Outcomes of Ivermectin in the treatment of COVID-19: a systematic review and meta-analysis

Castaneda-Sabogal et al., medRxiv, doi:10.1101/2021.01.26.21250420

Jan 2021

Source PDF All Studies Meta AnalysisMeta

4th treatment shown to reduce risk in August 2020, now with p < 0.00000000001 from 105 studies, recognized in 23 countries.

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

No treatment is 100% effective. Protocols combine treatments.

5,100+ studies for 109 treatments. c19ivm.org

Meta analysis of a very small subset of studies exhibiting very high bias and significant flaws. Some of the problems:

- As of the publication date, there are 35 studies, authors include only 4. (They list 5, but two are the same study, preprint and published version).

- From the 17 RCTs, authors include 0.

- Authors include only late treatment studies, excluding all 10 early treatment studies and all 10 prophylaxis studies.

- Authors did not locate 13 studies, despite this being trivial from existing meta analyses.

- There is no logic in the exclusion reasons. For example, they include the most biased study to date, Soto-Becerra, and assign the highest weight to it.

- Authors randomly exclude letters but include preprints (excluding letters to help avoid positive results, including preprints to include Soto-Becerra).

- Soto-Becerra has clear evidence of extreme bias. The study presents 30 day results and extended KM curves up to day 43 for ivermectin. At 30 days the result is negative but reverts (as do all treatments in the study) and becomes positive before day 43. Authors of this meta analysis ignore the extended followup. Soto-Becerra is a database analysis that includes anyone with ICD-10 COVID-19 codes which includes asymptomatic PCR+ patients, therefore many patients in the control group are likely asymptomatic with regards to SARS-CoV-2, but in the hospital for another reason. For those that had symptomatic COVID-19, there is also likely significant confounding by indication. In this study all medications show higher mortality at day 30, which is consistent with asymptomatic (for COVID-19) or mild condition patients being more common in the control group. For ivermectin they show 30 day mortality aHR = 1.39 [0.88 - 2.22]. KM curves show that the treatment groups were in more serious condition, and also that after about day 35 survival became better with ivermectin. More than the total excess mortality happened on the first day. This is consistent with treated patients being in more serious condition, and with many of the control group patients being in hospital for something unrelated to COVID-19. Authors use a machine learning based propensity scoring system that appears over-parameterized and likely to result in significant overfitting and inaccurate results. Essentially they test for all interactions between two and three covariates. The nature and large number of covariates means many random correlations may be found. COVID-19 severity is not used. In summary, this is the lowest quality ivermectin study to date. This study also does not compare treatments with a control group not receiving the treatment - authors put patients receiving treatments after 48 hours in the control group. Authors also state that outcomes within 24 hours were excluded, however KM curves show significant mortality at day 1 (only for the treatment groups).

- We checked the reported results for the mortality outcome and found they do not appear to match the actual papers.

- Rajter: authors list mortality as 13/85 (treatment), 24/74 (control), the paper shows (for the matched cohort) 13/98 (treatment), 24/98 (control). The adjusted result in the paper is OR 0.27 [0.09-0.80] (multivariate) or OR 0.47 [0.22-0.99] (PSM). These correspond to RR 0.33 and 0.54 respectively, or logRR -1.1 and -0.62. However authors here show logRR 0.54 and 0.85 - they include the study twice (preprint and published). The preprint and published papers have the same multivariate result, the PSM result was added in the published paper. Neither of the two results the authors use match the actual results.

- Khan: the paper shows RR 0.13, logRR -2.0. Authors show logRR 0.13.

- Soto-Becerra at day 30 shows wHR 1.39 [0.88-2.22], and day 43 weighted KM 0.82 [0.76-0.88]. These correspond to logRR 0.33 and -0.19. Authors show logRR 1.75.

- Gorial: there is zero mortality with treatment in this paper. Using the typical continuity correction, the paper shows RR 0.29 when accounting for the different group sizes, or 0.86 when using naive continuity correction that does not account for the very different group sizes. These correspond to logRR -1.24 or -0.15. Authors show logRR 0.60.

- Authors did not locate and reference the existing widely known meta-analyses from well-known researchers - Kory et al., Hill et al., Lawrie et al.

