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Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19

Kory et al., FLCCC Alliance
Dec 2020  
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Mortality 69% Improvement Relative Risk Ivermectin for COVID-19  Kory 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 23 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments.
Meta analysis of ivermectin clinical studies and natural experiments where ivermectin has been widely used, showing efficacy of ivermectin in prophylaxis and treatment of COVID-19.
There is potentially inaccurate data collection and/or reporting in some included trials.
7 meta analyses show significant improvements with ivermectin for mortality1-6, hospitalization7, recovery3, and cases3.
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, 69.0% lower, RR 0.31, p < 0.001, treatment 35 of 1,551 (2.3%), control 191 of 1,957 (9.8%), NNT 13, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kory et al., 18 Dec 2020, preprint, 10 authors.
This PaperIvermectinAll
Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19
MD, MPA Pierre Kory, MD G Umberto Meduri, Jose Iglesias, Do, MD Joseph Varon, MD Keith Berkowitz, MD Howard Kornfeld, MD Eivind Vinjevoll, MBChB Scott Mitchell, MD Fred Wagshul, MD Paul E Marik
In March 2020, the Front Line COVID-19 Critical Care Alliance (FLCCC) was created and led by Professor Paul E. Marik to continuously review the rapidly emerging basic science, translational, and clinical data to develop a treatment protocol for COVID-19. The FLCCC then recently discovered that ivermectin, an anti-parasitic medicine, has highly potent anti-viral and anti-inflammatory properties against COVID-19. They then identified repeated, consistent, large magnitude improvements in clinical outcomes in multiple, large, randomized and observational controlled trials in both prophylaxis and treatment of data showing impacts on population wide health outcomes have Review of the Emerging Evidence Supporting the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19 [FLCCC Alliance; updated Jan 16, 2021] 2 / 30 resulted from multiple, large "natural experiments" that occurred when various city mayors and regional health ministries within South American countries initiated "ivermectin distribution" campaigns to their citizen populations in the hopes the drug would prove effective. The tight, reproducible, temporally associated decreases in case counts and case fatality rates in each of those regions compared to nearby regions without such campaigns, suggest that ivermectin may prove to be a global solution to the pandemic. This was further evidenced by the recent incorporation of ivermectin as a prophylaxis and treatment agent for COVID-19 in the national treatment guidelines of Belize, Macedonia, and the state of Uttar Pradesh in Northern India, populated by 210 million people. To our knowledge, the current review is the earliest to compile sufficient clinical data to demonstrate the strong signal of therapeutic efficacy as it is based on numerous clinical trials in multiple disease phases. One limitation is that half the controlled trials have been published in peer-reviewed publications, with the remainder taken from manuscripts uploaded to medicine pre-print servers. Although it is now standard practice for trials data from pre-print servers to immediately influence therapeutic practices during the pandemic, given the controversial therapeutics adopted as a result of this practice, the FLCCC argues that it is imperative that our major national and international health care agencies devote the necessary resources to more quickly validate these studies and confirm the major, positive epidemiological impacts that have been recorded when ivermectin is widely distributed among populations with a high incidence of COVID-19 infections. 1 Review of the Emerging Evidence Supporting the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19 [FLCCC Alliance; updated Jan 16, 2021] 3 / 30 5 6 Review of the..
It is the authors opinion, that based on the totality of these data, the use of ivermectin as a prophylactic and early treatment option should receive an A-I level recommendation by the NIH in support of use by the nation's health care providers. When, or if, such a recommendation is issued, the Front Line COVID-19 Critical Care Alliance has developed a prophylaxis and early treatment protocol for COVID-19 (I-MASK+), centered around ivermectin combined with masking, social distancing, hand hygiene, Vitamin D, Vitamin C, quercetin, melatonin, and zinc, with all components known for either their anti-viral, anti-inflammatory, or preventive actions (Table 4 ). The I-MASK+ protocol suggests treatment approaches for prophylaxis of high-risk patients, post-exposure prophylaxis of household members with COVID-19, and an early treatment approach for patients ill with COVID-19. Contribution to the field statement COVID-19 has caused a worldwide pandemic that has caused over 1.5 million global deaths along with continued rising case counts, lockdowns, unemployment and recessions in multiple countries. In response, the Front Line COVID-19 Critical Care Alliance (FLCCC), formed early in the pandemic, began to review the rapidly emerging basic science, translational, and clinical data to develop effective treatment protocols. The supportive evidence and rationale for their highly effective hospital treatment protocol called "MATH+" was recently published in a major medical..
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