ra]_F(Sh)_PF1(SY_OM)_PFA_(OM)_PN(KM).pdf Use of Ivermectin as a Potential Chemoprophylaxis for COVID-19 in Egypt: A Randomised Clinical Trial Antiviral effect of high-dose ivermectin in adults with COVID-19: A proof-of-concept randomized trial https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00239-X/fulltext Crying wolf in time of Corona: the strange case of ivermectin and hydroxychloroquine. Is the fear of failure withholding potential life-saving treatment from clinical use? https://www.signavitae.com/articles/10.22514/sv.2021.043 Global trends in clinical studies of ivermectin in COVID-19 Morimasa Yagisawa, Ph.D.1,2, Patrick J. Foster, M.D.2 Hideaki Hanaki, Ph.D.1 and Satoshi Ōmura, Ph.D.1 https://kitasato-infection-control.info/swfu/d/ivermectin_20210330_e.pdf Ivermectin: a multifaceted drug of Nobel prize-honoured distinction with indicated efficacy against a new global scourge, COVID-19 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383101/ Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection Andrew Hill, Anna Garratt, Jacob Levi, Jonathan Falconer, Leah Ellis, Kaitlyn McCann, Victoria Pilkington, Ambar Qavi, Junzheng Wang, Hannah Wentzel https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab358/6316214#.YOSvFH94xL0.twitter 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 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088823/ Ivermectin for Prevention and Treatment of COVID-19 Infection A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines (peer reviewed & published June 12, 2021) Bryant, Andrew MSc1,*; Lawrie, Theresa A. MBBCh, PhD2; Dowswell, Therese PhD2; Fordham, Edmund J. PhD2; Mitchell, Scott MBChB, MRCS3; Hill, Sarah R. PhD1; Tham, Tony C. MD, FRCP4 https://journals.lww.com/americantherapeutics/Abstract/9000/Ivermectin_for_Prevention_and_Treatment_of.98040.aspx https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/ Ivermectin works on all variants: https://www.globenewswire.com/en/news-release/2021/05/18/2231755/0/en/Mountain-Valley-MD-Receives-Successful-Results-From-BSL-4-COVID-19-Clearance-Trial-on-Three-Variants-Tested-With-Ivectosol.html "Ivermectin was able to reduce virus replication by a factor of 1,000 even at low concentrations" https://twitter.com/Covid19Crusher/status/1390288935729905670 Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen Fatemeh Heidary & Reza Gharebaghi https://www.nature.com/articles/s41429-020-0336-z The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro https://www.sciencedirect.com/science/article/pii/S0166354220302011 https://c19ivermectin.com/caly.html "Rajter et al. summarize the author, noting that “the antiviral activities of ivermectin have been derived from laboratory experiments that largely involve high, generally non physiologic, multiplicities of infection, and cell mono layer cultures, often of cell lines such as Vero cells that are not clinically relevant. The EC50 values should not be interpreted beyond the fact that they reveal robust, dose dependent antiviral activity in the cell model system used, and it would be naive to strive for μM concentrations of ivermectin in the clinic based on them.” [4]." The broad spectrum host-directed agent ivermectin as an antiviral for SARS-CoV-2 ? https://www.sciencedirect.com/science/article/abs/pii/S0006291X20319598?via%3Dihub Ivermectin Docks to the SARS-CoV-2 Spike Receptor-binding Domain Attached to ACE2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652439/ Zimbabwee “The secretary for health and child care has authorized the MCAZ to authorize the importation and use of ivermectin for COVID-19. MCAZ will issue bulk section 75 approval for importation of human formulations of ivermectin manufactured by compliant facilities.” India(some states, with more switching to ivermectin as evidence is overwhelming enough to combat propaganda) https://joannenova.com.au/2021/05/cases-down-in-the-parts-of-india-that-approved-ivermectin-use/ Peru https://joannenova.com.au/2021/02/in-peru-ivermectin-cut-covid-deaths-by-75-in-6-weeks-cheap-safe-and-quite-ignored/

Many of these are systemic reviews, they are far higher quality secondary sources than some random opinion pieces which the corrupt mods here put as "consensus". No, the consensus is the meta analysis and it shows unequivocally that ivermectin works in thousands of different examples. There is almost no evidence that it doesnt. Every study that showed poor results used the drug at 7-14 days after symptoms, clearly well past the viral replication stage of covid. Using horrible quality sources as a heading in this section over the actual quality scientific reviews just exposes how many people here need to be removed from power. Asailum (talk) 05:38, 23 October 2021 (UTC)

Kindly refer to the consensus template at the head of this page to find what the WP:BESTSOURCES say. We shall not be using tweets from "Covidcrusher", primary sources, fraudulent research or discredited reviews to propagate quackery and misinformation, but instead shall be using reliable, mainstream sources to call it out, while carefully presenting the accepted scholarship of the wider world. Be aware this topic area is under WP:AC/DS. Alexbrn (talk) 05:50, 23 October 2021 (UTC)

Patience, patience..

A lot of more pro-Ivermectin studies will fall, eventually. garbage in, garbage out. --Julius Senegal (talk) 12:19, 23 October 2021 (UTC)

Or, at the very least, those purporting to show a miraculous effect, though it might not happen soon. Szmenderowiecki (talk) 00:26, 26 October 2021 (UTC)

At least the fraudulent Niaee et al. paper has now a warning. So much garbage with those pro-IVM "papers". --Julius Senegal (talk) 06:46, 26 October 2021 (UTC)

Is ivermectin diverse?

A few weeks ago I inserted an edit that said: It is considered a very diverse biopharmaceutical product.. Another editor reverted it with this summary: undue without explaining this is an oldish piece by Ivermectin's inventor, in the context of a parasitology journal which is not reliable for exceptional claims of general use. During a quick review of the literature I have found a few different and significant mentions of ivermectin being "diverse". For instance, some sources say that it is "broad spectrum", "versatile", or "an old drug with new tricks".

I propose we discuss here the precise meaning of this diversity. Is it:

1. Diverse among antiparasitic medications (i.e. it combats a more-diverse than usual range of parasitic diseases)
2. Diverse because it is both an antiparasitic and a drug "studied as a potential antiviral agent against chikungunya"
3. Diverse because it has a tradition of off-label prescriptions by physicians to treat not only parasites, but a diverse range of diseases

There is a danger in numerals 2 and 3 above. They can imply that it is normalized to consider ivermectin for treatment of diseases other than parasites. This implication can open the door for POV and fringy views that ivermectin is effective as a prophylactic for COVID-19. So, although the diversity deserves a mention, wording has to be extra careful here to keep things NPOV. Forich (talk) 03:39, 18 October 2021 (UTC)

Or does "diverse" mean it is used for lots of different animals? Or that it can be a oral medication, a sheep dip, or an ointment? Having "It is considered a very diverse biopharmaceutical product" was not good. Alexbrn (talk) 04:30, 18 October 2021 (UTC)

I requested help from the guys at Wikiproject Pharmacology, this is too technical for me. I suspect that it being used in lots of different animals is not the connotative meaning, though. Forich (talk) 04:41, 18 October 2021 (UTC)

Here is another synonym used: "multifaceted". It is so notable that they use it in the title.Forich (talk) 04:44, 18 October 2021 (UTC)

That is drivel. It's about as meaningful as saying the drug is "enigmatic". Alexbrn (talk) 04:50, 18 October 2021 (UTC)

Yeah... Wikipedia is written for the lay public, and any use of language which is technically correct but confusing is misunderstanding the purpose here. This sentence adds very little to popular understanding of the drug. — Shibbolethink ^{(♔ ♕)} 09:33, 18 October 2021 (UTC)

Let's go with the best MEDRS out there for a second. If we follow Heidari and Gharebaghi (2020), their first description of ivermectin in the introduction, which is the most appropiate place to find an NPOV summary of the drug, reads: Ivermectin has been used for several years to treat many infectious diseases in mammals.. (By the way, the section that opens the introduction is titled: "Ivermectin: a multifaceted medication" keep that in mind for my point below). This description is very different from the current one we are using, which says Ivermectin is a medication used to treat parasite infestations..

