The FDA not liking people using the horse version to treat illnesses that people have has nothing to do with ivermectin being ineffective for the illnesses in question.
We know that because in 2019 that already was the FDA position to be concerned about it’s usage for Rosacea. The FDA just opposes US citizens to use cheaper versions to treat their diseases then the human versions that they approve.
Ivermectin, and really any drug not deliberately designed either to bolster the human immune system or to fight viruses (and more specifically COVID-19), is deeply unlikely to be directly effective against COVID-19 for the same reason your mystery seed is unlikely to be a daikon radish.
This ignores the apriori reasons to believe that Ivermectin is a good candidate as a treatment.
Ivermectin has also been demonstrated to be a potent broad-spectrum specific inhibitor of importin α/β-mediated nuclear transport and demonstrates antiviral activity against several RNA viruses by blocking the nuclear trafficking of viral proteins. It has been shown to have potent antiviral action against HIV-1 and dengue viruses, both of which are dependent on the importin protein superfamily for several key cellular processes. Ivermectin may be of import in disrupting HIV-1 integrase in HIV-1 as well as NS-5 (non-structural protein 5) polymerase in dengue viruses.
Ivermectin has long been clinically administered for the treatment of parasitosis (63), but has recently come to attention as a potential inhibitor of IMPα/β (64). Ivermectin inhibition of IMPα/β has shown to inhibit the replication of RNA viruses such as dengue virus and HIV-1 (64). Ivermectin was recently tested for the inhibition of IAV in vitro, with nuclear import of vRNP complex (of both wild-type and antiviral MxA escape mutant) efficiently inhibited (65). Given ivermectin’s longstanding record of clinical applications and FDA-approved status, repurposing of this drug for the treatment of IAV should be considered, especially while under threat of pandemic IAV outbreak.
When COVID-19 came around and we started discussing what could be done on LessWrong, in April 2020 there were positions like:
What kind of treatments and vaccines might we expect? Derek Lowe outlines “The Order of the Battle” where first we try repurposing existing drugs (e.g., remdesivir, hydroxychloroquine, azithromycin, falapirivir, ivermectin), then monoclonal antibodies, then vaccines, and then potentially new treatments. It’s possible existing drugs or new treatments could greatly reduce the danger of COVID and allow for faster reopening, but it would take a vaccine to truly make it go away.
That was the position because we knew that ivermectin does more then just deworming. If we had a pro-Science administration in any Western country the reaction to COVID-19 would have been by that point to immediately fund powered trails for those candidates.
Unfortunately, that doesn’t happen but other people did fund the trials and as of June quality meta reviews of the available trial suggested it works. The problem is that the trials are mostly not run in Western countries and thus not as trustworthy then those that would have been run if the CDC would be pro-Science at the beginning of the pandemic.
The favorite catchphrase of critics of using ivermectin against COVID-19 don’t say “follow the science” or “believe the experts.”
The reason to not take ivermectin is essentially “don’t follow the science, because some of it is fraudulent” at this point in time. Back in the highest quality meta analysis were pro-ivermectin.
Note that this heuristic also often allows us to come to the right conclusion when the experts are right and when they’re wrong, without putting much thought into it.
The heuristics likely gets you to results such as not using various drugs such as SSRI’s when depressed because those hit a bunch of different targets and produce complex interactions which we don’t fully understand. Not taking drugs where there’s good evidence that they work but where the workings are complex enough that we don’t fully understand them gets you to a wrong conclusion many times.
With any heuristic, it’s going to have failure modes and will only get you so far. This is meant as a common-sense guideline for lay people, not as an intellectual stopping point for scientists, regulators, and clinicians.
Here, I’m aiming at people who are ivermectin partisans, both critics and supporters. Those who’d reject other treatments in favor of ivermectin, and those who think ivermectin has no possible relevance to COVID-19 and yet yet don’t seem to be thinking even at a baseline level of wisdom in their criticism.
This post is a tool, and I advocate using it only for what it’s for!
The FDA not liking people using the horse version to treat illnesses that people have has nothing to do with ivermectin being ineffective for the illnesses in question.
We know that because in 2019 that already was the FDA position to be concerned about it’s usage for Rosacea. The FDA just opposes US citizens to use cheaper versions to treat their diseases then the human versions that they approve.
This ignores the apriori reasons to believe that Ivermectin is a good candidate as a treatment.
From a paper in The Journal of Antibioticsfrom 2017:
From another paper in 2018:
When COVID-19 came around and we started discussing what could be done on LessWrong, in April 2020 there were positions like:
That was the position because we knew that ivermectin does more then just deworming. If we had a pro-Science administration in any Western country the reaction to COVID-19 would have been by that point to immediately fund powered trails for those candidates.
Unfortunately, that doesn’t happen but other people did fund the trials and as of June quality meta reviews of the available trial suggested it works. The problem is that the trials are mostly not run in Western countries and thus not as trustworthy then those that would have been run if the CDC would be pro-Science at the beginning of the pandemic.
The reason to not take ivermectin is essentially “don’t follow the science, because some of it is fraudulent” at this point in time. Back in the highest quality meta analysis were pro-ivermectin.
The heuristics likely gets you to results such as not using various drugs such as SSRI’s when depressed because those hit a bunch of different targets and produce complex interactions which we don’t fully understand. Not taking drugs where there’s good evidence that they work but where the workings are complex enough that we don’t fully understand them gets you to a wrong conclusion many times.
With any heuristic, it’s going to have failure modes and will only get you so far. This is meant as a common-sense guideline for lay people, not as an intellectual stopping point for scientists, regulators, and clinicians.
Here, I’m aiming at people who are ivermectin partisans, both critics and supporters. Those who’d reject other treatments in favor of ivermectin, and those who think ivermectin has no possible relevance to COVID-19 and yet yet don’t seem to be thinking even at a baseline level of wisdom in their criticism.
This post is a tool, and I advocate using it only for what it’s for!