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6 Feb, 11 tweets, 6 min read
Quelques éléments de contexte pour expliquer le communiqué de presse de @Merck qui conclut à l'absence quasi totale de preuves en faveur de l'#ivermectine (IVM) pour #COVID_19 🧵merck.com/news/merck-sta…
Petit disclaimer pour commencer : je ne suis ni "pro-IVM", ni "anti-IVM". Ces catégories n'existent que dans les esprits des gens qui politisent tout et n'importe quoi.
Je ne doute pas que Merck croit sincèrement que l'IVM ne marchera pas contre COVID-19.
Ceci étant, il faut analyser le contexte dans lequel s'inscrit cette prise de position assez catégorique et pour le moins inhabituelle d'un géant de l'industrie.
Commençons.
Merck, au travers du programme de donation @MectizanMDP, est le fournisseur historique d'IVM en Afrique pour lutter contre les maladies tropicales négligées (MTNs): onchocercose et filariose lymphatique.
.@MectizanMDP redoute (à juste titre) que l'usage off-label de l'IVM pour COVID-19 en Afrique ne se fasse au détriment de l'accès à l'IVM pour les MTNs.
L'IVM a reçu de nouvelles indications depuis plusieurs années (gale, strongylo, poux etc). Mais Merck s'est désintéressé de tout cela. Merck a systématiquement refusé que les donations par @MectizanMDP soient étendues à ces nouvelles indications.
Les distributions de masse d'IVM constituent également une piste très prometteuse contre le paludisme (effet anti- anopheles). Mais Merck ne s'implique que très peu dans cette nouvelle utilisation possible. ncbi.nlm.nih.gov/pmc/articles/P… Image
Dans un papier plus récent, les auteurs envisagent de recourir aux génériqueurs, plutôt qu'à Merck, pour cette nouvelle indication (anti-anopheles). C'est à mon avis un autre signe du désintérêt de Merck pour toute nouvelle indication pour l'IVM. pubmed.ncbi.nlm.nih.gov/31971144/ Image
A noter aussi que Merck développe deux traitements dont il est propriétaire contre COVID-19: molnupiravir & MK-7110. Ces molécules brevetées sont la priorité de Merck. Pas l'IVM, dont le brevet est tombé en 1996. merck.com/news/merck-dis…
Voici donc le contexte:
➡️@Merck montre peu d'intérêt pour les nouvelles indications possibles de l'#ivermectine.
➡️Merck redoute qu'une lame de fond en faveur de l'IVM contre COVID-19 mette en danger @MectizanMDP.
➡️Merck a misé sur des molécules brevetées contre #COVID_19.
Dernier point: il me semble important aujourd'hui d'augmenter la production mondiale d'ivermectine. J'aimerais savoir ce que Merck compte faire à ce sujet.

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Julien Potet Profile picture
11 Mar
1/
 🔥EXCELLENT results for Phase III multicentric double-blind RCT of #proxalutamide for hospitalized #COVID_19 patients🔥
n=588
Study led by @FlavioCadegiani in 🇧🇷
92% reduction in mortality ! prnewswire.com/news-releases/…
2/
Keep in mind that this is a press release, not a scientific publication.
A point is particularly unclear in the press release, i.e. authors claim 588 patients were enrolled, but then later write they were 294 in proxalutamide group & 296 in control group.
294+296=590≠588.
3/
Detailed results were shared in Portuguese during this press conference in 🇧🇷
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10 Mar
1/
 Excellent results for phase 3 placebo-controlled RCT in 🇺🇸 among mild-to-moderate #COVID_19 patients at high risk of clinical deterioration.
Cocktail of 700mg of #bamlanivimab & 1,400mg of #etesevimab reduced risk of hospitalizations & death by 87%.
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3/
 Concern now is that bamlanivimab is quite accessible in monotherapy, but not yet in combination w/ etesevimab.
In Oct 2020, @gatesfoundation signed a contract w/ Lilly & Fujifilm to manufacture more bamlanivimab. Could it now also include etesevimab?
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12 Feb
1/
 Large RCT (n=930) in Barcelona, 🇪🇸: #calcifediol vs control among hospitalized #COVID_19 patients.
Strong clinical benefit: ↘️ICU admission & ↘️mortality.
Unclear to me why this preprint got unnoticed (published three weeks ago) !
#VitaminD
papers.ssrn.com/sol3/papers.cf…
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These new results confirm similar positive results for calcifediol generated in Cordoba in a smaller pilot RCT
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Yet results are very encouraging !
It was apparently submitted to @TheLancet. I hope it will get published soon.
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11 Feb
Live-tweeting about the 1st online conference on noma disease. Stay tune !
#ZeroNoma #NTDs
Opening message by @PeterHotez. Peter is among other things editor of @PLOSNTDs. The journal recently agreed to include noma in the list of eligible diseases for publication. #NTDs
Noma survivor @FidelStrub tells his personal story. Underwent 27 surgical operations ! Moving testimony by a strong advocate !
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11 Jan
Bangladesh: large RCT (n=606) of #mouthwash, gargling, nasal spraying & eye drops w/ 1% povidone-iodine (PVP-I, aka #Betadine) for #COVID_19. Every 4 hours for 4 weeks.
Impressive results.
bioresearchcommunications.com/index.php/brc/…
h/t @Covid19Crusher
Mouthwash solutions of PVP-I can be easily purchased OTC in many countries. Nasal sprays and eye drops are less easily accessible (i.e. not available OTC in France).
There have been other in vivo and in vitro studies over the last months. A tiny RCT from Singapore had previously found encouraging results.
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Julien Potet Profile picture
7 Dec 20
1/
 There have been several small RCTs over the last weeks suggesting a clinical benefit for #ivermectin for #COVID_19.

It’s time for a MEGA THREAD on ivermectin, aka the “wonder drug”!

Let's start the show !🔥🔥🔥
2/
Ivermectin belongs to the family of avermectins, which are natural fermentation products of soil bacteria. A Nobel Prize of Medicine was awarded for their discovery. Image
3/
Ivermectin is indicated for several parasitic infections: onchocerciasis, lymphatic filariasis, strongyloidiasis, scabies. It works on head lice too. #NTDs

But ivermectin may have a broader therapeutic benefit. Hence its nickname, the “wonder drug”.
pubmed.ncbi.nlm.nih.gov/28196978/
Read 20 tweets

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