To make my case clearer, let me use an analogy. Suppose we were dicussing the description in the lead for Mark Allen (triathlete). The fact that Allen is a thriatlete, that is, an athlete that competes in many diverse sports is the equivalent of the multifaceted property of ivermectin that I am trying to include as an edit. Our current entry in Ivermectin omits this fact, which is the equivalent of saying of Mark Allen: "Mark Allen is a swimmer." coupled with information in the body of the article saying that he also does biking and running.

The analogy is not perfect, because in our current political climate it is risky to say that ivermectin is multifaceted. However, we can repeat Heidari and Gharebhaghi (2020) wording, because the "many diseases" implies multifacets, and the mammals implies (humans, livestock, horses, dogs, and many other animals), (CNN just misinformed saying that it is a horse dewormer, an error we should not repeat).

So, to sum up my recommendation: i) Open with the same wording as in the best MEDRS we have Ivermectin has been used to treat many infectious diseases in mammals. and ii) Inmediately make the distinction between FDA approved uses in humans (this part is not multifaceted) vs the medication's "properties", which pertain to inhibiting diseases in vitro, and include:

1. anti-parasitic
2. anti-viral (in vitro)
3. inhibiting the proliferation of cancer cells (in vitro)
4. regulating glucose and cholesterol in animals (in vitro and in vivo)

I disagree with Shibbolethink and Alexbrn's position to continue omiting the multifaceting property. Alex says it is nonsense (wrong, as proved by the MEDRS I showed) and Shibbolethink says it is too confusing for a lay reader. Perhaps after reading this longer explanation my point of introducing implicitly the multifaceted property by opening with "many diseases"+ inmediate distinction of FDA-approved uses and experimental properties may change your mind. Please comment, the article state is not optimal, as if would be the case if the entry on Mark Allen said that he was a swimmer instead of a thriatlete, in my opinion. Forich (talk) 03:02, 19 October 2021 (UTC)

The "MEDRS" also says ivermectin is "enigmatic". Scientists do write some crap sometimes. What you seem to want to do is cherry-pick the most imprecise and meaningless wording out of sources to water-down the meaningful knowledge that we precisely convey already, while also introducing a misleading slant about ivermectin somehow being a "drug" for cancer and so on. Writing a Wikipedia article means understanding and summarizing sources, not creating a collage of words from them. Alexbrn (talk) 03:44, 19 October 2021 (UTC)

To take your analogy to its logical extent... Mark Allen would only be a triathlete if he competed professionally with sponsorships in all 3 sports. Not if he competed professionally only as a runner, and then did some practice small-town bike and swim races on his off-weekends. Ivermectin is not approved or used widely in any evidence-based sense to treat these other things. So for our purposes, it's mainly an anti-parasitic, and then some people think it might be useful for other stuff, despite mostly negative clinical evidence.

It's still confusing and unnecessarily detailed for the purposes of this article. There's a reason we don't often go into the minutiae of in vitro vs in vivo uses, and it's because it runs afoul of WP:MEDRS sourcing for what counts as a "treatment." If anti-parasitic is the only indication for which it is actually clinically used in any meaningful evidence-based sense per our sources, then the most accurate and policy-compliant interpretation of "treatment of many diseases" is "treatment of many different parasites." See WP:MEDANIMAL and weigh the overall clinical evidence for the drug in these contexts vs this one review. It just isn't there, and we accurately describe the level of evidence already.

BTW, ivermectin really is a medication used to treat worms in horses.

Including: Red flukes (small strongyles) [31][32], Hairworms [33], Blood flukes (large strongyles) [34], Botworms/Botflies [35]. Intestinal Roundworms (Ascarids) [36], Intestinal threadworms [37], Pinworms (Oxyuris) [38], Lungworms (Dictyocaulus) [39], and Stomach worms (Habronema) [40].

It is literally a dewormer used in horses. That is not misinformation in any sense of the word. — Shibbolethink ^{(♔ ♕)} 03:58, 19 October 2021 (UTC)

@Alexbrn:, you said What you seem to want to do is cherry-pick the most imprecise and meaningless wording out of sources. To be clear and transparent, if one uses as a google-scholar-search-strategy the terms "allintitle: ivermectin review" and pick the first three results that come up, which the algorithm tends to show the one with most cites, we get these results:

1. Navarro et al (2020), describe ivermectin as: Anthelmintics available through drug donations are being used according to manufacturer recommendations and a large body of experience and knowledge has been gained through their use in millions of individuals. Ivermectin is probably the most remarkable anthelmintic drug owing to its impact on onchocerciasis and LF, with an efficacy and safety that have made it the most relevant tool for the control of those diseases..
2. Gonzalez et al (2008), use this wording on their first description of ivermectin in the introduction: Ivermectin is a semisynthetic derivative of avermectin B1 and consists of an 80:20 mixture of the equipotent homologous dehydro B1a and B1b. This antiparasitic agent, developed by Merck & Co., is frequently used in veterinary medicine, due to its broad spectrum of activity, high efficacy and wide margin of safety.
3. Heidari and Gharebhaghi (2020), describe ivermectin as: Ivermectin has been used for several years to treat many infectious diseases in mammals. It has a good safety profile with low adverse effects when orally prescribed. Ivermectin was identified in late 1970s and first approved for animal use in 1981. Its potential use in humans was confirmed a few years later. Subsequently, William C. Campbell and Satoshi Ōmura who discovered and developed this medication received the 2015 Nobel Prize in Physiology or Medicine. Studies revealed that ivermectin as a broad-spectrum drug with high lipid solubility possesses numerous effects on parasites, nematodes, arthropods, flavivirus, mycobacteria, and mammals through a variety of mechanisms. In addition to having antiparasitic and antiviral effects, this drug also causes immunomodulation in the host. Studies have shown its effect on inhibiting the proliferation of cancer cells, as well as regulating glucose and cholesterol in animals. Despite diverse effects of this medication, many of its underlying mechanisms are not yet known. Of note, some of these effects may be secondary to toxic effects on cells.

