Lesson of ivermectin: meta-analyses based on summary data alone are unreliable
To the Editor - The global demand for prophylactic and treatment options for COVID-19 has in turn created a demand for both randomized clinical trials, and the synthesis of those trials into meta-analyses by systematic review. This second ivermectin study has now been published6, and there is still no response from the authors in a request for data. As these two papers1,6 were the only studies included in that meta-analysis to demonstrate an independently significant reduction in mortality, the revision will probably show no mortality benefit for ivermectin. Several other studies that claim a clinical benefit for ivermectin are similarly fraught, and contain impossible numbers in their results, unexplainable mismatches between trial registry updates and published patient demographics, purported timelines that are not consistent with the veracity of the data collection, and substantial methodological weaknesses. We expect further studies supporting ivermectin to be withdrawn over the coming months. Specifically, we propose that clinical research should be seen as a contribution of data toward a larger omnibus question rather than an assemblage of summary statistics. Hurdles to the release of IPD from clinical trials are well described, and generally addressable with careful anonymization and integration of data sharing plans at the ethical approval stage of trial planning.