T.he editor of Limits in Pharmacology published an article on the use of the anti-parasitic drug ivermectin in COVID-19 patients. The paper, written by members of an organization called the Front Line COVID-19 Critical Care Alliance (FLCCC), was tentatively accepted by the journal in January and published in abstract form, but was finally rejected on Monday (March 1st). . The editors found it made unsubstantiated claims and violated the journal’s editorial guidelines.
By the end of last week, the abstract had been viewed more than 85,000 times according to snapshots available in the internet archive.
The removal of the paper angered members of the FLCCC and its supporters. In comments too Twitter and in an interview with The scientistThe organization’s president, Pierre Kory, describes the move as “censorship”. In the interview, he added that the paper had already successfully passed several rounds of reviews. To reverse the acceptance of the paper, the journal “allows some kind of external peer reviewer to comment on our paper,” he says. “I think that’s very abnormal.”
Ivermectin is widely used in tropical medicine to treat parasitic infections. However, its use as a COVID-19 drug has been controversial since the beginning of the pandemic. Large health organizations keep saying that there isn’t enough evidence of its effectiveness in preventing or treating parasites and the disease.
The FLCCC paper (also published on the organization’s website) reviewed epidemiological and clinical evidence of ivermectin’s use in people infected and exposed to SARS-CoV-2. In it, the authors argued that health agencies such as the National Institutes of Health (NIH) should update their recommendations to include the drug.
Frontiers does not take a position on the effectiveness of ivermectin in treating patients with COVID-19. However, we strongly oppose unbalanced or unsupported scientific conclusions.
– Frederick Fenter, Frontiers
After contacting The scientistThe Journal released a statement from Frontiers Editor-in-Chief, Frederick Fenter, stating, “Frontiers takes no position on the effectiveness of ivermectin in treating patients with COVID-19. However, we strongly oppose unbalanced or unsupported patients before scientific conclusions. “
During the review of the article in what the journal calls the “preliminary acceptance phase,” Fenter said in the statement, members of the Frontiers Research Integrity team identified “a number of strong, unsupported claims based on studies of insufficient statistical significance, and at times without the use of control groups. “
The statement continues, “In addition, the authors have promoted their own specific ivermectin-based treatment which is unsuitable for a review article and against our editorial guidelines. In our view, this paper offers neither an objective nor a balanced scientific contribution to the evaluation of ivermectin as a potential treatment for COVID-19. “
The statement did not provide any information as to why these concerns were raised and addressed now and not earlier in the publication process.
This is not the first time Kory and his colleagues have been accused by the FLCCC of making unsubstantiated claims about ivermectin. In December, at a US Senate hearing on COVID-19 treatments, Kory made a statement calling ivermectin “an effective miracle cure” that could eradicate disease transmission and prevent disease. back then. Kory, who used to oversee critical care at UW Health in Wisconsin, says The scientist that he now regrets using “miracle” and other hyperbolic terms.
Later in December, FLCCC founder Paul Marik, the first author of the now rejected, declined Limits The manuscript and a professor at Eastern Virginia Medical School authored an article on ivermectin that included references to debunked articles, including an observational study of ivermectin in COVID-19 patients led by the now-discredited Surgisphere Corporation. This study published on the preprint server SSRNwas abolished at the request of one of the authors in May after concerns about the origin of the company data were raised.
There have been a number of studies of ivermectin in COVID-19 patients, although they did not meet all of the criteria that scientists usually find necessary to generate strong evidence – i.e. randomized, well-controlled trials of hundreds or thousands of patients and outcomes, published in a peer-reviewed journal.
The NIH, which last updated its recommendations on ivermectin in COVID-19 patients on February 11, 2021, states that most of the studies showing the benefits of ivermectin “contain incomplete information and significant methodological limitations that make it difficult make common causes rule out the bias. “
The agency concludes that “there is not enough data. . . recommend either for or against the use of ivermectin for the treatment of COVID-19 ”and calls for“ sufficiently powerful, well designed and well conducted clinical studies ”.
Kory argues that this widespread criticism ignores the fact that there are multiple groups of researchers advocating the use of ivermectin and that the urgency of the situation means health organizations should consider smaller, uncontrolled studies and observational data, as well as the gold standard trials . He adds that larger studies of the drug are underway or planned. The multi-center TOGETHER study, conducted by researchers from McMaster University, for example, was announced earlier this year.
When the Frontiers Statement asked the authors to submit a revised version of the paper, Kory replied that while he would have been open to removing mentions of his own team’s treatment protocol, he does not want to work with the Journal again. “There was no communication with us, no clarification of your concerns, no discussion,” he says during the process. “The idea that I would resubmit this diary is pretty absurd, don’t you think?”