I purposefully quoted whole paragraphs from these papers to avoid the accusation of cherry-picking, so please aknowledge that I'm putting the effort to avoid selective editing. Let's keep this discussion productive. Forich (talk) 05:14, 19 October 2021 (UTC)

@Shibbolethink:, you said So for our purposes, it's mainly an anti-parasitic. Are you aware that our wording does not include the word "mainly"? I can compromise to including it, seems a fair description. Forich (talk) 05:17, 19 October 2021 (UTC)

To be honest I don't understand what you're doing, but it seems you somehow think the connotations of general words override specific meanings in texts. Is there a language problem maybe - are you a native English speaker? Alexbrn (talk) 05:20, 19 October 2021 (UTC)

@Alexbrn:, you said it seems you somehow think the connotations of general words override specific meanings in texts. I made this proposed wording for the lead: "Ivermectin has been used to treat many infectious diseases in mammals." I apologize if it wasn't clear that this is what I am recommending to include in the article. If you think I am pushing for a general word (I did mention "multifaceted", but not in the proposed text), let me make clear that I understand that including the word "multifaceted" or a similar term in the lead is too general and imprecise and, for that reason, it was not in my proposed text. So to answer directly your comment, I do not think that the connotation of general words should override specific meaning in texts, as my proposal to use the specific meaning "Ivermectin has been used to treat many infectious diseases in mammals." shows. My wording says many infectious diseases, the current text says "parasite infestations" so in this instance mine is more precise. My text says "in mammals" whereas the current words do not specify subjects of treatment, which to me seems like my proposal is more precise. I am not an english native speaker, perhaps that is influencing your perception of me being unclear. You do seem to speak english very well but I don´t mind collaborating with you even if you are not a native speaker. If that becomes a problem I can always ask a native speaker to proof-read my texts, just let me know. Forich (talk) 05:43, 19 October 2021 (UTC)

I suspected from your approach to language you might not be a native English speaker. Saying in the lede that ivermectin "has been used to treat many infectious diseases" would be misleading, ironically for exactly the same reason that calling ivermectin simply a "horse dewormer" would be. Such statements omit necessary precision and offer a technically correct but vague general statement that implies false things. Ivermectin can apparently be used to de-worm (some) reptiles, as well as mammals. Alexbrn (talk) 05:59, 19 October 2021 (UTC)

@Shibbolethink:, this also deserves quick response: Ivermectin is not approved or used widely in any evidence-based sense to treat these other things. Can you comment what part of my interventions led you to think that I want to edit the article to conform to Ivermectin being approved or used widely in other things than parasites? My request to have a secondary sentence following the opening description in which we make an explicit distinction between the FDA approved uses and the other properties seems to fail to make across the point that I understand the distinction exists and should be clear. I believe this back and forth is revealing where is our main point of miscommunication, please bear with me and you'll see where I'm going, we are getting closer I think. Forich (talk) 06:05, 19 October 2021 (UTC)

I feel an overall lesson of this discussion is that the three of us value the FDA approved uses to come across as the most important message to convey in Wikipedia. I would go as far to say that I do not mind to comply to a wikipolicy that enforces us to use in the first sentence of a drug entry exclusively the FDA approved uses of the drug in the United States. But we should be honest and admit that is the goal guiding us. If I get some time I will look at the articles for other drugs with notable off-label prescriptions to see what do their lead sections look like, maybe it is a de facto pattern to include the FDA-approved uses as the main descriptor and I have missed it. Forich (talk) 06:15, 19 October 2021 (UTC)

No, I think any text which says “many infectious diseases” or “many uses” or “diverse uses” is unnecessarily vague and imprecise. For our purposes, the most important thing is that we do not reference its unapproved uses in the same breath as its approved ones. Ever. That’s how we create a false equivalence. Even if we explain it immediately after, it still makes the article worse by unnecessary generalization. I have no interest in changing the current wording to one that changes “anti parasitic” or “treat parasitic diseases” to something that is not parasite specific. The difference in depth of use and context between A) its actual efficacious uses in veterinary medicine and human allopathic medicine versus B) its off label uses and infant research ideas means we should not use generalizing language to refer to both together… — Shibbolethink ^{(♔ ♕)} 10:02, 19 October 2021 (UTC)

Further, the review sources support this. All 3 of those sources you cited put its parasitic uses first. One, the last one, uses vague language which is the result of writing a review about its in vitro data as well. Unlike us, this review is for content experts, so they can get away with this sleight of hand. We cannot. — Shibbolethink ^{(♔ ♕)} 10:05, 19 October 2021 (UTC)

I can see where you are coming from. I'll think about it more through. Two of the three top MEDRS indeed prioritize the anti parasitic use in their decription. I disagree in discarding the 3rd MEDRS which doesn't, as you do, but I am not willing to die on a hill of expanding the MEDRS to top 5 or top 10 and counting how many of them use a broader-than-anti-parasitic description. Forich (talk) 21:30, 27 October 2021 (UTC)

Trichinosis and ivermectin

The current version of the article does not mention Trichinosis. According to MEDRS Ashour (2019), ivermectin has five "clinical uses", with number four being Trichinosis. It also says Although not yet approved, experimental studies with IVM have shown promising effects.. Given these fact shown in high quality sources, how should we proceed to mention Trichinosis:

1. Do not mention it because it is currently not approved
2. Mention it in the body of the article, but not in the lead, AND use the words "clinical use" to describe its relation to ivermectin
3. Mention it in the body of the article, but not in the lead, AND do not use the words "clinical use" to describe its relation to ivermectin. Try instead, 'experimental', 'potential', 'promising', 'off-label', or some other variation as long as a reader do not get confused that it received approved use
4. Mention it in the body and the lead, but abstain from "clinical use" wordings
5. Mention it in the body and the lead, and use the words "clinical use" regarding ivermectin and Trichinosis

Please discuss. Forich (talk) 03:05, 13 November 2021 (UTC)

The source does not mention any clinical use ivermectin (only animal studies) and such a use does not appear in its table listing clinical usages (Table 2). So it would appear the article has got its content messed-up in the wrong sections. At most, we can say ivermectin has been researched for treatment of Trichinosis. Alexbrn (talk) 06:10, 13 November 2021 (UTC)

My general feeling is that we should reserve the "Medical uses" section for diseases that the drug is being widely used to treat (typically following recommendation of some major health body). The source you link above suggests ivermectin and trichinosis is a topic of current research, but not clinically used. So I'd suggest mentioning it in the research section here. I don't think that merits mention in the lead. Ajpolino (talk) 23:33, 14 November 2021 (UTC)

Section Veterinary use

I noticed that the section Veterinary use is far down in the article, even though this is an important use. I would suggest merging it into the section Medical uses. --Leyo 16:27, 17 November 2021 (UTC)

Per WP:MEDSECTIONS vet stuff is usually last. Alexbrn (talk) 16:38, 17 November 2021 (UTC)

This does not seem to be a thoughtful sequence, especially for drugs that only have a veterinary use. --Leyo 17:29, 17 November 2021 (UTC)

It's not clear if you meant to imply this, but ivermectin does not only have veterinary uses. Firefangledfeathers 17:32, 17 November 2021 (UTC)

@Leyo: As I understand it, purely veterinary drugs would not fall under WP:MEDRS/WP:MEDMOS, and guidance for such topics could be sought at WP:VET. Alexbrn (talk) 17:34, 17 November 2021 (UTC)

I am aware that ivermectin has other uses, but its veterinary use is quite important. The information on different uses should be kept together for the ease of reading IMHO. --Leyo 17:40, 17 November 2021 (UTC)

Since ivermectin is a massive blockbuster drug in veterinary medicine I tend to agree that it should be mentioned higher up, probably after the "medical uses" section. I'd oppose merging the two sections as I think that'd become unwieldy to the reader. WP:MEDSECTIONS is clear that its section order is just a suggestion and we needn't be overrigid in applying it. I'll take a look for sources to improve the veterinary section sometime this week; my impression is that ivermectin is among the bestselling veterinary drugs of all time (possibly the bestselling?), though it's always easier to find sources for human medicine than veterinary... Ajpolino (talk) 17:54, 17 November 2021 (UTC)

Separate sections in a modified order is fine with me. Firefangledfeathers 19:06, 17 November 2021 (UTC)

Sounds like a good solution. --Leyo 21:44, 17 November 2021 (UTC)

edit request

There is nothing in the chemistry section about its total synthesis. I propose to add the following text:

"The total synthesis of ivermectin and related avermectins have been reported by various groups."

