Originally Posted by revelarts
FYIhttps://ebm.bmj.com/content/early/20...bm-2021-111678...
A recently published systematic review and network meta-analysis35 compared the efficacy and safety of pharmacological interventions for COVID-19 in hospitalised patients. It included 110 studies (78 published and 38 unpublished) with 40 randomised clinical trials and 70 observational studies. Based on observational data, they found that high-dose intravenous immunoglobulin, ivermectin and tocilizumab were associated with reduced mortality rate in critically ill patients. None of the analysed drugs was significantly associated with increased non-cardiac serious adverse events compared with standard care, but the overall certainty of the evidence was very low in all outcomes and reduced the ability for recommendation.
Different websites (such as https://ivmmeta.com/, https://c19ivermectin.com/, https://tratamientotemprano.org/estudios-ivermectina/, among others) have conducted meta-analyses with ivermectin studies, showing unpublished colourful forest plots which rapidly gained public acknowledgement and were disseminated via social media, without following any methodological or report guidelines. These websites do not include protocol registration with methods, search strategies, inclusion criteria, quality assessment of the included studies nor the certainty of the evidence of the pooled estimates. Prospective registration of systematic reviews with or without meta-analysis protocols is a key feature for providing transparency in the review process and ensuring protection against reporting biases, by revealing differences between the methods or outcomes reported in the published review and those planned in the registered protocol. These websites show pooled estimates suggesting significant benefits with ivermectin, which has resulted in confusion for clinicians, patients and even decision-makers. This is usually a problem when performing meta-analyses which are not based in rigorous systematic reviews, often leading to spread spurious or fallacious findings.36
Concluding, research related to ivermectin in COVID-19 has serious methodological limitations resulting in very low certainty of the evidence, and continues to grow.37–39 The use of ivermectin, among others repurposed drugs for prophylaxis or treatment for COVID-19, should be done based on trustable evidence, without conflicts of interest, with proven safety and efficacy in patient-consented, ethically approved, randomised clinical trials.
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