If the peer reviewed research shows them to not be effective, and if snake oil salesmen figure out a business model to fleece people with it, that’s when it becomes “alternative” medicine.
Perhaps Snake Oil [1] is worth a study or two.
[1] - https://www.organicfacts.net/health-benefits/oils/snake-oil....
When a medical doctor prescribes a drug for a purpose that is currently being studied scientifically, that is not "alternative medicine". Ivermectin is still being studied. Hydroxychloroquine was emergency authorized by the FDA.
Unfortunately, it means just "trusting a peer reviewed study" is even harder than it should be. You have to dig into the study to see if it even makes any sense which can be very difficult. And you have to follow the money, not "even" if the study says what you think it ought to say, but especially when it says what you want it to say.
Very disappointing when you go digging in.
Take for example acetaminophen (aka paracetamol/tylenol): it is borderline ineffective, has been superseded by ibuprofen for almost all use cases, and the required dosage for its tiny effect is also very close to dangerous levels. Yet it is still the go-to drug of parents, GPs and hospitals for a range of ailments from the common cold to post-operative pain. "Good old paracetamol" is in every medicine cabinet in the Western world. I've told my folks a hundred times that it simply doesn't work, but they use it for pretty much any condition. Mum even gave it to her old dog. It's trusted like oxo cubes, Campbell's soup or a nice cup of tea. And that's why it's the foremost cause of acute liver failure in the Western world. While it hasn't had it's approval removed yet, I wouldn't be surprised if it did some day, and I doubt it would be approved today if it were being introduced.
Even so: is it still very much "medicine", not "alternative medicine".
This is only really accurate in a small window of analysis. It's been shown that paracetamol + ibuprofen has synergistic effects for most pain-related issues and paracetamol is superior to ibuprofen for migraine headaches; furthermore, the obvious correct headache drug of choice is aspirin/paracetamol/caffeine, aka Excedrin, which is vastly superior to ibuprofen.
I won't argue that paracetamol has acute liver toxicity issues (the largest drug of overdose problems, though a lot of this is intentional rather than accidental), but ibuprofen is abused in a chronic fashion with buildup over time leading to renal failure and worse (pro/amateur athletes are particularly at risk of chronic abuse issues).
I won't argue that paracetamol is way more dangerous than people think, and there should be far more warning labels (which J&J fights against), but I would be genuinely shocked if it got its approval revoked; similarly, I'd expect it to be approved if it was around today as well - especially if we knew about the synergistic effects it has with aspirin and caffeine.
It really is, as there is absolutely no evidence it has any effect whatsoever and at best it only serves as a placebo. In short, it's snake oil. Worse: politically-motivated snake oil.
Please let me know when a reputable study that undergoes peer review in an established and respected journal reports that the drug does work as their fans and militants claim.
Until then, keep in mind that "alternative" in "alternative medicine" stands for "hand-waving". As the old adage goes, alternative medicine that works does have a special name. It's called medicine.
There is one ongoing right now: Oxford University's PRINCIPLE trial. Until results of that trial are reported, about the only accurate thing anyone can say is that current evidence is ambiguous.
https://www.principletrial.org/news/ivermectin-to-be-investi...
Complementary and alternative medicines (CAMs) are treatments that fall outside of mainstream healthcare.
> Are the people participating in the scientific studies of the drug participating in alternative medicine?
Well the placebo group taking sugar pills for their cancer are not exactly going 'by the book' or lamestream healthcare and the active group taking whatever ... well lets just agree to disagree shall we?
What do you say to the multitude of positive studies though? https://c19ivermectin.com/ Are all of them wrong?
" Ivermectin is currently not approved in the UK for the prophylaxis or treatment of COVID-19," [1]
There are no good studies demonstrating the validity of Ivermectin, and the Oxford study is not complete and there's no indication results are positive.
Why are people so crazy about this drug?
It doesn't look like it works, though there is some possibility it will, but we'll only know when the Oxford trial is complete. Given the knowledge we have today, it just isn't a therapy for COVID.
There's a big trial ongoing, and the rest of the evidence is mixed. You can't say that "it doesn't look like it works"...we just don't know.
I personally put the prior probability of any intervention working for any illness at a very low number, but too many people are eager to dismiss things -- or accept them -- before they've been tested.
It's disturbing, and is mostly about politics. Many of the same people who dismiss Ivermectin for low-quality evidence eagerly seize upon any dubious shred of evidence for their favored interventions, and enact widespread mandates.
That means it (probably) doesn't work.
They've given Ivermectin to a lot of people by now - if it was a solution, then it would stand out.
The Oxford trial will give us a better answer but I'm doubtful.
If Ivermectin did work, it should show up, but it's not.
We're doing the Oxford trial really because of some shady information and results, that could possibly indicate that there's some theraputic value. Not because people have high hopes.
Here is Merk's statement:
" It is important to note that, to-date, our analysis has identified:
No scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies;
No meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease, and;
A concerning lack of safety data in the majority of studies."
No, that's a thing you made up. The biggest problem with the "not good studies" of Ivermectin is that they've been underpowered or poorly controlled. The efficacy signal ranges from neutral to strongly positive, but the neutral signal could be due to under-powered studies. The positive results could be due to confounders. Neither are "negative indicators". That's silly. It's like saying that having weak efficacy data for a drug in vitro is a "negative indicator" prior to trials. Any efficacy data is a positive indicator. Some positive indicators are stronger than others.
The Merck quote is an opinion. They're entitled to their opinion, but it's not definitive.
The point is: we'll see. You don't need to predict the future. You can just wait for the data. Science is great that way. Everything else is politics.