@142.157.199.66: It is already mentioned that once avermectin homologues are produced that they separately undergo hydrogenation to give ivermectin. Obama gaming (talk) 02:35, 27 October 2021 (UTC)

@Obama gaming: yes but there is no discussion on the total synthesis of the avermectins, which is worth a brief discussion at least. 142.157.199.66 (talk) 02:55, 27 October 2021 (UTC)

@142.157.199.66: I see where you're getting at, although I think if you gave it a bit more context (i.e. date, whether useful or not etc) it would be great. I'd be more than happy to add it in for you Obama gaming (talk) 05:50, 27 October 2021 (UTC)

References

I have closed this request as answered due to the above conversation. Z1720 (talk) 20:50, 24 November 2021 (UTC)

Semi-protected edit request on 17 November 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.

---

Change "COVID-19 Misinformation" section to "Treatment of COVID-19" while adding information that supports successful treatment of COVID-19 with ivermectin.

The current article only speak to a very one-sided view on the subject with very dubious support from media references rather than published research. It also maintains that "misinformation" is spread by right-wing politician rather than medical and scientific community. On contrary, there is substantial body of evidence that ivermectin is a medication uniquely suited to treat COVID-19 given its now well-described, potent anti-viral and anti-inflammatory properties. The efficacy of ivermectin is supported by results from 64 controlled trials, 32 of them randomized, and 16 of those were double-blinded, the gold standard of research design.

If there is controversy in the use of ivermectin for COVID-19 treatment, such controversy should be reflected in the article based on the very spirit of Wikipedia and must not be blocked from editing. "Wikipedia is an online free content encyclopedia project helping create a world in which everyone can freely share in the sum of all knowledge. It is supported by the Wikimedia Foundation and based on a model of freely editable content."

A list of research articles can be found here:

• https://covid19criticalcare.com/wp-content/uploads/2021/09/FLCCC-Summary-of-the-evidence-of-ivermectin-in-COVID-19.pdf

Here's an extract:

• https://oce.ovid.com/article/00078401-202005000-00007
• https://oce.ovid.com/article/00078401-201811000-00006
• https://oce.ovid.com/article/00004548-201208000-00014
• https://oce.ovid.com/article/00078401-201309000-00013
• https://pubmed.ncbi.nlm.nih.gov/32641484/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762688/
• https://www.jcdr.net/articles/PDF/14529/46795_CE%5bRa%5d_F(Sh)_PF1(SY_OM)_PFA_(OM)_PN(KM).pdf
• https://www.medrxiv.org/content/10.1101/2021.03.26.21254398v1
• https://www.ijidonline.com/article/S1201-9712(21)00345-3/fulltext#secsect0090
• https://media.marinomed.com/8b/7a/c7/nota-journal-of-biomedical-research-safety-adn-efficacy-iota-carrageenan-and-ivermectin.pdf
• https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247163
• https://www.sciencedirect.com/science/article/abs/pii/S015196382030627X
• https://ejmed.org/index.php/ejmed/article/view/599
• https://c19ivermectin.com/vallejos.html
• https://www.cureus.com/articles/64807-prophylactic-role-of-ivermectin-in-severe-acute-respiratory-syndrome-coronavirus-2-infection-among-healthcare-workers
• https://c19ivermectin.com/mondal.html
• https://www.cureus.com/articles/63131-ivermectin-as-a-sars-cov-2-pre-exposure-prophylaxis-method-in-healthcare-workers-a-propensity-score-matched-retrospective-cohort-study

Glebl1 (talk) 18:48, 17 November 2021 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. covid19criticalcarecom is not a WP:MEDRS compliant source. Also, we don't get any of your donation money, so we don't really care about donations. ScottishFinnishRadish (talk) 18:54, 17 November 2021 (UTC)

Nobody cares if you threated to withdraw your donations to Wikipedia, we don't get paid for our work, and there are many other people who donate to Wikipedia so your total contribution to the funds is miniscule and irrelevant. Hemiauchenia (talk) 21:13, 17 November 2021 (UTC)

@Glebl1: Comment The first 4 research articles you linked don't even mention coronavirus, CoV2, or COVID-19. EvergreenFir (talk) 22:54, 17 November 2021 (UTC)

PLOS ONE is not a reliable source? "We conclude that two-dose ivermectin prophylaxis at a dose of 300 μg/kg body weight with a gap of 72 hours was associated with a 73% reduction of SARS-CoV-2 infection among HCWs in the following one month." Please get updated.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247163 Otaku00 (talk) 05:35, 25 November 2021 (UTC)

Case studies are not reliable sources (see WP:MEDASSESS). Alexbrn (talk) 06:39, 25 November 2021 (UTC)

If you need a meta analysis, Hill et al. was corrected (70 percent reduction in mild cases): https://academic.oup.com/ofid/article/8/11/ofab358/6316214 Otaku00 (talk) 12:59, 25 November 2021 (UTC)

Low-quality journal - see the statement at the top of this page for the WP:BESTSOURCES which Wikipedia uses. Bottom like: Wikipedia is not getting suckered in by the ivermectin BS, but reflects accepted mainstream knowledge as it is bound to do. Alexbrn (talk) 14:47, 25 November 2021 (UTC)

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Tone and wording vs NPOV

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Words like "suckered in"and "misinformation" like in the article only show that a neutral viewpoint is not given anymore. Your link does not say who decided that this source is "low quality". Was it you? I would therefore be good to explicitly name ALL the only sources that are considered high quality here because otherwise there will always be the same rhetoric answers. Otaku00 (talk) 15:09, 25 November 2021 (UTC)

And by the way, you got yourself trapped here because number 2 of those given sources on the top of this page is the same as the one I gave. Otaku00 (talk) 15:15, 25 November 2021 (UTC)

Which says "Compared with the standard of care or placebo, IVM did not reduce all-cause mortality, LOS, or viral clearance in RCTs in patients with mostly mild COVID-19. IVM did not have an effect on AEs or SAEs and is not a viable option to treat patients with COVID-19.", So I am unsure how you think this is saying it's a viable treatment.Slatersteven (talk) 15:21, 25 November 2021 (UTC)

• Open forum infectious diseases is not a MEDLINE-indexed journal, which is a critical count against it for quality (per WP:MEDRS, a Wikipedia guideline). It should not be used, except for maybe mundane non-controversial information. The ivermectin push is misinformation per multiple reliable sources. See the COVID-19 misinformation article for a thorough exposition of why. "Ivermectin works" for some time has merely been the province of quacks and grifters, and the marks they've suckered. Alexbrn (talk) 15:34, 25 November 2021 (UTC)

