Ivermectin doesn't reduce risk of Covid hospitalization, according to a large study. Also this: “At some point it will become a waste of resources to continue studying an unpromising approach,” one expert said https://t.co/f8GSjUXkkb

— delthia ricks 🔬 (@DelthiaRicks) March 31, 2022

https://t.co/Bt4Kexu9re

— simonthong aka kitty poo (@KittyPo80176717) March 31, 2022

Ivermectin: the largest randomized, double-blind trial yet conducted, with early treatment, indicates there is no difference compared with placebo. It doesn't work. Period. https://t.co/wiFygjRgkk
just published @NEJM pic.twitter.com/uZ0mMZnO0E

— Eric Topol (@EricTopol) March 30, 2022

I’ve written about the #TOGETHER trial before (see my fluvoxamine 🧵below)

Briefly #TOGETHER is a large double blind multi-arm platform RCT. Pretty much the 1st 🥇 gold standard for high quality medical research.

2/ https://t.co/IAYvJ09oa6

— Nick Mark MD (@nickmmark) March 30, 2022

The primary endpoint was a composite of hospitalization or >6hr ED visit. (Not an awesome primary endpoint IMO 🤷).

Secondary endpoints included: time until hospitalization, hospital LOS, need for mechanical ventilation, duration of MV, and death. (All very reasonable 👍)

4/

— Nick Mark MD (@nickmmark) March 30, 2022

The study was stone cold NEGATIVE.

There was NO statistically significant difference in the primary endpoint or *ANY* of the secondary endpoints.

Beyond the overall negative findings, there was no prespecified subgroup that benefited from ivermectin.

Super duper negative.
6/ pic.twitter.com/KfhvouYVYO

— Nick Mark MD (@nickmmark) March 30, 2022

“BuT tReAtMeNt sTaRtEd ToOoOo LaTe!”

Roughly half the patients (44%) got treatment within 3 days. That’s early. Among the patients who were treated earlier they did… worse!

8/ pic.twitter.com/Z6938Upm3k

— Nick Mark MD (@nickmmark) March 30, 2022

“BuT mOrTaLiTy wAs LoWeR!”

A common misconception about stats.
Let’s look at the 0.88 mortality effect.
The confidence intervals mean there is a 95% chance that mortality is between 51% less OR 55% more with IVM.
Would *YOU* take a drug that might increase mortality by 55%?
10/ pic.twitter.com/1jEHVvHohg

— Nick Mark MD (@nickmmark) March 30, 2022

Related dumb criticism:
“ThE vAcCiNeS wOuLd LoSe tHiEr EUA iF iVeRmEcTiN wAs PrOvEn!”

This is nonsense. The EUA for *vaccines* to prevent severe disease has nothing to do with the absence of therapies. Otherwise Dex, Bari, Toci, etc would have already “voided the EUAs”
12/ pic.twitter.com/rTQorSQq1H

— Nick Mark MD (@nickmmark) March 31, 2022

On the other hand the *only* trials that have found *any* benefit to ivermectin are:
– fraudulent (Surgisphere, Elegazzar, etc)
– flawed observational studies that are likely biased
– tiny studies looking at non patient centered outcomes like viral load

14/ https://t.co/5lsLwch01y

— Nick Mark MD (@nickmmark) March 31, 2022

You can read more about this here: https://t.co/Im5AXnQsAX

You can also watch a grand rounds I did at @NJHealth debunking ivermectin:https://t.co/TZbkyKtfVL

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— Nick Mark MD (@nickmmark) March 31, 2022