For more issues see:1,2. Authors on Twitter:3-6.

7 meta analyses show significant improvements with ivermectin for mortality7-12, hospitalization13, recovery9, and cases9.

Currently there are 105 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 81% fewer cases [71‑87%].

Important missing comments or errors? Let us know.

1. web.archive.org, web.archive.org/web/*/https://twitter.com/Covid19Crusher/status/1354463260599328778.web.archive.org/web/*/https://twitter.com/Covid19Crusher/status/1354463260599328778.

2. twitter.com, twitter.com/joshuanbarbozam/status/1354471295690403840.twitter.com/joshuanbarbozam/status/1354471295690403840.

3. twitter.com (B), twitter.com/DiegoMichilot.twitter.com/DiegoMichilot.

4. twitter.com (C), twitter.com/carlostoro_29.twitter.com/carlostoro_29.

5. twitter.com (D), twitter.com/christiansr96.twitter.com/christiansr96.

6. twitter.com (E), twitter.com/joshuanbarbozam.twitter.com/joshuanbarbozam.

7. 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.lww.com, doi.org.

8. 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.wiley.com, doi.org.

9. 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.lww.com, doi.org.

10. 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.filesusr.com.

11. 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.signavitae.com, doi.org.

12. Zein et al., Ivermectin and mortality in patients with COVID-19: A systematic review, meta-analysis, and meta-regression of randomized controlled trials, Diabetes & Metabolic Syndrome: Clinical Research & Reviews, doi:10.1016/j.dsx.2021.102186.sciencedirect.com, doi.org.

13. Schwartz, E., Does ivermectin have a place in the treatment of mild Covid-19?, New Microbes and New Infections, doi:10.1016/j.nmni.2022.100989.sciencedirect.com, doi.org.

Castaneda-Sabogal et al., 27 Jan 2021, preprint, 6 authors.

This Paper Ivermectin All

Outcomes of Ivermectin in the treatment of COVID-19: a systematic review and meta-analysis

Alex Castañeda-Sabogal, Diego Chambergo-Michilot, Carlos J Toro-Huamanchumo, Christian Silva-Rengifo, José Gonzales-Zamora, Joshuan J Barboza

doi:10.1101/2021.01.26.21250420

Background: To assess the outcomes of ivermectin in ambulatory and hospitalized patients with COVID-19. Methods: Five databases and websites for preprints were searched until January 2021 for randomized controlled trials (RCTs) and retrospective cohorts assessing ivermectin versus control in ambulatory and hospitalized participants. The primary outcome was overall mortality. Secondary outcome was recovered patients. For meta-analysis, random-effects and inverse variance meta-analyses with logarithmic transformation were performed. ROBINS-I for cohort studies, and the Cochrane Risk of Bias 2.0 tool for trials were used. The strength of evidence was assessed using GRADE. Results. After the selection, twelve studies (five retrospective cohort studies, six randomized clinical trials and one case series), were included. In total, 7412 participants were reported, the mean age was 47.5 (SD 9.5) years, and 4283 (58%) were male. Ivermectin was not associated with reduced mortality (logRR: 0.89, 95% CI 0.09 to 1.70, p = 0.04, I 2 = 84.7%), or reduced patient recovery (logRR 5.52 , 95% CI -24.36 to 35.4, p = 0.51, I 2 = 92.6%). All studies had a high risk of bias, and showed a very low certainty of the evidence. Conclusions: There insufficient certainty and quality of evidence to recommend the use of ivermectin to prevent or treat ambulatory or hospitalized patients with COVID-19.