Slatersteven: It depends on what you quote, e.g. "Time to clinical recovery and binary clinical recovery showed significant improvement with ivermectin in comparison with SOC." And again, the language of Alexbrn ("quacks", implying as a non-physician that Paul Marik and others are such) confirms a non-neutral viewpoint. There is no "mainstream" reflected here as Ivermectin was given off-label by probably thousands of doctors even outside the named countries, as you can best see in social media, and hear from patient's reports. A good week after the Japanese people bought it (due to a famous physician's recommendation and against official advice), their cases dropped dramatically. Wiki is rather blind to what I'd call "mainstream". Otaku00 (talk) 15:55, 25 November 2021 (UTC)

Unsourced nonsense. Getting a strong WP:NOTHERE vibe. Alexbrn (talk) 15:58, 25 November 2021 (UTC)

Does it, I can't find that line, what page is it on?Slatersteven (talk) 16:00, 25 November 2021 (UTC)

I quoted from the meta analysis, the link is above. Otaku00 (talk) 16:09, 25 November 2021 (UTC)

What? Did you quote source two at the top of this page, or analysis of source 2?Slatersteven (talk) 16:11, 25 November 2021 (UTC)

The wording the OP is pushing is in respect of the "supplementary analysis" that was "performed by including studies at a high risk of bias". I.e. it's only the crap studies which show ivermectin works. As it goes on to say, some of these studies have subsequently turned out to be outright fraud. I'm not sure whether the OP's misrepresentations are malicious, incompetent, or just trolling - but if an admin's watching a TBAN given under DS could probably spare us more of this crap. In any event we're not going to use the Hill source because it's weak (even though, in corrected form, it is unsurprising), and we have strong sources. Alexbrn (talk) 16:20, 25 November 2021 (UTC)

@Slatersteven: the OP is referring to the Hill source, pmid:34410284, this is not the same as "source 2" at the head of the page as the OP asserted. When they said that they were ... how shall I put it ... wrong. Alexbrn (talk) 16:42, 25 November 2021 (UTC)

I was giving them a chance to admit it.Slatersteven (talk) 16:44, 25 November 2021 (UTC)

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Hoping, and a call for a tiny little just a smidge of neutral language in the lead

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Let's just hope that if (more likely when) Ivermectin is accepted in the U.S. as effective in treating Covid-19, before or after catching a case, that there has not been even one desperate reader who has actually taken Wikipedia as their main source and given up on seeking out the medicine. No neutral wording has been allowed to stay in the lead, even simple language like "no benefit, which has been disputed..." would be much better. So please add a few words of neutrality. Don't cage this section for awhile, would like to read some comments. Feeling I have to write this, and make an attempt rather than sit by and not at least try, for myself and for the benefit of editors who won't allow it and will have to live with their stance, just as U.S. media, medical personnel, and politicians will have to live with what they've done in their realms of influence. As this page is read worldwide, even in countries where Ivermectin is successfully used for Covid-19 prevention and treatment, the lead violates WP international and reflects a U.S. and other western nation bias. Randy Kryn (talk) 12:40, 26 November 2021 (UTC)

When (and if) it is accepted as a treatment we will reflect this. But being a (say) an aid to recovery does not mean it is (for example) a cure (or a preventative), thus that would still be misinformation. But at this time that is not the case, and the medical consensus is it is not an effective treatment, and that is what (at this time) we must reflect.Slatersteven (talk) 12:43, 26 November 2021 (UTC)

No, that's a US centered approach and so isn't neutral language concerning, say, India and Japan. This page is read worldwide, not just in North America and Europe. Randy Kryn (talk) 12:45, 26 November 2021 (UTC)

There's no evidence ivermectin is an effective drug against COVID, and no reason to suppose it could be. This is well established in multiple solid RS. Messages to the contrary all either ignorant or active misinformation. Randy Kryn is pushing a WP:PROFRINGE POV. Alexbrn (talk) 12:47, 26 November 2021 (UTC)

OK, what countries have licensed its use as a Covid treatment?Slatersteven (talk) 12:48, 26 November 2021 (UTC)

And how do you that Ivermectin is successfully used for Covid-19 prevention and treatment? Are there any WP:MEDRS sources for that? --Hob Gadling (talk) 12:51, 26 November 2021 (UTC)

Calls for doing so have been issued (just one example, this is worldwide and many physicians have spoken out, as we all know. Adding just a few neural words, just a sentence fragment. This seems surely a WP:IAR issue, maybe its most important use yet. Randy Kryn (talk) 12:56, 26 November 2021 (UTC)

This is why we can't [41], it has not been licensed as a treatment, so we can't say it might work based upon a few (often falsified) reports or studies. So when it becomes a formally recognized treatment we can revisit this, until then it's not.Slatersteven (talk) 13:03, 26 November 2021 (UTC)

Then use WP:IAR to add just a few words. As most here know, if another treatment is officially recognized then that would automatically change some of the present US policies. Even the Japanese statement linked above could justify "which has been disputed". Randy Kryn (talk) 13:08, 26 November 2021 (UTC)

IAR is involved when rules stop us from making the site better, this does not. It will push Covid misinformation (and for that reason I invoke IAR, we can't allow our readers to be mistaken into thinking this is an effective treatment when at best it seems to just aid recovery, not provide any kind of protection (which is how it is being touted)). When and if the scientific consensus changes, and when and if it is licensed for use as a treatment we will know what it is being used for. Until then we do not even imply it is an effective treatment, as people's lives are at stake..Slatersteven (talk) 13:13, 26 November 2021 (UTC)

IAR cannot be invoked to override NPOV. Randy Kryn should know blogs are not reliable sources, and the fact that the chair of some doctors' group in Tokyo gave (yet another) whacky press conference means nothing, despite how it's been lapped-up and twisted in in the crank-o-sphere. Alexbrn (talk) 13:19, 26 November 2021 (UTC)

@Randy Kryn in most of the world, we practice evidence-based medicine, not eminence-based medicine. The opinion of a famous doctor does not override the conclusions of the rest of the medical research community. — Shibbolethink ^{(♔ ♕)} 13:37, 26 November 2021 (UTC)

Just wanted to try to get the tiniest amount of neutrality, as many have before and I tried a small amount with one post awhile ago. Not saying the other editors are acting other than in good faith here, sticking to the exact language which allows not even small disagreement in the lead of just a clarifying word or two. This is my last post in this section, and still ask that it be left open so other editors can address the issue without the locked-section wall, thanks. Randy Kryn (talk) 15:48, 26 November 2021 (UTC)

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This article has multiple issues.

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This article needs more medical references for verification or relies too heavily on primary sources.

Omission bias over Japan success using the treatment. Country not mentioned at all

Omission bias over India success using the treatment. Country not mentioned at all

Omission bias over several countries success on using the treatment. — Preceding unsigned comment added by 2804:128:856B:D500:7CA5:29AB:2D67:4857 (talk) 17:46, 26 November 2021 (UTC)

Lets have some sources that say (see wp:medrs) this.Slatersteven (talk) 17:49, 26 November 2021 (UTC)

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Wikipedia:NPOV

This article violates NPOV. From Impartial Tone:

“ Wikipedia describes disputes. Wikipedia does not engage in disputes. A neutral characterization of disputes requires presenting viewpoints with a consistently impartial tone; otherwise, articles end up as partisan commentaries even while presenting all relevant points of view. Even where a topic is presented in terms of facts rather than opinions, inappropriate tones can be introduced through how facts are selected, presented, or organized. Neutral articles are written with a tone that provides an unbiased, accurate, and proportionate representation of all positions included in the article.