It looks to be a combination of right wing political commentators and a fringe anti-vax group.
https://www.forbes.com/sites/stevensalzberg/2021/08/30/no-iv... https://twitter.com/oneunderscore__/status/14310404563648102...
"Ridicule is man's most potent weapon. There is no defense. It is almost impossible to counterattack ridicule. Also it infuriates the opposition, who then react to your advantage."
"Pick the target, freeze it, personalize it, and polarize it."
You practically invent your own enemies to knock down.
Experts say one thing.
Another group says a different thing.
When people say that the other group is not acting rationally, they respond with your post and claim that the experts are being mean.
Ivermectin is only being treated like a tribalistic team sport by the people who aren't experts.
There are more than 60 peer reviewed studies showing positive effect for ivermectin. Similarly the single trial that the media touted as "proof" that HCQ did not work administered what amounted to an overdose to terminally ill patients, in contrast to the recommended early/prophylactic regimen.
These lies have gone on for far too long - no thanks to irresponsible and, frankly, inexcusable censorship by fb, youtube et al on grounds of "misinformation".
This site[0] has been up for over a year now and the citation count has continued to grow.
It seems people are more interested in poo pooing proponents of ivermectin/HCQ than actually examining evidence. Medicine should not be a political team sport.
0. ivmmeta.com
Just use google directly to find the trials I’m talking about, instead of being blinded by the ivm meta site creators (who created a similar site last year for HCQ). IvmMeta mixes in poor quality studies with studies that actually found no significant effect for IVM and claims they all are pro IVM.
I couldn't help but notice your use of purposely vague and misleading weasel words such as "positive effect".
Meanwhile I recall reading one of those ivermectin studies presented on another discussion on HN, and it certainly raised some red flags regarding how it was put together. For instance, if my memory doesn't fail me, it relied on an astonishingly small sample (100 patients, all reported as mild cases, divided into control and treatment) and to make matters worse the control group was given hydroxychloroquine instead of a placebo, effectively comparing ivermectin to hydroxychloroquine.
In the end the study reported that the fatality rate in the control and treatment groups was the same, and the only claim was that the statistical analysis suggested more patients from the ivermectin group were discharged earlier, which could very well be just statistical noise. Other than this the paper reported no benefit at all.
So, this is what weasel words buy: they are used to hide facts and misguide people. So unless you actually substantiate your claims and point exactly the very best study you feel shows that said "positive effect" is and how it was quantified, I have to dismiss your claim as something between a baseless assertion and blatant misinformation.
But then you pull a bait-and-switch in your own comment, complaining about just one study, which you completely neglect to cite (so it could be made up, for all we know). You subtly outsource your opinion, trying to lend it an air of objectivity by saying that it "raised some red flags" (after you accused him of using weasel words). You couch the whole comment in an air of faux fairness by writing as if you are some judge called upon to arbitrate a dispute, who just has to rule a certain way because, of course, that's what the evidence requires. And you imply that your unsourced complaint about one study invalidates all such studies, therefore he must be wrong.
You accused him of being purposely misleading, but at least he offered a link, and he didn't try to trick people into thinking that a criticism of one thing invalidates other things, which you did.
Your whole comment is a textbook example of propaganda techniques. And then you wonder why people don't know what to believe anymore. It's like the whole Internet is a political, psychological battleground for public mindshare, and the truth doesn't matter at all.
I suppose it would be easier to just point out a single paper out of said 60 that supported the thesis that ivermectin works.
Somehow, in spite of the claim that there are so many papers, it seems it's impossible to actually find a single one that does support the claim.
I did more than that: I pointed out not only the use of weasel words but also that no assertion is substantiated in what boils down to a baseless appeal to authority.
Consequently, it's critical that, for the sake of objectiveness and to avoid spreading misinformation, these personal assertions cannot be backed up by handwaving and instead must be supported by concrete evidence, such as references to said studies, if they exist at all.
Actually it is. The whole point of that was to illustrate the importance of actually looking into what these papers actually said, if they exist at all, instead of pulling the appeal to authority card with numbers pulled out of thin air.
The OP asserted that ivermectin worked. He proceeded to state that 60 papers report it. Well... Where are they? Can anyone like me actually take a look at one of these supposedly decisive papers? I'd be happy if I could just check the best one out of the hypothetical 60.
>I couldn't help but notice your use of purposely vague and misleading weasel words such as "positive effect".
This isn't a weasel word, this is exactly the correct term to capture the uncertainty considering that there has to my knowledge not been a large scale double blind RCT. But there are, once again, over 60 studies showing positive effect which, individually, are not absolute proof that the medicine works, but together clearly show promise. Your bias is rather extreme and frankly I don't appreciate your dishonest insinuation that I am somehow arguing in bad faith. Again, I linked a collection of more than 60 positive studies. It is unlikely that every one is poor quality and/or fraudulent.
Here is the link again[0], maybe you could actually click the link before responding, as you should have done previously. And yes, I've read a number of them. I can also provide the following [1] which suggests (in silico) the mechanism of action of ivermectin is inhibition of protease, which is the target enzyme of at least one other drug under development by pfizer for treatment of covid.
If you think "positive effect" is a weasel word then perhaps you do not understand the scientific process. I'm not claiming with certainty that ivermectin works, only that in light of, again, some 60 studies showing positive effect, inneffectiveness is unlikely. While you check these sources, please also check your rabid bias.
[0]ivmmeta.com
Note: This isn't a political statement or criticism. It's Human Comms and Human Behaviour 101.
Seems pretty political to me.
Again. These are properties of human behavior.
Things move from "alternative medicine" to being "medicine" when people do good, peer-reviewed science to actually study the effects and find them to be effective. "Alternative medicine" like ivermectine or hydroxychloroquine have no scientific, properly studied basis for being used.