References

Ahmed, Karim, Ross, Hossain, Clemens et al., A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness, Int J Infect Dis

Banerjee, Nandy, Dalai, Ahmed, The Battle against COVID 19 Pandemic: What we Need to Know Before we "Test Fire" Ivermectin, Drug Res (Stuttg)

Bray, Rayner, Noel, Jans, Wagstaff, Ivermectin and COVID-19: A report in Antiviral Research, widespread interest, an FDA warning, two letters to the editor and the authors' responses, Antiviral Res

Caly, Druce, Catton, Jans, Wagstaff, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Res

Camprubi, Almuedo-Riera, Marti-Soler, Soriano, Hurtado et al., Lack of efficacy of standard doses of ivermectin in severe COVID-19 patients, PLoS ONE

Carvallo, Hirsch, Farinella, Safety and Efficacy of the combined use of ivermectin, dexamethasone, enoxaparin and aspirin against COVID-19, medRxiv

Castillo, The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebocontrolled, randomized clinical trial, EClinicalMedicine

Cepelowicz, Sherman, Fatteh, Vogel, Sacks et al., ICON (Ivermectin in COvid Nineteen) study: Use of Ivermectin is Associated with Lower Mortality in Hospitalized Patients with COVID19, medRxiv

Chaccour, Casellas, Blanco-Di Matteo, Pineda, Fernandez-Montero et al., None

Chirinos, Vf, Heresi-Dávila, Hernandez, Málaga et al., Sobre las recomendaciones del Ministerio de Salud para el tratamiento farmacológico de la COVID-19 en el Perú, Acta Médica Peruana

Dixit, Yadav, Singh, Ivermectin: Potential Role as Repurposed Drug for COVID-19, Malays J Med Sci

Formiga, Leblanc, De Souza Reboucas, Farias, De Oliveira et al., Ivermectin: an award-winning drug with expected antiviral activity against COVID-19, J Control Release

Gorial, Mashhadani, Sayaly, Dakhil, Almashhadani et al., Effectiveness of Ivermectin as add-on Therapy in COVID-19 Management, Pilot Trial

Heidary, Gharebaghi, Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen, J Antibiot

Higgins, Thompson, Deeks, Altman, Measuring inconsistency in metaanalyses, BMJ (Clinical research ed

Higgins, Tj, Chandler, Cumpston, Li et al., Chapter 24: Including non-randomized studies on intervention effects

Khan, Khan, Debnath, Nath, Mahtab et al., Ivermectin Treatment May Improve the Prognosis of Patients With COVID-19

Kim, An, Kim, Hwang, Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: A systematic review and network meta-analysis, PLoS Med

Marcolino, Pimentel, Barao, What to expect from different drugs used in the treatment of COVID-19: A study on applications and in vivo and in vitro results, Eur J Pharmacol

Padhy, Mohanty, Das, Meher, Therapeutic potential of ivermectin as add on treatment in COVID 19: A systematic review and meta-analysis, J Pharm Pharm Sci

Page, Mckenzie, Bossuyt, Boutron, Hoffmann et al., The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

Podder, Nc, Ibne Sina, Md Mohosin, Haque, Outcome of ivermectin treated mild to moderate COVID-19 cases: a single-centre, open-label, randomised controlled study, IMC Journal of Medical Science

Rajter, Sherman, Fatteh, Vogel, Sacks et al., Use of Ivermectin Is Associated With Lower Mortality in Hospitalized Patients With Coronavirus Disease, The ICON Study

Schmith, Zhou, Lohmer, The Approved Dose of Ivermectin Alone is not the Ideal Dose for the Treatment of COVID-19, Clin Pharmacol Ther

Schünemann, Bj, Guyatt, Oxman, GRADE handbook for grading quality of evidence and strength of recommendations

Shakhsi Niaee, Ng, Ivermectin as an adjunct treatment for hospitalized adult COVID-19 patients: A randomized multi-center clinical trial

Soto-Becerra, Culquichicon, Hurtado-Roca, Araujo-Castillo, Real-world effectiveness of hydroxychloroquine, azithromycin, and ivermectin among hospitalized COVID-19 patients: results of a target trial emulation using observational data from a nationwide healthcare system in Peru, medRxiv

Sterne, Hernán, Reeves, Savović, Berkman et al., ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions, BMJ (Clinical research ed

Sterne, Savović, Page, Elbers, Blencowe et al., RoB 2: a revised tool for assessing risk of bias in randomised trials, BMJ

Waheed, Prophylactic Ivermectin in COVID-19 Contacts -Study Results -ClinicalTrials

Wiersinga, Rhodes, Cheng, Peacock, Prescott, Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review, JAMA

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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.

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