Thread by @alexandrosM

So, the 7 months delayed TOGETHER study paper on Ιvermectin is about to be published. They're doing extra effort to get in the press ahead of publication, with surgically crafted statements. SCIENCE.

So, what's the current state of the evidence? A 🧵

archive.is/QZzU7

Last time I looked at the evidence, even when excluding everything and anything anyone objected to, there still seemed to be clear evidence in favor: doyourownresearch.substack.com/p/a-conflict-o…

But don't take it from me. Even notorious anti-ivm activist @gidmk has recently done his own, (highly subjective) summation, and concludes that "the jury is still out". Weird. He makes sure to pepper his piece with the usual talking points, of course. gidmk.medium.com/the-jury-is-st…

Besides the studies though, a usual objection is that the drug doesn't work, because it *can't* work. Or if it does, we have no idea how.

@JoomiKim1 takes a scalpel to that claim, and finds it completely devoid of substance: joomi.substack.com/p/misconceptio…

Well, if the evidence is there, and the mechanism and dosing questions have been resolved, why aren't the proper authorities recommending it?

Well, there's no way to sugar-coat this. The answer appears to be that it's due to a well-evidenced case of academic fraud.

Wait, wasn't fraud the reason ivm had any backing to begin with? Actually, no.

The sloppy or fraudulent studies that have been highly publicized are only a small subset of the total, and less than the baseline of fraudulent studies that we should expect in any body of research.

I've dug into the claims by this group of fraud researchers in detail, one such thread here, examining if indeed we see an anomalous pattern in the set of studies:

https://twitter.com/alexandrosM/status/1446823118241107968?t=ygtWqA7-aAeHzkHnPz8esQ&s=19

But what kind of fraud *against* ivermectin am I alleging?

Well, the earliest meta-analysis, which advised the health organizations that there wasn't enough evidence to approve, had been improperly modified by a sponsor, as the author confessed on video.

https://twitter.com/alexandrosM/status/1500124283850219528?s=20&t=RPkPdyQOtZ766Ct1TZel_A

It gets worse. The person who most likely did the modifications to the paper, without being an acknowledged author, appears to be Professor Andrew Owen. Who also prepared the evidence for the strange WHO meta-analysis. philharper.substack.com/p/professor-ti…

Another negative meta-analysis, by Roman et al., makes comical errors, literally inverting the data for the treatment and control groups for a study, which were pointed out but ignored on the preprint. Had they got it right, the analysis would be positive. bird-group.org/letter-to-edit…

The gold-standard "Cochrane" review also appears to make an extreme effort to discard most of the data, and balkanize what's left, just so it can conclude there is "no evidence". osf.io/peqcj/

A reminder that Cochrane had accepted Tess Lawrie's offer to do a meta-analysis, with a team that had conducted over Cochrane 100 reviews already, and then declined to publish it.

https://twitter.com/alexandrosM/status/1486167962461433856?t=jp7vnQ6LgfCExAGtP2eG7g&s=19

Adding to the series of strange coincidences around this molecule, Nobel prize winner and discoverer of Ιvermectin, Professor Satoshi Omura, asked Merck to study it in the context of COVID-19 and was rejected.

https://twitter.com/wmiddelkoop/status/1477559921969348609?t=jp7vnQ6LgfCExAGtP2eG7g&s=19

Another study, PRINCIPLE, announced that they had halted their study of Ιvermectin, due to "supply chain issues". The supplier denied there had ever been such issues. The trial has now resumed, but we have no idea why it was halted to begin with.

https://twitter.com/andrewbostom/status/1475073027784298499?t=jp7vnQ6LgfCExAGtP2eG7g&s=19

What about the TOGETHER trial, discussed at the top of this thread? Well, it seems to have made several serious errors, most of which would have been disqualifying on their own, including not checking if the control group was already on the drug! doyourownresearch.substack.com/p/what-went-wr…

In the meantime, ivmmeta.com, a site with as many fans as it has haters, shows positive, consistent results that fit the proposed mechanisms of action, and are robust to exclusions. It's like 700+ researchers worldwide conspired to make it look like this.

What about safety though? Can we afford to take a risk if we're not certain? Well, it's no remdesivir, but it's pretty ok. I'm kidding, of course. @chrismartenson has reviewed an exhaustive review paper on this, concluding it's about as safe as it gets.

https://twitter.com/alexandrosM/status/1438159018267004930?t=gJ_FBSjM9eV4ntu3-GzIKQ&s=19

So, as it stands, it does seem that Ιvermectin is the most prominent and blatant demonstration of manipulation of the medical and scientific literature throughout the pandemic, to invert the obvious conclusion of the studies when summarized plainly.

And even if one believes we should have more data, we must ask the question: why didn't the NIAID perform a large scale thorough and fair trial, so it can answer the question for good? It didn't have a problem advocating for remdesivir on much less data. doyourownresearch.substack.com/p/the-remdesiv…

I suppose we'll see more studies rolling in, and the usual pattern: negative studies will get press, while positive ones, like the one from @sabinehazanmd, will be ignored.

https://twitter.com/SabinehazanMD/status/1504833348245499907?s=20&t=UY2lmXGq6F0dwd6ugSQ3Mw

As for me, I await a trial that is done to the same standard as other early treatment anti-viral agents, such as Molnupiravir and Paxlovid. We know what a good study design looks like, let's use it. If it fails, it fails. But let's, for once, apply even standards.

And please no more garbage studies like the recent one from Malaysia that had the patients fail the primary endpoint in 3 days, while claiming to test a 5-day treatment. Drugs don't have time machines.

https://twitter.com/alexandrosM/status/1495062648357937153?s=20&t=UY2lmXGq6F0dwd6ugSQ3Mw

And in the meantime, if this bill passes the Senate too, consider a move to New Hampshire?

https://twitter.com/jeffreyatucker/status/1504465808310874116?t=rzPtGnFICNDklPhce1esyg&s=19