Why are people poisoning themselves with horse dewormer to treat COVID-19?
Let's explore ivermectin in this week's #DeepDive
Ivermectin is a medication which is perscribed to combat parasites.
It jams itself into chloride channels, permanently turning the nerves off.
It can't do that to people, so it has a pretty good safety profile if you stick to the correct doses.
Okay, but viruses don't have nerves.
So why would an insecticide work on a virus?
It does something else, too. It blocks the import of proteins into the nucleus.
Kind of.
dicyt.uto.edu.bo/observatorio/w…
See, once we get outside of a petri dish, the antiviral properties of ivermectin become a bit questionable.
Sometimes, it works in mice, sometimes it doesn't. Bodies are a lot more complicated than petri dishes.
XKCD
bit.ly/3zlEfju
go.nature.com/3kjQ9EB
The other problem, is that for the medicine to reach the levels needed to treat COVID-19, you need a really high dose.
Like, well over 10x what's currently given to people.
ascpt.onlinelibrary.wiley.com/doi/full/10.10…
So there's SOME evidence it works, at least. In animal models. And in cells.
The big paper which set all of this off was a well-performed paper looking at the drug in cell cultures.
sciencedirect.com/science/articl…
This paper set off a lot of clinical trials, many with varying quality, different confounding factors...it's just hard to parse so many trials run so differently on the fly.
I'm not a doctor, so I'm going to refer to BMJ here:
ebm.bmj.com/content/early/…
Ultimately, though, it looks like it has some weak effects. Weak, but positive.
So maybe if we find the right dosing regime.
The problem, however, is that a lot of this is based on preprints.
...and a lot of this data just isn't quality data.
One paper that's been widely cited in online spheres relied on a withdrawn paper for 15% of its effect size.
nature.com/articles/d4158…
So that's where we are on ivermectin. It's a big "maybe" with a lot of legitimate questions about whether it works...which it very likely might not based on how it's metabolized in people.
Vaccines DO work, so if you can, get vaccinated.
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