All Studies Meta Analysis

A Comparative Study on Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin Therapy on COVID-19 Patients

Chowdhury et al., Eurasian Journal of Medicine and Oncology, doi:10.14744/ejmo.2021.16263, NCT04434144

Jul 2020

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Ivermectin for COVID-19

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, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments.

5,100+ studies for 112 treatments. c19ivm.org

Small 116 patient RCT with low-risk patients comparing ivermectin+doxycycline and HCQ+AZ, showing lower hospitalization, higher viral clearance, and faster symptom resolution and viral clearance with ivermectin+doxycycline. Mid-recovery resolution of symptoms is statistically significantly better with treatment, while other measures do not reach statistical significance. Instructions were to take ivermectin on an empty stomach, reducing lung tissue concentration.

This is the 1st of 52 COVID-19 RCTs for ivermectin, which collectively show efficacy with p=0.00000021.

This is the 2nd of 105 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 774 quintillion).

Important missing comments or errors? Let us know.

risk of hospitalization, 80.6% lower, RR 0.19, p = 0.23, treatment 0 of 60 (0.0%), control 2 of 56 (3.6%), NNT 28, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).

risk of no recovery, 46.4% lower, RR 0.54, p < 0.001, treatment 27 of 60 (45.0%), control 47 of 56 (83.9%), NNT 2.6, mid-recovery day 5.

recovery time, 15.2% lower, relative time 0.85, p = 0.07, treatment 60, control 56.

risk of no viral clearance, 80.6% lower, RR 0.19, p = 0.23, treatment 0 of 60 (0.0%), control 2 of 56 (3.6%), NNT 28, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), primary outcome.

time to viral-, 4.3% lower, relative time 0.96, p = 0.23, treatment 60, control 56.

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

Chowdhury et al., 14 Jul 2020, Randomized Controlled Trial, Bangladesh, peer-reviewed, 6 authors, study period 2 May, 2020 - 5 June, 2020, dosage 200μg/kg single dose, this trial compares with another treatment - results may be better when compared to placebo, this trial uses multiple treatments in the treatment arm (combined with doxycycline) - results of individual treatments may vary, trial NCT04434144 (history).

This Paper Ivermectin All

A Comparative Study on Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin Therapy on COVID-19 Patients

Abu Taiub, MD. Mohammed Mohiuddin Chowdhury, Mohammad Shahbaz, Md Rezaul Karim, Jahirul Islam, Guo Dan, MD; PhD. Shuixiang He

Eurasian Journal of Medicine and Oncology, doi:10.14744/ejmo.2021.16263

C oronavirus disease 2019 (COVID-19) is a global pan- demic declared by the world health organization (WHO). Over ninety million people have already been infected by severe acute respiratory syndrome-corona-virus-2 (SARS-CoV-2), and billions have been affected by the socioeconomic squeal. As SARS-CoV-2 is a novel virus, there are no proven treatment options yet. Early treatment before the disease becomes severe would be optimal. The Objectives: We investigated the outcomes of Ivermectin-Doxycycline vs. Hydroxychloroquine-Azithromycin combination therapy in mild to moderate COVID19 patients. Methods: Patients were divided randomly into two groups: Ivermectin 200µgm/kg single dose + Doxycycline 100mg BID for ten days in group A, and Hydroxychloroquine 400mg for the first day, then 200mg BID for nine days + Azithromycin 500mg daily for five days in group B (Control group). RT-PCR for SARS-CoV-2 infection was repeated in all symptomatic patients on the second day onward without symptoms. Repeat PCR was done every two days onward if the result found positive. Time to the negative PCR and symptomatic recovery was measured for each group. Results: All subjects in Group A reached a negative PCR, at a mean of 8.93 days, and reached symptomatic recovery, at a mean of 5.93 days, with 55.10% symptom-free by the fifth day. In group B, 96.36% reached a negative PCR at a mean of 9.33 days and were symptoms-free at 6.99 days. In group A 31.67% of patients expressed symptoms caused by medication, this was 46.43% in group B. Conclusion: The combination therapy of Ivermectin-Doxycycline showed a trend towards superiority to the combination of Hydroxychloroquine-Azithromycin for mild to moderate COVID19 disease.

Disclosures Acknowledgment: Alexis Lieberman, MD; Associate chief for Ambulatory Pediatrics and Director of the Adolescent Program at Albert Einstein Medical Center in Philadelphia, Pennsylvania, for his kind assistance in editing this manuscript.

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