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 admission, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments.

5,100+ studies for 109 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.

References

Abegunde, Doxycycline plus ivermectin versus ivermectin alone for treatment of patients with onchocerciasis, Cochrane Database of Systematic Reviews, doi:10.1002/14651858.CD011146.pub2

Accapezzato, Chloroquine enhances human CD8+ T cell responses against soluble antigens in vivo, Journal of Experimental Medicine, doi:10.1084/jem.20051106

Bhiuyan, Saber, A Case Series of 100 COVID-19 Positive Patients Treated with Combination of Ivermectin and Doxycycline Mtalam, R Murshed, Bangladesh Coll Phys Surg, doi:10.3329/jbcps.v38i0.47512

Caly, Druce, Catton, Jans, Wagstaff, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Res, doi:10.1016/j.antiviral.2020.104787

Caly, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Research, doi:10.1016/j.antiviral.2020.104787

Chan, A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster, The Lancet, doi:10.1016/S0140-6736(20)30154-9

Chen, COVID-19 infection: the China and Italy perspectives, Cell Death & Disease, doi:10.1038/s41419-020-2603-0

Conforti, Doxycycline, a widely used antibiotic in dermatology with a possible anti-inflammatory action against IL-6 in COVID-19 outbreak, Dermatologic Therapy, doi:10.1111/dth.13437

Gautret, Lagier, Parola, Hoang, Meddeb et al., Clinical and microbiological effect of a combination of Hydroxychloroquine and Azithromycin in 80 COVID-19 patients with at least a six-day follow up: an observational study, doi:10.1016/j.tmaid.2020.101663

Gautret, Lagier, Parola, Hydroxychloroquine and Azithromycin as a treatment of COVID-19: results of an openlabel non-randomized clinical trial, Int J Antimicrob Agents

Holmes, Charles, Safety and Efficacy Review of Doxycycline, Clinical Medicine Insights: Therapeutics, doi:10.4137/CMT.S2035

Juurlink, Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection, Canadian Medical Association Journal, doi:10.1503/cmaj.200528

Laing, Ivermectin -Old Drug, New Tricks?, Trends in Parasitology, doi:10.1016/j.pt.2017.02.004

Li, Clinical features of familial clustering in patients infected with 2019 novel coronavirus in Wuhan, China, Virus Research, doi:10.1016/j.virusres.2020.198043

Liu, Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro, Cell Discovery, doi:10.1038/s41421-020-0156-0

Mahmudpour, COVID-19 cytokine storm: The anger of inflammation, Cytokine, doi:10.1016/j.cyto.2020.155151

Meyerowitz, Rethinking the role of hydroxychloroquine in the treatment of COVID-19, The FASEB Journal, doi:10.1096/fj.202000919

Molina, No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection, Médecine et Maladies Infectieuses, doi:10.1016/j.medmal.2020.03.006

Momekov, Ivermectin as a potential COVID-19 treatment from the pharmacokinetic point of view: antiviral levels are not likely attainable with known dosing regimens, doi:10.1101/2020.04.11.20061804

Rajter, ICON (Ivermectin in COvid Nineteen) study: Use of Ivermectin is Associated with Lower Mortality in Hospitalized Patients with COVID19, doi:10.1101/2020.06.06.20124461

Savarino, Tarek, Pharmacokinetic bases of the hydroxychloroquine response in COVID-19: implications for therapy and prevention

Schaper, A Mechanism of Action for Hydroxychloroquine and Azithromycin to Inhibit Coronavirus Disease COVID-19, doi:10.26434/chemrxiv.12148914

Schmith, The Approved Dose of Ivermectin Alone is not the Ideal Dose for the Treatment of COVID-19, doi:10.1101/2020.04.21.20073262

Sodhi, Therapeutic Potential for Tetracyclines in the Treatment of COVID-19, The Journal of Human Pharmacology and Drug Therapy, doi:10.1002/phar.2395

Wang, Cao, Zhang, Remdesivir and chloroquine effectively inhibit the recently emerged novel Coronavirus (2019-nCoV) in vitro, Cell Res, doi:10.1038/s41422-020-0282-0

Weniger, Organization WH Review of side effects and toxicity of chloroquine

Yao, Ye, Zhang, In vitro antiviral activity and projection of optimized dosing design of Hydroxychloroquine for the treatment of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), Clin Infect Dis, doi:10.1093/cid/ciaa237

Ye, The pathogenesis and treatment of the `Cytokine Storm' in COVID-19, Journal of Infection, doi:10.1016/j.jinf.2020.03.037

Şimşek Yavuz, Serap, Serhat, Antiviral treatment of COVID-19, Turkish Journal of Medical Sciences, doi:10.3906/sag-2004-145

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