Science

Misinformation: fraudulent ivermectin studies open up a new battlefield

Since the beginning of the COVID-19 pandemic, various treatments have been tried to help fight the disease. Among them, ivermectin, a drug commonly used against parasites, such as scabies. According to a press release from the Institut Pasteur, this molecule would help limit inflammation of the respiratory tract and also protect against anosmia (loss of smell), at least in hamsters. But researchers point the finger at most human studies, the conclusions of which are based on biased, even fraudulent, data.

“Several hundred thousand patients have been administered ivermectin, based on an evidence base that has dramatically evaporated under close scrutiny,” the researchers write in Nature Medicine. Gideon Meyerowitz-Katz, an epidemiologist at the University of Wollongong in New South Wales, and his colleagues have reviewed more than a dozen studies touting the efficacy of ivermectin as both a preventive and a curative. Four of them, made public, raise “serious concerns”, specifies the expert; several others are still under evaluation.

Impossible figures, unexplained discrepancies between trial record updates and published patient demographics, alleged delays that are inconsistent with the accuracy of data collection, methodological weaknesses – these are many of the flaws highlighted by this team of experts when they scrutinized the studies of their colleagues. The effectiveness of ivermectin against COVID-19 has never been proven, however this drug quickly became very popular.

Studies based on fake patients

The first “bogus” study on ivermectin was published as preprint a few months after the pandemic began, in April 2020, stating that the drug was reducing the mortality of hospitalized COVID-19 patients. It turned out that the data had been tampered with and the patients in question didn’t even exist. The article was removed from the prepress server, but the machine was already in motion: According to this study, the Peruvian government included ivermectin in its national treatment guidelines.

And although other studies have indicated that this drug does not have a significant impact on the viral load of patients with COVID-19 and that more studies are needed, on a larger scale, to evaluate its effectiveness, several countries in Latin America, and then others countries around the world, adopted it as a treatment for COVID-19. The United States, the United Kingdom, and Australia have also been affected by the hype surrounding this drug. Influential politicians and controversial researchers frequently broadcast studies claiming to support its use.

But these studies are mainly based on suspicious data. In July, The Guardian Australia revealed that the results of a randomized controlled trial conducted in Egypt had been withdrawn due to “ethical concerns”. This month, Buzzfeed News reported that an Argentine study claiming that ivermectin “prevented 100% of COVID-19 infections” contained suspect data: the number, sex and age of study participants were inconsistent. A hospital named in the study as a participant in the experiments said they had no record of this! Likewise, health officials in the province of Buenos Aires said they had no record of local approval for the study.

A lack of rigor that fuels conspiracy theories.

This situation raises several important problems. For starters, researchers who want to conduct rigorous studies on the effectiveness of this molecule, especially in South America, are scrambling to recruit “virgin” participants to take ivermectin. This is particularly the case of Dr. Carlos Chaccour, who has been researching this substance for more than 15 years for its ability to control tropical diseases.

Furthermore, this misinformation goes a long way to fuel conspiracy theories. In fact, Dr. Chaccour criticizes the media for having attributed the decrease in cases of infections in Peru to ivermectin rather than to the containment measures implemented. From then on, it was easy for people to imagine that their government was deliberately “hiding” this wonderful drug, inexpensive and widely available, therefore not profitable for the pharmaceutical industry, at least not as profitable as the new treatments. However, the recent popularity of ivermectin has been particularly lucrative for the laboratories that produce it, as well as for the pharmaceutical companies that manufacture generic versions (since the molecule is no longer patented).

Why did the researchers knowingly participate in these dubious studies? For Dr. Chaccour, it is a question of social pressure and prestige. He explains to The Guardian that early in their careers, investigators sometimes work up to “120 hours per week for less than minimum wage.” “The more you publish, the bigger the article, the more recognized is the magazine that publishes it, the closer you get to a more stable lifestyle and the recognition of your peers,” he adds.

Today, ivermectin is still considered a wonderful drug, despite all the reputable organizations pointing out the lack of strong evidence for its efficacy. In Australia, the National Covid-19 Clinical Evidence Task Force, a task force charged with developing recommendations to combat COVID-19, does not recommend the use of this drug outside of randomized controlled trials. Likewise, the World Health Organization says that “current data on the use of ivermectin to treat COVID-19 patients is inconclusive. Until more data are available, WHO recommends that this drug be administered only in clinical trials. “

Gideon Meyerowitz-Katz and the other authors of the article published today in Nature Medicine call for more rigor and believe that it is essential to review the evaluation process of meta-analyzes related to COVID-19, which in particular should involve careful and systematic examination. of individual patient data (and anonymized). “We believe that what happened in the case of ivermectin justifies our proposal: a poorly examined evidence base has supported the administration of millions of doses of a potentially ineffective drug worldwide, and yet when this evidence was submitted to a very basic digital exam, it collapsed in a few weeks ”, they conclude.

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