Effectiveness of a multidrug therapy consisting of ivermectin, azithromycin, montelukast and acetylsalicylic acid to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico
, Effectiveness of a multidrug therapy consisting of ivermectin, azithromycin, montelukast and acetylsalicylic..,
Prospective trial of 768 COVID-19 outpatients in Mexico, 481 treated with ivermectin, AZ, montelukast, and aspirin, and 287 control patients with various treatments, showing significantly lower mortality and hospitalization, and significantly higher recovery at 14 days with treatment.
|
risk of death, 77.7% lower, RR 0.22, p < 0.001, treatment 15 of 481 (3.1%), control 52 of 287 (18.1%), NNT 6.7, adjusted per study, odds ratio converted to relative risk, multivariate.
|
|
risk of mechanical ventilation, 51.9% lower, RR 0.48, p = 0.15, treatment 8 of 434 (1.8%), control 11 of 287 (3.8%), NNT 50.
|
|
risk of hospitalization, 67.4% lower, RR 0.33, p < 0.001, treatment 44 of 481 (9.1%), control 89 of 287 (31.0%), NNT 4.6, adjusted per study, odds ratio converted to relative risk, multivariate.
|
|
risk of no recovery, 58.6% lower, RR 0.41, p < 0.001, treatment 75 of 481 (15.6%), control 118 of 287 (41.1%), NNT 3.9, adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, recovery at day 14 after symptoms, multivariate.
|
| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
Lima-Morales et al., 10 Feb 2021, prospective, Mexico, peer-reviewed, 9 authors, average treatment delay 7.2 days, dosage 12mg single dose, this trial uses multiple treatments in the treatment arm (combined with azithromycin, montelukast, and aspirin) - results of individual treatments may vary.
Abstract: International Journal of Infectious Diseases 105 (2021) 598–605
Contents lists available at ScienceDirect
International Journal of Infectious Diseases
journal homepage: www.elsevier.com/locate/ijid
Effectiveness of a multidrug therapy consisting of Ivermectin,
Azithromycin, Montelukast, and Acetylsalicylic acid to prevent
hospitalization and death among ambulatory COVID-19 cases in
Tlaxcala, Mexico
René Lima-Moralesa , Pablo Méndez-Hernándezb,c,j,* , Yvonne N. Floresc,d,e,
Patricia Osorno-Romerob , Christian Ronal Sancho-Hernándezk ,
Elizabeth Cuecuecha-Rugeriob , Adrián Nava-Zamorab ,
Diego Rolando Hernández-Galdamezf , Daniela Karola Romo-Dueñasg,h , Jorge Salmeróni
a
Secretaría de Salud de Tlaxcala, Dirección General, Tlaxcala, Mexico
Secretaría de Salud de Tlaxcala, Dirección de Atención Especializada a la Salud, Tlaxcala, Mexico
Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Blvd. Benito Juárez No. 31,
Colonia Centro, Cuernavaca, Morelos, Mexico
d
UCLA Department of Health Policy and Management and Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Los Angeles, CA,
90095, United States
e
UCLA Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90095,
United States
f
INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
g
Red Nacional de Registros de Cáncer, Guanajuato, Mexico
h
Instituto de Salud Pública del estado de Guanajuato (ISAPEG), Unidad de Vigilancia Epidemiológica Hospitalaria (UVEH), Hospital General León, Guanajuato, Mexico
i
Research Center on Policies, Population, and Health. Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
j
Universidad Autónoma de Tlaxcala, Facultad de Ciencias de la Salud, Tlaxcala, Mexico
k
Secretaría de Salud de Tlaxcala, Hospital General de Nativitas, Tlaxcala, Mexico
b
c
A R T I C L E I N F O
A B S T R A C T
Article history:
Received 20 November 2020
Received in revised form 2 February 2021
Accepted 4 February 2021
Objective: There is an urgent need for effective treatments to prevent or attenuate lung and systemic
inflammation, endotheliitis, and thrombosis related to COVID-19. This study aimed to assess the
effectiveness of a multidrug-therapy consisting of Ivermectin, Azithromycin, Montelukast, and
Acetylsalicylic acid ("TNR4" therapy) to prevent hospitalization and death among ambulatory COVID19 cases in Tlaxcala, Mexico.
Design and methods: A comparative effectiveness study was performed among 768 confirmed SARS-CoV2 cases aged 18–80 years, who received ambulatory care at the Ministry of Health of Tlaxcala. A total of
481 cases received the TNR4 therapy, while 287 received another treatment (comparison group). All
participants received home visits and/or phone calls for clinical evaluation during the 14 days after
enrollment.
Results: Nearly 85% of cases who received the TNR4 recovered within 14 days compared to 59% in the
comparison group. The likelihood of recovery within 14 days was 3.4 times greater among the TNR4
group than in the comparison group. Patients treated with TNR4 had a 75% and 81% lower risk of being
hospitalized or death, respectively, than the comparison group.
Conclusions: TNR4 therapy improved recovery and prevented the risk of..
Late treatment
is less effective
is less effective
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, 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.