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. 2023 May 23;12(11):3625. doi: 10.3390/jcm12113625
  • 1. 
    Repeated references indicating that only a 3-day placebo group was used for analysis
    • In an NEJM twitter thread of 30 March 2022, when asked about the composition of the placebo group of TOGETHER-IVM, coauthor David Boulware replied: “The analysis is via concurrently randomized placebo only. Stated a few places, including in Figure 1 caption. ‘Only the results in the 3-day ivermectin group as compared with the concurrent placebo group are reported in this article’” [77]. (Figure 1 to which Boulware refers is from the TOGETHER-IVM study paper [15]).
    • In response to a follow-up query, “placebo same 3 days?” Boulware replied: “…in this case, yes a 3d [3-day] placebo was run while IVM was running” (as cited above).
    • The TOGETHER-IVM study protocol, p. 169, Appendix 1.2, ivermectin, specifies: “Placebo administration: Once daily for 3 days”.
  • 2. 
    A vague and inconsistent mixed-day placebo scenario
    • The TOGETHER-IVM study report, p. 5, states that 3-day and 14-day placebos were included in the placebo group: “Although all the participants who had been assigned to the 3-day and 14-day placebo regimens were included in the intention-to-treat population, only those who had been assigned to the 3-day placebo regimen were included in the PP population”.
    • However, that study report also has references to 1-, 3-, 10- and 14-day placebos scattered throughout the study paper, e.g., for Table 3 (of [15]), p. 9: “The duration of placebo use was 1, 3, 10, or 14 days.”
    • Its caption for Figure 1, p. 6, states: “Participants in the placebo group received placebo for 1, 3, 10, or 14 days,” but the caption also states: “only the results in the 3-day ivermectin group as compared with the concurrent placebo group are reported in this article”.
    • The 1-day placebo for the TOGETHER trial that corresponded to its interferon lambda treatment was given by injection, as was the drug (the ClinicalTrials.gov record for the TOGETHER trial, v5, available online: https://clinicaltrials.gov/ct2/history/NCT04727424?V_5 (accessed on 3 July 2022)). Interferon lambda was administered to 69% of the patients in the TOGETHER trial who took a 1-day drug course (TOGETHER-IVM, p. 6). A 3-day oral treatment course of IVM could hardly be blinded using a 1-day placebo consisting of a single placebo injection.
    • The study does not specify numbers of patients for any of these mixed-day placebos, either for 1-, 10- or 14-day, or for only 14-day, placebos.
    • Without any stated or apparent rationale, the TOGETHER-IVM study report, Figure 1 caption, p. 6, states that whereas 1-, 3-, 10- and 14-day placebos were included in the study’s ITT group, ”only those in the 3-day placebo groups were included in the PP population.” This is a discrepant variation of the above-quoted assertion that the ITT placebo group consisted of 3-day and 14-day placebo patients, but “only those who had been assigned to the 3-day placebo regimen were included in the PP population”.
    • In the study report and supplementary documents of TOGETHER-IVM’s three sister publications for other drug arms, nowhere is any such drop-out of mixed-day placebos described for the PP placebo group [12,13,14].