Watchdog scientists are sounding the alarm on studies of covid-19 involving ivermectin, a long-used antiparasitic that some say may be effective in treating or preventing viral disease. In a new article this week, they argue that ivermectin research has been hampered by widespread fraud and lax oversight by other researchers. The best way to prevent similar problems from progressing, they say, is to impose stricter standards in general on how data is collected and reanalyzed by scientists conducting evidence reviews.
Ivermectin has become an unexpected cultural totem for the pandemic. Some people, who are also often wary of vaccines or have played down the pandemic, believe that ivermectin is a very effective covid-19 drug that has been kept away from the public at the behest of Big Pharma. Many people have been rightly skeptical of these claims, although some have been misled by reports claiming that ivermectin overdoses have overwhelmed emergency rooms or are causing a massive epidemic of infertility in patients. users.
In truth, Ivermectin is an extremely valuable drug which is very safe and effective when taken as an antiparasitic. But despite some early animal or laboratory studies suggesting that it may also help kill the coronavirus, the bulk of the evidence does not point to a major benefit of the drug for true covid-19 patients, at least to date. . The largest and apparently the highest quality studies found no real effect on mortality or prevention of infection. Meanwhile, the results of some studies that seemed to show a huge effect have since been called into question.
In a new paper published this week in Nature Medicine, scientists from the UK, Australia, Sweden and the US shed light on two such suspicious studies they have drawn attention to in the past: one purported clinical trial in Egypt which has now been pulled from the preprint server where it has been posted amid plagiarism allegations and suspicious data, and another in Iran which has found benefit in reducing patient mortality hospitalized. The Iranian study may not have succeeded in correctly randomizing participants to treatment and control groups, an important step in obtaining valid results, according to the authors.
But they say these examples are just the tip of the iceberg. There are plenty of other ivermectin studies they’ve found where even a quick review of the data reveals glaring errors, conflicting details and numbers so impossible they’ve likely been falsified, the group argues. Not only are these studies bad science, they add, but they are actively harming people.
Hundreds of thousands of people, often in poorer countries with little access to expensive antivirals or experimental drugs that have shown promise in treating covid-19, have been given ivermectin for covid-19 , despite very little solid evidence that it does anything for them. In the United States, some people have been injured while taking ivermectin without medical supervision. As recently as today, New Mexico health officials reported that at least two residents were killed as a result of ivermectin toxicity, while others developed seizures and hallucinations.
“Relying on low-quality or questionable studies in today’s global climate presents serious and immediate damage,” the authors wrote. “The enormous impact of covid-19 and the resulting urgent need to demonstrate the clinical efficacy of new treatment options provide fertile ground for even poorly proven efficacy claims to be amplified, both in the scientific literature. and on social networks. “
One of the main ways to amplify these studies is through what is called a meta-analysis, which is when scientists take a bunch of relevant studies on a topic and try to summarize the state of evidence. While meta-analyzes are an important part of science, they must be done with care to rule out poorly conducted or suspicious research, or their results may be skewed. The authors note that at least two meta-analyzes claimed to find a net benefit for ivermectin, largely thanks to the inclusion of the Egyptian study. Following the withdrawal from this study, the authors of a meta-analysis withdrew their article and said they would reanalyze and republish their work without the Egyptian or Iranian study.
Scientific research is a flawed process at the best of times. But scientists and institutions like academic journals and the media are particularly vulnerable to fraud because the basic premise is that everyone makes a good faith effort to conduct science ethically. Without rigorous checks and balances, even studies so fragile that they collapse at a glance can attract media attention or get published. The new popularity of ivermectin makes some even more skeptical about checking the stones, as many fans will turn a blind eye to questionable studies that claim to have found huge benefits for the drug.
Throughout this year and last, for example, ivermectin proponents have touted a study from Argentina that appeared to show ivermectin could prevent 100% of infections in healthcare workers. Still, a Buzzfeed News survey released earlier this month uncovered evidence that parts of the study’s claimed methods and results simply don’t make sense and may have been fabricated, while some of the authors of this new article have critical this too.
While scientific fraud can be difficult to eradicate, the authors say much more could be done to prevent it from hijacking clinical research, not just for covid-19 but in general. They are asking scientists to adopt a new standard for meta-analyzes, where individual patient data, and not just a summary of that data, is provided by the scientists who conducted the original trials and then collected for analysis. While this would mean more work for scientists (among other things, data needs to be properly anonymized to protect people’s privacy), having access to this kind of raw data would make it much easier for researchers to detect potential fraud or fraud. fatally flawed studies. Studies whose authors do not provide this information should be considered at high risk of bias or excluded altogether from a meta-analysis, they add.
“We recognize that this is a change from a long accepted practice and that it is significantly more rigorous than the standards generally applied today, but we believe that what has happened in the case ivermectin justifies our proposition, “wrote the authors.
Notably, the authors of the Brazilian and Iranian studies have so far refused to make their patient data accessible to anyone.
Clinical trials with ivermectin are still ongoing, in the United States and elsewhere, and it is not inconceivable that the drug may still have modest benefit for covid-19. But as it stands, the state of ivermectin research is shameful. “This research has created undue confidence in the use of ivermectin as a prophylactic or treatment for covid-19, usurped other research agendas, and likely resulted in inappropriate treatment or substandard patient care,” wrote the authors.