Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection
et al., Research Square, doi:10.21203/rs.3.rs-148845/v1, Jan 2021
Ivermectin for COVID-19
4th treatment shown to reduce risk in
August 2020, now with p < 0.00000000001 from 106 studies, recognized in 24 countries.
No treatment is 100% effective. Protocols
combine treatments.
6,200+ studies for
200+ treatments. c19early.org
|
Meta analysis of 18 ivermectin RCTs with 2,282 patients showing faster viral clearance (dose and duration dependent), improved clinical recovery, and lower hospitalization and mortality. In six RCTs of moderate or severe infection, there was a 75% reduction in mortality, RR 0.25 [0.12-0.52], p = 0.0002.
A documentary about the external influences changing the conclusions of this study, and the resulting negative impacts, can be found at1.
A sponsor reportedly required the conclusion of this paper to be changed against the wishes of the authors (to suggest that more trials should be done as opposed to the existing evidence being sufficient)2-4. Reportedly, Unitaid had influence over the conclusions5,6. See also7.
Note that one of the 18 studies in this analysis has since been withdrawn (Elgazzar).
7 meta analyses show significant improvements with ivermectin for mortality8-13,
hospitalization14,
recovery10, and
cases10.
Currently there are 106 ivermectin for COVID-19 studies, showing 47% lower mortality [34‑58%], 35% lower ventilation [17‑50%], 40% lower ICU admission [12‑58%], 34% lower hospitalization [21‑44%], and 79% fewer cases [69‑86%].
|
risk of death, 75.0% lower, RR 0.25, p < 0.001.
|
| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
2.
francesoir.fr, www.francesoir.fr/videos-les-debriefings/le-scandale-de-livermectine-tess-lawrie-le-retour.
4.
reddit.com, www.reddit.com/r/ivermectin/comments/m5kr7b/dr_tess_lawrie_discusses_her_ivermectin/.
5.
worldcouncilforhealth.org, worldcouncilforhealth.org/multimedia/tess-lawrie-conversation-andrew-hill/.
6.
trialsitenews.com, trialsitenews.com/the-case-of-dr-andrew-hill-was-their-unethical-activity-associated-with-his-ivermectin-meta-analysis-or-just-another-drug-dev-day/.
7.
roundingtheearth.substack.com, roundingtheearth.substack.com/p/who-manages-unitaid-context-behind.
8.
Bryant et al., Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines, American Journal of Therapeutics, doi:10.1097/MJT.0000000000001402.
9.
Hariyanto et al., Ivermectin and outcomes from Covid-19 pneumonia: A systematic review and meta-analysis of randomized clinical trial studies, Reviews In Medical Virology, doi:10.1002/rmv.2265.
10.
Kory et al., Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19, American Journal of Therapeutics, doi:10.1097/MJT.0000000000001377.
11.
Lawrie et al., Ivermectin reduces the risk of death from COVID-19 – a rapid review and meta-analysis in support of the recommendation of the Front Line COVID-19 Critical Care Alliance, Preprint, b3d2650e-e929-4448-a527-4eeb59304c7f.filesusr.com/ugd/593c4f_8cb655bd21b1448ba6cf1f4c59f0d73d.pdf.
12.
Nardelli et al., Crying wolf in time of Corona: the strange case of ivermectin and hydroxychloroquine. Is the fear of failure withholding potential life-saving treatment from clinical use?, Signa Vitae, doi:10.22514/sv.2021.043.
Hill et al., 19 Jan 2021, preprint, 40 authors.
Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection
doi:10.21203/rs.3.rs-148845/v1
Forum Infectious Diseases published a version of this preprint. The authors subsequently learned that one of the studies on which this analysis was based had been withdrawn due to fraudulent data. An expression of concern was issued on August 9, 2021.
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"abstract": "<title>Abstract</title>\n <p>Ivermectin is an antiparasitic drug being investigated for repurposing to SARS-CoV-2. In-vitro, ivermectin showed limited antiviral activity and a COVID-19 animal model demonstrated pathological benefits but no effect on viral RNA. This meta-analysis investigated ivermectin in 18 randomized clinical trials (2282 patients) identified through systematic searches of PUBMED, EMBASE, MedRxiv and trial registries. Ivermectin was associated with reduced inflammatory markers (C-Reactive Protein, d-dimer and ferritin) and faster viral clearance by PCR. Viral clearance was treatment dose- and duration-dependent. In six randomized trials of moderate or severe infection, there was a 75% reduction in mortality (Relative Risk=0.25 [95%CI 0.12-0.52]; p=0.0002); 14/650 (2.1%) deaths on ivermectin; 57/597 (9.5%) deaths in controls) with favorable clinical recovery and reduced hospitalization. Many studies included were not peer reviewed and meta-analyses are prone to confounding issues. Ivermectin should be validated in larger, appropriately controlled randomized trials before the results are sufficient for review by regulatory authorities.</p>",
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