The tone of Wikipedia articles should be impartial, neither endorsing nor rejecting a particular point of view.”

Presenting the conversation surrounding Ivermectin as “misinformation” is clearly attempting to characterize opposing/contentious viewpoints as “lies” which is incredibly problematic and antithetical to Wikipedia’s values.

Consider changing the article to present both sides of the debate without attempting to authenticate either side. No definite scientific consensus has been reached and it is dishonest for Wikipedia to suggest otherwise. 49.195.100.179 (talk) 03:52, 23 December 2021 (UTC)

 Not done. There is no "dispute". There's science & reality on one side and grift & ignorance on the other, and Wikipedia doesn't do "both sides" in such cases. Alexbrn (talk) 04:02, 23 December 2021 (UTC)

NPOV (part 2)

Subsequent to the previous post re: NPOV.

Go to PubMed and search “ivermectin Covid”. You will see study after study finding efficacy of the drug as a treatment against the virus. So there is definitely a debate, at the very least. The previous commenter who responded to the above, sounds highly biased: “science and reality on one side” isn’t that what every person thinks in an argument? It sounds like one side of the debate has got hold of this page, and are using it to push their version of events - instead the article should simply read that “some studies have shown promise of Ivermectin as a treatment(sources), however this is not currently an approved use of this medicine by the FDA or WHO.”

Because anyone can see for themselves that there is a multitude of studies showing effectiveness of this treatment, and very few to the contrary, if you look at journal articles. So there is clearly a lot of research in this space, and to claim, categorically, that there is some kind of overwhelming consensus to the point that Wikipedia needs to violate its own principle of not being biased (the word “misinformation” is incredibly biased), is simply, dishonesty, and undermines this website’s credibility. 121.45.59.35 (talk) 11:17, 23 December 2021 (UTC)

Yeah, there's lots of poor/fraudulent research boosting ivermectin. Fortunately we have reliable sources that have sifted it and found the knowledge (see the box at the top of this page). You inexpert assessment is of no worth here. Alexbrn (talk) 11:43, 23 December 2021 (UTC)

How do you decide the "prevailing view"?

Firefangledfeathers says that citing Korey would violate WP:REDFLAG because it's "Claims that are contradicted by the prevailing view within the relevant community or that would significantly alter mainstream assumptions—especially in science, medicine...."

This raises the question of what is the "prevailing view." Neil deGrasse Tyson would say that the "prevailing view" is what's in the textbooks. When there are still different views, Tyson thinks you should acknowledge that there are different views, because that's the way science works. Covid-19 is so new that it's literally not in the textbooks, and there are lots of conflicting views. (Many of the CDC's statements, like the new rules on quarantining after infection 5 days rather than 10, don't even reflect the consensus.)

When you eliminate the debate over ivermectin, and censor Korey and Mahmud from the discussion, that's censoring the scientific method to make your results look better. It's like Louis Pasteur going over his vaccination data and changing them to make them look better for publication.

Tyson: I don't want you to not talk about it, but say, "This is not yet verified. It's not yet this, it's not yet that. And it's been criticized by these other people anyway." So be more open about how wrong the thing is you're reporting on could be, because otherwise you're doing a disservice to the public. And that disservice is that people out there say, "Scientists don't know anything." But what gives you that idea? "Well, one week cholesterol is good for you and the next week it's bad for you. They don't know what they're doing!" That's on the frontier. On the frontier, science is flip-flopping all the time. Yes, if you're going to report from the frontier, it looks like scientists are clueless about everything. You take a few steps behind the line, where experiments have verified and re verified results, that's the stuff for the textbooks. That's the stuff that is objectively true. That's the stuff you should be paying attention to. That's the stuff where you should be thinking about laws and legislation related to that. [42]

--Nbauman (talk) 01:47, 30 December 2021 (UTC)

See the section at the top: "Treatments for COVID-19: Current consensus".

This is not the same type of situation an astrophysicist like Tyson will meet. Medical research is done using statistics, and it is not only very easy to make mistakes there, especially since statistics is a field where people tend to overestimate themsleves, but there will be misleading results even if you do everything right. When a drug does not work for a condition, 5% of the studies will still have statistically significant results. That is why scientists will not accept a primary study at face value. Several primary studies need to be evaluated in secondary studies. That is one of the criteria used by Wikipedia to discern good sources from bad. The good sources all say the same thing. --Hob Gadling (talk) 05:05, 30 December 2021 (UTC)

See also WP:MEDSCI, a section entirely about how we determine the prevailing scientific view for medical claims. — Shibbolethink ^{(♔ ♕)} 22:38, 30 December 2021 (UTC)

Misinformation

"During the COVID-19 pandemic, misinformation has been widely spread claiming that ivermectin is beneficial for treating and preventing COVID-19.[18][19] Such claims are not backed by credible scientific evidence.[20][21]

Not true. There's over 40 credible scientific papers by top research scientists stating it is beneficial, including a Monash University study revealing Ivermectin kills COVID within 48 hrs, paper snippet here and National Library of Medicine here which indicates a five day treatment is effective. The media is lying and trying to make Ivermectin look like a controversial medicine when it is even on the WHO list of essential medicines and is considered safe for human use. † Encyclopædius 08:06, 7 September 2021 (UTC)

That is a lot of ifs buts and maybes. When you have a source that says it is beneficial we can change the wording. Slatersteven (talk) 12:07, 7 September 2021 (UTC)

What about this article from the American Journal of Therapeutics? It is a reputable, peer-reviewed journal. (Justus R. Hope mentioned this same article, but it was subsequently removed from this Wikipedia page.) Sdekk (talk) 18:32, 20 September 2021 (UTC)

Buts and maybes? How do you get "a lot of buts and maybes" from the citation of multiple scientific papers demonstrating the claim that the conclusion of those studies is "not backed by credible scientific evidence"? This makes absolutely no sense. — Preceding unsigned comment added by 2601:280:c081:9220:f570:6e02:44a7:32e4 (talk) 22:38, 19 October 2021 (UTC)

You can check https://osf.io/preprints/socarxiv/r93g4/ and https://osf.io/9egh4 among others for scientific published evidence of the EFFECTIVENESS of Ivermectin against covid19. The statement is not true.

