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A Comparison of Ivermectin and Non Ivermectin Based Regimen for COVID-19 in Abuja: Effects on Virus Clearance, Days-to-discharge and Mortality

Thairu et al., Journal of Pharmaceutical Research International, doi:10.9734/jpri/2022/v34i44A36328 (date from preprint)

Feb 2022

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Ivermectin for COVID-19

4th treatment shown to reduce risk in August 2020

^*, now known with p < 0.00000000001 from 102 studies, recognized in 22 countries.

Lower risk for mortality, ventilation, ICU admission, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine complementary and synergistic treatments. ^* >10% efficacy in meta analysis with ≥3 clinical studies.

4,000+ studies for 60+ treatments. c19ivm.org

PSM retrospective 87 patients in Nigeria, 61 treated with ivermectin, showing lower mortality, faster recovery, and faster viral clearance with ivermectin treatment. All patients received zinc and vitamin C. A synergistic effect was seen for viral clearance when ivermectin and remdesivir were combined, as predicted by In Vitro research Jeffreys. Subject to confounding by time, with ivermectin patients from April-June 2021, and non-ivermectin patients from September-November 2021.

This is the 79th of 102 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 560 quintillion).

49 studies are RCTs, which show efficacy with p=0.00000038.

This study is excluded in the after exclusion results of meta analysis: significant confounding by time possible due to separation of groups in different time periods.

1. Jeffreys et al., Remdesivir-ivermectin combination displays synergistic interaction with improved in vitro activity against SARS-CoV-2, International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2022.106542.sciencedirect.com, doi.org.

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risk of death, 87.9% lower, RR 0.12, p = 0.12, treatment 0 of 21 (0.0%), control 4 of 26 (15.4%), NNT 6.5, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), propensity score matching.

risk of death, 93.0% lower, RR 0.07, p = 0.007, treatment 0 of 61 (0.0%), control 4 of 26 (15.4%), NNT 6.5, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), all patients.

time to discharge, 54.6% lower, relative time 0.45, p < 0.001, treatment 61, control 26, propensity score matching.

risk of no viral clearance, 94.8% lower, RR 0.05, p = 0.001, treatment 0 of 21 (0.0%), control 10 of 26 (38.5%), NNT 2.6, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), propensity score matching, day 21.

risk of no viral clearance, 95.2% lower, RR 0.05, p < 0.001, treatment 1 of 21 (4.8%), control 26 of 26 (100.0%), NNT 1.1, propensity score matching, day 14.

risk of no viral clearance, 28.6% lower, RR 0.71, p = 0.005, treatment 15 of 21 (71.4%), control 26 of 26 (100.0%), NNT 3.5, propensity score matching, day 5.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Thairu et al., 25 Feb 2022, retrospective, Nigeria, peer-reviewed, mean age 41.7, 6 authors, study period April 2021 - November 2021, dosage 200μg/kg days 1-5. Contact: bablo57@gmail.com.

This Paper Ivermectin All

A Comparison of Ivermectin and Non Ivermectin Based Regimen for COVID-19 in Abuja: Effects on Virus Clearance, Days-to-discharge and Mortality

Y Thairu, O E Babalola, A A Ajayi, Y Ndanusa, J O Ogedengbe, Omede O.

Journal of Pharmaceutical Research International, doi:10.9734/jpri/2022/v34i44a36328

Aim: To compare outcomes from ivermectin (IVM) -and non-ivermectin (NIVM)-based treatments for COVID-19 in Abuja, Nigeria. Methods: Sixty-one consecutive virology-proven cases were recruited and managed with IVMbased regimes. A subsequent cohort of 26 patients was treated with NIVM due to physician preference, with varying combinations of lopinavir/ritonavir (Alluvia), remdesivir, azithromycin, and enoxapramin. All patients received zinc sulfate, vitamin C and supportive therapy. Propensity matching was carried out as indicated, and Repeat Measures Analysis of Variance (RMANOVA) allowing for time*treatment interaction was carried out for time dependent variables, deriving Likelihood Ratio (LR) and P values. Original Research Article Main Outcome Measures: Change in cycle threshold (viral load) over time, positivity status by day 5, improvement in clinical status using myalgia scores, days to discharge (DTD), change in SpO2 and death. Results: IVM was associated with a greater and faster reduction in viral clearance (LR=64.2 p< 0.0001 for the N gene): 31% and 95% were negative by days 5 and 14, respectively, versus 0% on NIVM. The mean DTD on IVM was 8.8 days versus 19.4 days, p< 0.0001. IVM proved significantly superior for Myalgia scores, LR= 23.45, P=0.0007. The mortality rate was 0/61 (0%) in IVM but 4/26 (15.3%) in NIVM. Three of the 4 deaths were in females, and 2 had been vaccinated, one fully. The SP02% increased significantly more on IVM (p < 0.0001 RMANOVA) than the NIVM group. C-reactive protein and D-dimer levels dropped significantly more sharply during IVM (P= 0.0068, 0.063), suggesting anti-inflammatory and antifibrinolytic activity. Conclusions: The IVM-based regimen caused earlier discharge from treatment and reduced mortality, in addition to clinical and laboratory improvements. Vaccination did not protect some patients from SARS-CoV-2 breakthrough infection and mortality.

ETHICS APPROVAL AND CONSENT The Project was approved by the University of Abja Teaching Hospital Human Research Ethics Committee. The Approval number was UATH/HREC/PR/2020/015/10. Consent to participate was obtained from each individual patient using a standard consent form in which the project was explained. COMPETING INTERESTS Authors have declared that no competing interests exist.

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Late treatment
is less effective

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