Bayes Theorem Confirms Meta-analysis of Ivermectin’s Effectivity against COVID-19

In June 2021, two different meta-analyses came out that had opposite conclusions about the effectiveness of ivermectin against COVID-19.

The peer-reviewed study, Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines, was published in the American Journal of Therapeutics by Bryant et al. [1] on June 21, 2021. They concluded that ivermectin is cheap and effective for the treatment of COVID-19. They conclude,

Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.

Bryant et al. arrived at their conclusion using statistical analysis of the data.

Then on June 28, 2021, the journal Clinical Infectious Diseases published a study by Roman et al., Ivermectin, for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials. [2] Their conclusion is the opposite,

In comparison to SOC (standard of care) or placebo, IVM (ivermectin) did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease. IVM did not have an effect on AEs (adverse effects) or severe AEs. IVM is not a viable option to treat COVID-19 patients.

As a response, two co-authors of Bryant, Fordham, and Lawrie wrote in an Attempt to discredit landmark British ivermectin study, Medical Disinformation from the BBC [3], said that the Roman study was subjective and had several mistakes,

The study surveys only 1,173 patients over 10 studies, with the remaining known randomised trials arbitrarily excluded. Moreover, the article misreports published clinical trial data in a way that verges on falsification of data, as an Open Letter to the Editor-in-Chief has detailed. The initial misreporting while on the preprint server medRxiv included a farcical reversal of the treatment and control ‘arms’ of the clinical trial of Niaee et al, drawing protest from Dr Niaee himself which can still be found in the comments section of medRxiv. Unfortunately for Clinical Infectious Diseases, further misreporting (undetected by the journal’s peer reviewers) remains, in a way that renders the article worthless.

I strongly recommend reading Attempt to discredit landmark British ivermectin study. Lots of gems there.

So what would you believe? Is ivermectin useful or useless for COVID-19?

This study will answer that question, Bayesian Meta-Analysis of Ivermectin Effectiveness in Treating COVID-19 [4]. It was done by Neil and Fenton from the University of London.

The data they used are from the trials based on the study of Bryant et al.

Bayes’ Theorem describes the probability of an event based on prior knowledge of conditions that might be related to the event. This paper highlights the advantages of using Bayesian methods over classical statistical methods for meta-analysis.

We will cut thru the discussion and go straight to the conclusions of Bayesian Meta-Analysis of Ivermectin Effectiveness in Treating COVID-19, with emphasis added.

We show that there is overwhelming evidence to support a causal link between ivermectin, Covid-19 severity and mortality, and:

i) for severe Covid-19 there is a 90.7% probability the
risk ratio favours ivermectin

ii) for mild/moderate Covid-19 there is an 84.1% probability the
risk ratio favours ivermectin

iii) for patients with severe Covid-19, the mean probability of death without ivermectin treatment is 22.9%, whilst with the
application of ivermectin treatment it is 11.7%

Take-away message

Bayesian analysis shows that ivermectin is overwhelmingly effective in mild, moderate, and severe COVID-19, and ivermectin’s use is associated with fewer COVID-19 deaths. It confirms the study of Bryant et al., Ivermectin for Prevention and Treatment of COVID-19 Infection : A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines.

Knowledge about Covid-19 is rapidly evolving. Information may update as new studies are made. Stay current by subscribing. Feel free to share and like.

Don’t Get Sick!

References:

Bryant A, Lawrie TA, Dowswell T, Fordham EJ, Mitchell S, Hill SR, Tham TC. Ivermectin for Prevention and Treatment of COVID-19 Infection : A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines. Am J Ther. 2021 Jun 21;28(4):e434-e460. doi: 10.1097/MJT.0000000000001402. PMID: 34145166; PMCID: PMC8248252.
Roman YM, Burela PA, Pasupuleti V, Piscoya A, Vidal JE, Hernandez AV. Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials. Clin Infect Dis. 2021 Jun 28:ciab591. doi: 10.1093/cid/ciab591. Epub ahead of print. PMID: 34181716; PMCID: PMC8394824.
Attempt to discredit landmark British ivermectin study by HART Group.
Neil, Martin & Fenton, Norman. (2021). Bayesian Meta-Analysis of Ivermectin Effectiveness in Treating Covid-19 Disease. 10.13140/RG.2.2.31800.88323.

Image Credit: By Bayes_sig.jpg: Thomas Bayes convert to SVG: Bennett Kanukaderivative work: Mikhail Ryazanov (talk) – Bayes_sig.png, Public Domain, https://commons.wikimedia.org/w/index.php?curid=17455228

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