Thread by @drabbyphilips

Y #Ivermectin doesn't work
1 #ivermectin craze 4 #COVID19India started in South-America, spread like wildfire to USA/Europe. Heavily criticized in countries upholding #science, didnt find place in guidelines. BUT, nw it reached #India, into minds/hearts of doctors not due to...

2...the #science, but bcoz National institutions such as @aiims_newdelhi/ certain govts @goacm endorse it - without getting into the science of it. Nw, #ivermectin is slowly bcoming nationalist boy scout of #medicine in #India, wrngly endorsed by naïve students/senior professors.

3 Ivermectin is broad-spectrum antiparasitic approved by @US_FDA, proved to be safe at dose of ≤200 µg/kg. In a 60 kg man, the max conventional dose in 12 mg.
Caly et al (not Baba Ramdev) bit.ly/3vO9cuK identified in-vitro (cell study) anti-#SARSCoV2 ivermectin activity

4 Tis was followd by in-silico studies (performed on computer or via computer simulation) tat showd potential of #ivermectin 4 inhibition of #coronavirus replication. Note tat these R all preclinical/cell based/computer-generated data/NOT real.
It can remain in 'valley of death'

5 For #ivermectin 2 show #anticovid effect 0.5µM concentration is warranted. EVEN WITH dosing at 1700 µg/kg (nine times more than FDA approved/ = to 102 mg / V R using 12mg🙄) the 'effective' concentration of #ivermectin reached is only measly 0.28µM
bpspubs.onlinelibrary.wiley.com/doi/10.1111/bc…

6 So #scientific basis 4 assessing #ivermectin 4 #COVID19 at clinical level is insufficient. Wich is Y, @WHO excluded #Ivermectin frm Solidarity Trial.
Watevr #ivermectin dosing is used in various studies (FLCCC or BIRD) or othr #ivermectincult grps is ACTUALLY #homeopathy level

7 Nw in real life, A LOT of #ivermectin publications are mostly pre-prints, un-reviewed, unpublished and part of #IVERMECTIN craze groups webpages/websites. This is not #science and quoting or linking these show the paucity in #scientific temper of the person sharing these.

8 Ther R SO MANY issues wit #ivermectin trials: published/unpublished
➡️heterogeneity in patients receiving ivermectin (frm ICU patients to family contacts!/treating mild to ICU cases or even normal persons!
➡️VERY differnt dosings
➡️patients receiving various cointerventions...

9...➡️control groups received different comparators ranging frm placebo to even #HydroxyChloroquine absolutely USELESS (but still prescribed by physicians like @drakchaurasia) drug for #COVID19
➡️in gud pooled analyses, certainty of evidence was very low due 2 high risk of bias

10 THE BIGGEST ISSUE -
Diff websites (such as ivmmeta.com, c19ivermectin.com, tratamientotemprano.org/estudios-iverm…) conduct low quality meta-analyses showing unpublished colourful graphs
2 deceive public
shared via social media
witout folowing any methodological guidelines

11
One such, FLCCC is a fraud, grifter [someone who cheats others out of money/ also known as chiselers, defrauders, gougers, scammers, swindlers] organization wich publish #ivermectin data on their webpage, fleece people of their hard earned money, unleashing radicalization...

12...their recent low class, third rate publication on #ivermectin (wich they claim is effective thru poor and biased analysis) is currently the 'holy grail' for #ivemectin quacks in #India.
This publication is utter nonsense and has been debunked here 👇

https://twitter.com/drabbyphilips/status/1391055035652468738?s=20

13
These group based website analyses are full of errors and misleading claims.
➡️No protocol registration
➡️No methods, search strategies, inclusion criteria
➡️No quality assessment of the included studies
➡️No certainty of the evidence of pooled estimates

14
These websites ARE THE MAIN REASON for confusion among clinicians, patients and even decision-makers. An issue when performing metanalyses wich R not based on rigorous systematic reviews
Leading to spread spurious or fallacious findings - wich further damage #scientific temper

15
Also understand that #ivermectin controversy has politicisized and divided the medical community in certain countries.
bmj.com/content/373/bm…
Doctors MUST be scientists wich ensures adequate knowledge in processing information and preventing unecessary prescriptions.

16
Lot of my discussion is taken frm this excellent paper ebm.bmj.com/content/early/…
To conclude #ivermectin is USELESS 4 #COVID19India/MUST not be promoted

@pash22 @AnooBhu @malini_aisola @dawalelo @just1doctorwala @GorwayGlobal @deralteGaukler @drkamnakakkar

17 Here R som more imp links showcasing poor measures in #ivermectin promotion including data fraud to show benefits!

https://twitter.com/paimadhu/status/1391797231213322247?s=20

https://twitter.com/donnghaile/status/1391827759421394948?s=20

fda.gov/consumers/cons…

Promotion of #ivermectin thru The Weather Channel 😭

https://twitter.com/aaronhoyland/status/1391092125119385603?s=20

End

@netshrink @Neurophysik @IMAIndiaOrg @Asif_DrMed @thewittydoctor_ @PriyankaPulla @omlakhani @juneymb @stethospeaks @viswas_mr @QuackDetector @athrvakhrbde @LadyDoctorSays @free_thinker @zoo_bear @AltNews @imacuriosguy @grumpeoldman @d_s_thakur @BLRrocKS @chiragbarjatyaa

18
For proper, realistic, high quality, validated analysis on all treatments for #COVID19India, plz see
covid-nma.com which is run collaboratively by the best research organization of the world, not grifter organizations like FLCCC and BIRD etc...

19
Here is wat #scientific societies with evidence based analysis say about #Ivermectin
👇

https://twitter.com/drabbyphilips/status/1390639555452149762?s=20