Thursday, February 10, 2022

Old drug shows some promise in fighting lung damage of Covid, Disulfiram

But will Disulfiram be able to survive the politics of the Democrats in the lap of Big Pharma?

https://udumbara.net/decades-old-drug-may-help-protect-against-severe-covid-19-symptoms-study

Other drugs approved for different uses have shown some success against COVID-19, including ivermectin, hydroxychloroquine, and fluvoxamine, though U.S. health officials primarily recommend ones such as paxlovid that are specifically approved for combating the illness.

I looked at one of the studies on Ivermectin (a meta-analysis of published articles) and found something in the small print. Note: Ivermectin must be used in the very early stages of the disease and symptoms.

"Conflicts of interest.
Pharmaceutical drug trials often have conflicts of interest whereby sponsors or trial staff have a financial interest in the outcome being positive. Ivermectin for COVID-19 lacks this because it is off-patent, has many manufacturers, and is very low cost. In contrast, most COVID-19 ivermectin trials have been run by physicians on the front lines with the primary interest of finding the best methods to save human lives and minimize the collateral damage caused by COVID-19. While pharmaceutical companies are careful to run trials under optimal conditions (for example, restricting patients to those most likely to benefit, only including patients that can be treated soon after onset when necessary, ensuring accurate dosing), many ivermectin trials do not represent the optimal conditions for efficacy.
Two ivermectin trials to date involve very large financial conflicts of interest [López-Medina, Together Trial] — companies closely involved with the trial or organizers stand to lose billions of dollars if ivermectin efficacy becomes more widely known. The design of these trials favors producing a null outcome as detailed in [López-Medina, Together Trial]. Note that biasing an RCT to produce a false positive result is difficult (suppressing adverse events is relatively easy [Evans]), but biasing a trial to produce a false negative result is very easy — for example, in a trial of an antiviral that works within the first 24 hours of symptom onset, trial organizers only need to avoid treating people within the first 24 hours; or with a disease like COVID-19, organizers only need to select a low-risk population where most people recover quickly without treatment. We note that, even under the very suboptimal designs, these trials produced positive results, although without statistical significance.

Designed to fail. Additional upcoming trials including ACTIV-6, COVID-OUT, and PRINCIPLE have been designed in a way that favors finding no effect, with a number of methods including late treatment, selecting low-risk patients, fasting administration, very high conflict of interest medication sourcing, and dosing below current clinical practice. For discussion see [Goodkin].

One patient reported their experience with one of the remote outpatient ivermectin/fluvoxamine trials: they were offered enrollment 7 days after symptoms (receipt of medication would be even later), were offered $400 to participate, and reportedly target healthy people [twitter]. ACTIV-6 also reportedly does not ship study medications on the weekend, adding additional delays [twitter (B)]. https://ivmmeta.com/ivm-meta.pdf

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