Watchers of COVID-19 repurposed drug trials are abuzz with the news that a sizable Egyptian trial sponsored by Benha University in Egypt is actually problematic. Why? It looks like a confluence of factors, from laziness and plagiarism to more than likely lack of resources and what appears to be a fraudulent misrepresentation of data, taint a widely cited study known as Elgazzar et al. TrialSite celebrates this moment. This is what this platform is all about—transparency is key, and one of the fundamental criticisms of some of the apex players in research evidence, from the U.S. National Institutes of Health (NIH) to the World Health Organization (WHO), have called out that a considerable number of the many dozen randomized controlled trials from around the world have the potential to reveal design problems, data inconsistency, etc. Their criticism includes some correct points in that the potential is there and, in this case, a sharp “medical student” did a great job finding them. That’s to be applauded. But there’s more to this story. As it turns out, the author, positioned as a humble medical student, turns out to be a disinformation buster in partnership with some sort of blogging network. Moreover, according to reports from the study author(s) from Egypt, they were not given a proper chance to respond to the allegations. TrialSite’s position herein is that while this is not a good look and most certainly heightens the overall risk premium perhaps applied to a bundle of studies conducted in low-and middle-income countries (LMICs), the accumulation of data based on feedback from other ivermectin meta-analyses authors evidences real potential as a public health tool in the COVID-19 pandemic—especially in poor countries that won’t see the majority of their populations vaccinated anytime soon. How do we know? Why else would the U.S. government spend $155 million on ACTIV-6 unless, in part, to study ivermectin? Why would the University of Oxford, even if begrudgingly—finally announce conclusively that they will include the antiparasitic tablets in the PRINCIPLE trial? Why would one of America’s largest health insurance companies, UnitedHealthcare, fund the COVID-OUT study, led by the University of Minnesota, featuring same-day shipment of ivermectin for early-onset COVID-19 patients for at-home care? These institutions wouldn’t make such investments of money, time, resources, and effort unless there was considerable potential. And to provide a different point of view, this Egypt-based study was but one out of 62 total studies to date, plus dozens of real-world care initiatives involving millions of people TrialSite has tracked from Mexico City and Bangladesh to Uttar Pradesh, India, that when aggregated continue to be at least a compelling unfolding story of potential.

Money, Drugs & Power

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