The TOGETHER Trial of Ivermectin Isn’t All That Together

However, a careful reading of the NEJM article finds it is not nearly as conclusive and persuasive as the two doctors’ quotes and other media coverage would lead us to believe. In fact, because the results of the TOGETHER Trial suggest that ivermectin actually did benefit the Brazilians in the treatment groupresults that are in agreement with 87% of the other clinical trials that tested ivermectin—there is still good reason to continue studying the drug as a possible preventative or treatment for COVID-19.

This is one of the opening paragraphs of Charles L. Hooper and David R. Henderson, “Ivermectin and the TOGETHER Trial,” Regulation, Summer 2022.

One of the many problems with the study:

Further, ivermectin is widely available in Brazil as an over-the-counter drug — unlike in most clinical trials, where the drug under study is available only via the trial. Prospective participants who wanted ivermectin because they believed they had COVID could have taken it on their own and thus would be disinclined to enroll in a trial where they faced a 50 percent chance of getting a placebo. Further, those who wanted ivermectin likely would have had a serious case of COVID; hence their desire for the drug. Therefore, we can assume that the trial participants skewed toward those who considered themselves at low risk from the illness. This conflicts with the stated goal of the trial, which was to study high-risk patients.

Read the whole thing.