Due to the wave of reporting that ivermectin is only used to treat heart worms in horses, often from sources or in the same articles correctly identifying that ivermectin is not approved for covid treatment, I think this section should have it noted that it is erroneous that ivermectin is not suitable for any human application. — Preceding unsigned comment added by 75.164.76.179 (talk) 14:14, 12 September 2021 (UTC)

We require higher quality sources for medical claims on wikipedia. These preprints do not apply. — Shibbolethink ^{(♔ ♕)} 14:20, 12 September 2021 (UTC)

I have a question about this: does the article in the American Journal of Therapeutics not comply with the criteria of "Higher Quality Resources for medical claims"? The article appears to be a peer reviewed secondary source within the Wikipedia definition of secondary sources. It appears to be a review article and meta analysis of peer reviewed primary sources. Please can somebody explain. Robscovell (talk) 01:47, 4 October 2021 (UTC)

See WP:REDFLAG and past discussion on this topic in the archives. Firefangledfeathers (talk) 02:08, 4 October 2021 (UTC)

I think it would be educational to explain why the article in the American Journal of Therapeutics meets the "Red Flag" criteria listed in WP:REDFLAG. On the face of it it appears to be a valid meta-analysis in a reputable peer-reviewed medical journal. I have reviewed the past discussion on the topic in the archives and I haven't found a detailed critique of the article yet. It would help me, and others, if there could be a detailed explanation of the inadequacy of the article.Robscovell (talk) 00:32, 10 October 2021 (UTC)

The specific REDFLAG criterion for me is "Claims that are contradicted by the prevailing view within the relevant community or that would significantly alter mainstream assumptions—especially in science, medicine, history, politics, and biographies of living and recently dead people. This is especially true when proponents say there is a conspiracy to silence them." Firefangledfeathers (talk) 00:41, 10 October 2021 (UTC)

I still think it would be highly instructive, from a science education point of view, to provide a critique of the article in the American Journal of Therapeutics by members of the relevant community (who are they?) and in the context of mainstream assumptions (what are the relevant assumptions?). That would help reader to understand the AMA's decision and would also help provide clarity as to the dangers of Ivermectin. Of course, there is a meta-question here: who decides what is the 'relevant community' and what the 'mainstream assumptions' are? Robscovell (talk) 01:19, 10 October 2021 (UTC)

WP:REDFLAG applies to claims, not (merely) to sources. If one article in a minor journal makes claims which contradict what every major medical organization is saying, and has been criticized for its undisclosed conflicts of interest by reliable sources, then it's safe to say it is suspect and does not reflect accepted knowledge. As to "who decides", Wikipedia operates according to consensus, as rooted in the WP:PAGs. As it's turned out, Wikipedia has been entirely right to take this stance as the pro-ivermectin/COVID research has all turned out to be dodgy and the ivermectin boosters, quacks. Alexbrn (talk) 01:28, 10 October 2021 (UTC)

In that case, this leads naturally to questions about whether or not Wikipedia's approach is valid or not, which is obviously a much broader topic beyond the limit of this discussion, so I won't pursue it here. It is true that the consensus opinion of major medical organisations is that pro-Ivermectin/COVID research is flawed, so I will leave it there, because that is the highest claim that Wikipedia is constitutionally able to make. Robscovell (talk) 03:21, 10 October 2021 (UTC)

The research fraud and quackery is just the reality (something the pro-ivermectin crank-o-sphere has trouble with) and Wikipedia likes to contextualize WP:FRINGE views properly: historically WP:QUACKS have disliked this but, as an encyclopedia, Wikipedia is only meant to offer a handy summary of accepted knowledge as published in high-quality sources. Alexbrn (talk) 03:33, 10 October 2021 (UTC)

• Justus Wilby Dunn wishes to comment on Desert Tosh being deleted in five minutes – what took you so long? Haven't managed to find mention in the archives, but he's been at it again, in case you didn't notice. Hat tip to Sjoerd Verweij at Ars, with some pointed comments. . . dave souza, talk 20:02, 15 October 2021 (UTC)

Missing anti-viral properties as primary description. Ivermectin has known anti-viral properties as well as anti-parasitic properties. Failing to mention it's anti-viral properties in the first paragraph is noteworthy, and is obviously due to the controversy about it's efficacy with the coronavirus that causes COVID-19. Regardless of whether this article cites the potential of Ivermectin to treat COVID, the anti-viral properties of Ivermectin are well-established and obvious, as the vast majority of the citations in this article testify to. The first sentence should read "Ivermectin is a medication used to treat parasitic and viral infections". To do otherwise violates Nuetrality. — Preceding unsigned comment added by 2601:280:C081:9220:F570:6E02:44A7:32E4 (talk) 22:35, 19 October 2021 (UTC)

@AlexBrn reverted my edit to the Ivermectin article which provided three references, available from NIH, on the ability of Ivermectin to bind to the COVID-19 spike protein, indicating that it may be useful for treatment of the disease. Clinical trials are ongoing, and it is certainly not yet approved by the various agencies, but I think this information is useful. I think peer-reviewed articles from respectable journals, available at the National Institute of Health website do not qualify as "unreliable/misinformation". Here are the articles: Please let me know if this changes your opinion. PAR (talk) 20:47, 11 November 2021 (UTC)

References

It's actually more an issue of WP:MEDPRIMARY and WP:MEDASSESS. What you are making is a medical claim: "it may be useful for treatment of the disease." But what you have brought are not WP:MEDRS sources. They are A) primary sources (not secondary narrative review articles), B) from pretty low impact and not well regarded journals, and C) extremely low on the totem pole of evidence around here. This is also an example of WP:OR given that these are primary sources, we would need high quality secondary sources to say this even if it wasn't a medical claim. The fact that it's a medical claim raises the bar even higher. — Shibbolethink ^{(♔ ♕)} 03:56, 12 November 2021 (UTC)

OK, I read the American Journal of Therapeutics review by Korey. Korey says that the largest double-blinded RCT was by Mahmud in J Int Med Res [43]. In other words, that's their best case. This was a 400-patient trial, 200 placebo and 200 treatment. Primary outcome was time to clinical recovery. Secondary outcomes were disease progression and RT-PCR positivity, which reached statistical significance. A secondary outcome, survival, was 3 deaths in the placebo group and 0 deaths in the treatment group -- which they say is statistically significant at p = 0.016. They published it in a peer-reviewed journal on PubMed. You can't change clinical practice on the basis of one study, but they checked all the boxes. It may be that this was just a statistical anomaly. It may be that multiple other studies failed to replicate their result. I'd like to see letters commenting on this study. But otherwise I don't see how we can dismiss a published RCT like this, and/or the review by Korey.

I'm an ivermectin skeptic, and I'd be happy to find well-designed studies debunking it. (That's what I came here for.) But I learned that in science, you have to give all the information supporting your position, and all the information opposing your position. (I just heard Daniel Griffin say that again on TWIV.) Do we all agree on that? --Nbauman (talk) 20:30, 11 December 2021 (UTC)

"all the information opposing your position" ← no, sounds intellectually incompetent, and falls right into the trap of the quacks and grifters. In any case, see the top of this page for the consensus from reliable sources. We're not going to be undercutting high-quality sources with obvious crap like the Kory review. Alexbrn (talk) 20:40, 11 December 2021 (UTC)

Okay, this is a fair idea, to think that we must consider all available evidence before making a decision. But we must also weight all of this evidence in proportion to the quality of the evidence. This review cites this trial uncritically, without considering the many well-known criticisms of the Mahmud RCT. To count just a few:

1. "Group assignment was not stratified according to disease severity". This means it is possible that the placebo group could have, by chance, received a slightly sicker set of patients. Well-designed trials overcome this weakness by using a rolling basis model, and assigning patients to the different treatment groups based on maintaining an even proportion of severity, age, comorbidities, etc. in the two groups. So that we can be sure we have removed the influence of these other factors on the outcome.
2. Severity in particular was probably comparable between the two (see their Table 1). But the placebo group was A) older, B) had worse comorbidities, and C) more severe symptoms than the treatment group.
3. "The trial was registered retrospectively" Meaning they could have run this study as many times or ways as they liked, and registered only the ones that worked.
4. Randomization was conducted by the head of the dept of Medicine, not by an independent agency. This means that dept head could have fudged the results by deciding which patients were randomized into which group. This is technically double-blind because the treating physicians didn't know the code. But it is also nowhere near as ethical or ideal as having an independent agency do the randomization.
5. Typically we judge the chosen outcomes of a study by "clinical utility." Does it actually matter to the patient or the provider if they recover 1.5-2 days earlier? Especially when the two groups overlap in this measure by something like 87%... Does it actually matter? If the mortality benefit is minimal? I would say it does not.
6. This study is underpowered to find the differences they claim to have found.
7. A lot of the evidence for their conclusions is based in surrogate or post-hoc measures, which are known to be tainted by experimenter bias. (e.g. "Increase in stage of severity" is an outcome measure they did not decide on from the outset.)

