Dr Tess Lawrie: Meta-analysis on Ivermectin - evidence is overwhelming

People keep saying they're listening to the experts. Well, Dr Tess Lawrie has more credentials than Whitty, Vallance, Fauci and Tedros combined.


Trialsite News:


UK-based Meta Analysis Peer Reviewed & Published Suggests Ivermectin A Key Public Health Weapon in the War Against COVID-19


Just published in the peer-reviewed American Journal of Therapeutics, Dr. Tess Lawrie, an expert in medicinal evidence, along with other experts in population health and gastroenterology out of the United Kingdom (UK), conducted a comprehensive meta-analysis involving the certainty of evidence using an approach known as GRADE, which led to the focus on twenty-four ivermectin-centered randomized controlled trials involving 3,406 participants. The authors concluded based on this extensive review that ivermectin actually reduced the risk of death compared with no ivermectin (average risk ratio 0.38, 95% CI 0.19-0.73; n = 2438; I2 = 49%; moderate-certainty evidence). This result, posits Dr. Lawrie and team, confirmed via trial sequential analysis employing what was the same DerSimonian-Laird method behind the unadjusted analysis. The authors also ran their findings against a trial sequential analysis employing the Biggerstaff-Tweedie method. They found low-certainty evidence that ivermectin prophylaxis (as a preventive method) actually lowered infection association with SARS-CoV-2, the virus behind COVID-19, by an average of 86% (95% CI 79-91%). Also, the team’s findings reveal that the evidence for secondary outcomes, such as efficacy associated with “need for mechanical ventilation” is less compelling; however, effective estimates for “improvement” and “deterioration” point to the positive impact of ivermectin use. The authors found little safety risk as reports of severe adverse events were rare among the reviewed studies.


This study published in the peer-reviewed American Journal of Therapeutics suggests a “moderate-certainty evidence” indicating a substantial reduction in COVID-19 related deaths would be a feasible outcome with the use of ivermectin. The study results mirror what TrialSite’s observed in study after study from Bangladesh and India to Peru and Argentina; from Israel and Nigeria to the ICON study in South Florida and population-wide public health initiatives using ivermectin from Mexico City to Uttar Pradesh, India, that there’s now overwhelming data that this generic drug used as an antiparasitic treatment should be considered on at least an emergency basis as another tool in the medical tool chest to fight SARS-CoV-2.


Dr. Lawrie shared with the TrialSite:


We are overjoyed to have the product of months of hard work finally published! And what a wonderful author team – it’s been an honour to work with people of such high integrity, who maintained a spirit of hope and optimism in spite of all the difficulties with which we have been confronted. Thank you for not giving up! Now the authorities have all the evidence they need to approve ivermectin immediately.”

The preprint of this review received no funding. This updated version was funded by the crowdfunding initiative.


TrialSite’s Coverage of Ivermectin


TrialSite’s been one of the few, if not the only, media platforms to consistently chronicle ivermectin-based research since the initial findings of a group of scientists last April at Monash University that the generic drug absolutely destroys the SARS-CoV-2 pathogen in a lab setting. TrialSite chronicled the organization, conduct, and conclusion of dozens of studies since then. The platform’s only been rivaled by the anonymously owned platform that tracks every ivermectin study, now at 60. One of the key authors here, Dr. Tess Lawrie, has been a guest on the TrialSite podcast and is a frequent contributor.


Lead Research/Investigator

  • Andrew Bryant, MSc, Division of Gastroenterology, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom

  • Theresa A. Lawrie, MBBCh, PhD, Division of Gastroenterology, Evidence-based Medicine Consultancy, Bath, United Kingdom

  • Therese Dowswell, PhD, Division of Gastroenterology, Evidence-based Medicine Consultancy, Bath, United Kingdom

  • Edmund J. Fordham, PhD, Division of Gastroenterology, Evidence-based Medicine Consultancy, Bath, United Kingdom

  • Scott Mitchell, MBChB, MRCS, Emergency Department, Princess Elizabeth Hospital, Guernsey, United Kingdom

  • Sarah R. Hill, PhD, Division of Gastroenterology, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom

  • Tony C. Tham, MD, FRCP, Division of Gastroenterology, Ulster Hospital, Dundonald, Belfast, Northern Ireland, United Kingdom

Call to Action: Perhaps health regulators and apex research institutes can revisit their assessment of this drug. Note the corresponding author is Andrew Bryant who can be reached at andy.bryant@ucl.ac.uk


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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


Abstract


Background:

Repurposed medicines may have a role against the SARS-CoV-2 virus. The antiparasitic ivermectin, with antiviral and anti-inflammatory properties, has now been tested in numerous clinical trials.

Areas of uncertainty:

We assessed the efficacy of ivermectin treatment in reducing mortality, in secondary outcomes, and in chemoprophylaxis, among people with, or at high risk of, COVID-19 infection.

Data sources:

We searched bibliographic databases up to April 25, 2021. Two review authors sifted for studies, extracted data, and assessed risk of bias. Meta-analyses were conducted and certainty of the evidence was assessed using the GRADE approach and additionally in trial sequential analyses for mortality. Twenty-four randomized controlled trials involving 3406 participants met review inclusion.

Therapeutic Advances:

Meta-analysis of 15 trials found that ivermectin reduced risk of death compared with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73; n = 2438; I2 = 49%; moderate-certainty evidence). This result was confirmed in a trial sequential analysis using the same DerSimonian–Laird method that underpinned the unadjusted analysis. This was also robust against a trial sequential analysis using the Biggerstaff–Tweedie method. Low-certainty evidence found that ivermectin prophylaxis reduced COVID-19 infection by an average 86% (95% confidence interval 79%–91%). Secondary outcomes provided less certain evidence. Low-certainty evidence suggested that there may be no benefit with ivermectin for “need for mechanical ventilation,” whereas effect estimates for “improvement” and “deterioration” clearly favored ivermectin use. Severe adverse events were rare among treatment trials and evidence of no difference was assessed as low certainty. Evidence on other secondary outcomes was very low certainty.

Conclusions:

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.


Full PDF:



Ivermectin_for_Prevention_and_Treatment_of.98040
.pdf
Download PDF • 2.75MB

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In the first edition of CATalyst, Shabnam Palesa Mohamed engages Advocate Dipali Ohja (IBA), Dr Pierre Kory (FLCCC), and Dr Tess Lawrie (EBMC) about the Indian Bar Association's decision to issue legal notice on WHO chief scientist, Dr Soumya Swaminathan. The 51 page notice, served 25th of May, claims as its legal basis alleged WHO's 'disinformation and censorship' on the Ivermectin issue.