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Evidence on the efficacy of ivermectin for COVID-19: another story of apples and oranges
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  • Published on:
    Rapid Response, BMJ Evidence-Based Medicine
    • Andrew Bryant, Research Associate (Biostatistician) Newcastle University
    • Other Contributors:
      • Theresa A Lawrie, Evidence based medicine researcher
      • Edmund J Fordham, Physicist / patient advocate
      • Scott Mitchell, Emergency Medicine Clinician

    Rapid Response, BMJ Evidence-Based Medicine
    Re: Popp M, Kranke P, Meybohm P, et al. Evidence on the efficacy of ivermectin for covid-19: another story of apples and oranges. BMJ Evidence-Based Medicine Published Online First: 20 August 2021. doi: 10.1136/bmjebm-2021-111791

    Ivermectin in Covid-19

    Andrew Bryant MSc
    Population Health Sciences Institute, Newcastle University
    Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK
    Theresa A Lawrie MBBCh PhD
    Edmund J Fordham PhD FInstP
    EbMCsquared, a Community Interest Company
    Northgate House, Upper Borough Walls, Bath BA1 1RG, UK
    Scott Mitchell MBChB MRCS
    Emergency Department, Princess Elizabeth Hospital, Guernsey

    To the Editor
    The sole substantive critique in this Letter[1] is the description of Bryant[2] et al. (hereafter “Bryant”) as a “bowl of colourful fruit salad”[1], because of the pre-specified comparison of “ivermectin” vs “no ivermectin”. Trials with (potentially) active comparators were indeed included. Reflection should show that any bias is conservatively against ivermectin. Helpful control interventions would dilute the apparent benefit of ivermectin, relative to inactive comparators exclusively. Efficacy will be understated, not overstated, with respect to controls.
    Unsuspected active agents in ivermectin combination therapies might...

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    Conflict of Interest:
    Conflicts of interest: AB TAL EJF and SM are co-authors of Ref [2] attacked in the Letter [1]. They were members of the British Ivermectin Recommendation Development (BiRD) panel at the “Evidence to Decision” event convened on 20 February 2021. TAL and AB were members of the steering group and did not vote. EJF and SM were ordinary members of the panel. BiRD is a public information activity managed by EbMCsquared, a non-profit Community Interest Company funded by public donations. EJF and SM are unpaid volunteers entirely without financial interest. EJF is a member of the Health Advisory and Recovery Team (HART), an unincorporated membership association with no financial or material interests in ivermectin or any other medical product. This work, and Ref [2], are not projects of HART, and are not funded or influenced in any way by them