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All Studies   Meta Analysis    Recent:   

Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection

Hill et al., Research Square, doi:10.21203/
Jan 2021  
  Source   PDF   All Studies   Meta AnalysisMeta
Mortality 75% Improvement Relative Risk Ivermectin for COVID-19  Hill et al.  META ANALYSIS Favorsivermectin Favorscontrol 0 0.5 1 1.5 2+
Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020
*, now with p < 0.00000000001 from 104 studies, recognized in 22 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments.
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Note that one of the 18 studies in this analysis has since been withdrawn (Elgazzar).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 104 ivermectin for COVID-19 studies, showing 48% lower mortality [35‑59%], 35% lower ventilation [17‑50%], 40% lower ICU admission [12‑58%], 34% lower hospitalization [21‑44%], and 81% fewer cases [71‑87%].
risk of death, 75.0% lower, RR 0.25, p < 0.001.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Hill et al., 19 Jan 2021, preprint, 40 authors.
This PaperIvermectinAll
Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection
Dr Andrew Hill, Ahmed S Abdulamir, Sabeena Ahmed, Asma Asghar, Olufemi Emmanuel Babalola, Rabia Basri, Carlos Chaccour, Aijaz Zeeshan Khan Chachar, Abu Tauib Mohammed Chowdhury, Ahmed Elgazzar, Leah Ellis, Jonathan Falconer, Anna Garratt, Basma M Hany, Hashim A Hashim, Wasim Ul Haque, Arshad Hayat, Shuixiang He, Ramin Jamshidian, Wasif Ali Khan, Ravi Kirti, Alejandro Krolewiecki, Carlos Lanusse, Jacob Levi, Reaz Mahmud, Sermand Ahmed Mangat, Kaitlyn Mccann, Anant Mohan, Mortezza Shakshi Niaee, Nurullah Okumus, Victoria Pilkington, Chinmay Saha Podder, Ambar Qavi, Houssam Raad, Mohammaed Sadegh Rezai, Surapaneni Sasank, Veerapaneni Spoorthi, Tejas Suri, Junzheng Wang, Hannah Wentzel
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.
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, doi:10.1016/j.ijid.2020.11.191
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Jermain, Hanafin, Cao, Lifschitz, Lanusse et al., Development of a Minimal Physiologically-Based Pharmacokinetic Model to Simulate Lung Exposure in Humans Following Oral Administration of Ivermectin for COVID-19 Drug Repurposing, J Pharm Sci, doi:10.1016/j.xphs.2020.08.024
Kirti, Low Low Low Low Low Low Good
Kirti, Roy, Pattadar, Raj, Agarwal et al., Ivermectin as a potential treatment for mild to moderate COVID-19: A double blind randomized placebo-controlled trial, doi:10.1101/2021.01.05.21249310
Kramer, Grandi, Passeri, Gianelli, Genchi et al., Evaluation of lung pathology in Dirofilaria immitis-experimentally infected dogs treated with doxycycline or a combination of doxycycline and ivermectin before administration of melarsomine dihydrochloride, Veterinary parasitology
Krolewiecki, Lifschitz, Moragas, Travacio, Valentini et al., Antiviral Effect of High-Dose Ivermectin in Adults with COVID-19: A Pilot Randomised, Controlled, Open Label, Multicentre Trial
Liu, Liang, Chen, Wang, Qu et al., Ivermectin induces autophagymediated cell death through the AKT/mTOR signaling pathway in glioma cells, Biosci Rep, doi:10.1042/BSR20192489
Navarro, Camprubí, Requena-Méndez, Buonfrate, Giorli et al., Safety of high-dose ivermectin: a systematic review and meta-analysis, Journal of Antimicrobial Chemotherapy
Niaee, Gheibi, Namdar, Allami, Zolghadr et al., Invermctin as an adjunct treatment for hospitalized adult COVID-19 patients: a randomized, multi-center clinical trial
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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>', 'DOI': '10.21203/', 'type': 'posted-content', 'created': {'date-parts': [[2021, 1, 19]], 'date-time': '2021-01-19T19:56:12Z', 'timestamp': 1611086172000}, 'source': 'Crossref', 'is-referenced-by-count': 9, 'title': 'Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection', 'prefix': '10.21203', 'author': [ { 'given': 'Andrew', 'family': 'Hill', 'sequence': 'first', 'affiliation': [{'name': 'University of Liverpool'}]}, { 'given': 'Ahmed', 'family': 'Abdulamir', 'sequence': 'additional', 'affiliation': [{'name': 'College of Medicine, Alnahrain University, Baghdad, Iraq'}]}, { 'given': 'Sabeena', 'family': 'Ahmed', 'sequence': 'additional', 'affiliation': [ { 'name': 'International Centre for Diarrhoeal Disease Research, Dhaka, ' 'Bangladesh,'}]}, { 'given': 'Asma', 'family': 'Asghar', 'sequence': 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