For all of the above reasons, one must consider how much weight to give this study in comparison to the much larger and better-designed trials which have found no effect. Importantly, Wikipedia does not consider single RCTs to be very much evidence worthy of mentioning. We prefer systematic reviews and meta-analyses. Such analyses have found that this study is not consistent with the prevailing evidence that demonstrates a lack of efficacy in these candidate treatments.

And perhaps that is the most important point in this consideration. Wikipedians should not be engaging in peer review. We should be trusting the conclusions of the prevailing scientific community in these controversies. That prevailing consensus is that ivermectin and HCQ do not work. — Shibbolethink ^{(♔ ♕)} 21:05, 11 December 2021 (UTC)

User:Alexbrn, Daniel Griffin, MD, PhD, and Vincent Racaniello, PhD, are "intellectually incompetent" because they say that a scientist has to give all the information supporting his position, and all the information opposing his position? Do you want to think that over? Nbauman (talk) 23:46, 11 December 2021 (UTC)

User talk:Shibbolethink Thanks for your detailed answer. But that's your answer. If there are many well-known criticisms of the Mahmud RCT, where have they been published? --Nbauman (talk) 23:54, 11 December 2021 (UTC)

Among other places, here: [44] [45] [46] (these are some of the best available sources on this question)

Those sources additionally criticized the intervention schema, for altering the "standard of care" between the two groups even when setting Ivermectin aside. This could have had significant influence on the results, and is part of why this study fails the "Cochrane risk of bias tool 2" (RoB 2) [47]

And here are some other secondary reviews which do not directly discuss this study, but still demonstrate that the landscape of the evidence is currently against the conclusions of Mahmoud et al. [48] [49]. — Shibbolethink ^{(♔ ♕)} 01:35, 12 December 2021 (UTC)

Yup, Mahmoud et al. is a primary source failing WP:MEDRS and of no consequence here. Knowledge is not based on "all the information" for or against "positions", but only on the relevant high-quality evidence. Luckily our decent sources do that sifting so we don't have to. It is in fact a hallmark of junk sources that they don't sift and use "all the information" - see ivmmeta.com. (It's also a bit odd to think that there should be evidence "opposing" a drug; except in cases where it's positively unsafe the tell of an ineffective drug is a lack of good evidence of effect, not evidence "opposing" effect, an illogical concept).

Incidentally, Cochrane's living systematic review, PMID:34318930 is an example of how this should be done. It systematically reduces > 300 initial records ("all the information") to just 13 for consideration, so as to ensure only high-quality evidence is used. Mahmud et al is one of the RCTs that doesn't make the cut, because it "evaluated a combination of ivermectin with other treatments that were different between groups". And as MEDRS says: "cite reviews, don't write reviews". Alexbrn (talk) 05:39, 12 December 2021 (UTC)

Several new studies are linked in this article on horse medicine that might suggest some updates to this page: — Preceding unsigned comment added by Dougransom (talk • contribs) 16:02, 13 December 2021 (UTC)

This does not pass wp:medrs.Slatersteven (talk) 16:09, 13 December 2021 (UTC)

Zerohedge is deprecated on Wikipedia. Firefangledfeathers 16:09, 13 December 2021 (UTC)

User:Shibbolethink So why not mention Mahmud, and say that Deng and Popp rejected it from their systematic review for the reasons given? If I'm reading the literature, and I find an article that makes a claim, it would be valuable for me to know that the article is red-flagged by other authors and why. If I'm debating somebody, and they pull out Mahmud as evidence, it would be valuable for me to already know about Mahmud, and why he's wrong.

If in a Wikipedia article you delete Mahmud and say, "We cleaned up the article, we deleted everything we disagreed with," then you're engaging in the censorship that the pro-ivermectin people are accusing science of doing. --Nbauman (talk) 01:01, 30 December 2021 (UTC)

we didn't "delete everything we disagreed with", we deleted unreliable sources. This is not a website to help you debate your friends about Ivermectin. It's a website to collate and catalogue what the most reliable sources say about a subject. We only describe the controversy when it is published in reliable sources. If you find a reliable source which debunks Mahmud, then we can include that debunking. — Shibbolethink ^{(♔ ♕)} 01:09, 30 December 2021 (UTC)

I agree. Your sources, Deng and Popp, which you cited, debunk Mahmud. So we can mention [Korey and] Mahmud, and debunk him with Deng and Popp. OK? --Nbauman (talk) 01:21, 30 December 2021 (UTC)

Deng does not mention Mahmud at all. Popp mentions it only in a long list of clinical trials. Neither afford the study significant coverage, which is what is required per WP:DUE. — Shibbolethink ^{(♔ ♕)} 22:40, 30 December 2021 (UTC)

Semi-protected edit request on 26 December 2021

Articles that this page sites as per Ivermetin and COVID-19 are not scholarly articles but "sensational" sources: they are basically periodicals with no scienctific basis. I recommend removing all of them. Big Mouth 1234 (talk) 17:43, 26 December 2021 (UTC)

 Not done. Alexbrn (talk) 17:47, 26 December 2021 (UTC)

This article fails to mention that ivermectin is a zinc ionophore or discuss the effects of zinc ionophores in medicine. PMID: 34929542 — Preceding unsigned comment added by 67.232.112.153 (talk) 23:06, 30 December 2021 (UTC)

Review of alternative treatments/early treatments

Please subject all three vaccines to the same same standard of testing and review and report your results. That would be an honest and transparent step. 71.212.220.11 (talk) 09:54, 2 January 2022 (UTC)

We do, in what way do you think we do not?Slatersteven (talk) 11:17, 2 January 2022 (UTC)

Claims that much of the research finding benefit was fradulent is not supported by the source used

The source used (I'm ignoring the BBC article, since that's not a real source on this topic) to support that a lot of research was problematic is simply not supported by the article used as a source. The article mentions that ONE study was problematic and TWO meta studies had used that one study. This is not "a lot" by any stretch of the imagination. — Preceding unsigned comment added by 89.239.195.102 (talk) 02:19, 4 January 2022 (UTC)

The Nature Medicine source describes more than one study being problematic. Firefangledfeathers 02:42, 4 January 2022 (UTC)

And the BBC source is fine. All this is dealt with in detail at the main article which is linked. Alexbrn (talk) 07:19, 4 January 2022 (UTC)