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Efficacy of single-dose and double-dose ivermectin early treatment in preventing progression to hospitalization in mild COVID-19: A multi-arm, parallel-group randomized, double-blind, placebo-controlled trial

Mirahmadizadeh et al., Respirology, doi:10.1111/resp.14318, Jun 2022
https://c19ivm.org/mirahmadizadeh.html
Ventilation, 24mg 67% Improvement Relative Risk Ventilation, 12mg 33% Hospitalization, 24mg 46% primary Hospitalization, 12mg 27% primary Recovery, 24mg 39% Recovery, 12mg 31% Recovery time, 24mg 0% no CI Recovery time, 12mg 0% no CI Ivermectin  Mirahmadizadeh et al.  EARLY TREATMENT  DB RCT Is early treatment with ivermectin beneficial for COVID-19? Double-blind RCT 261 patients in Iran (April - May 2021) Lower ventilation (p=0.37) and hospitalization (p=0.22), not sig. c19ivm.org Mirahmadizadeh et al., Respirology, Jun 2022 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 105 studies, recognized in 24 countries.
No treatment is 100% effective. Protocols combine treatments.
6,000+ studies for 175 treatments. c19ivm.org
RCT with 131 24mg ivermectin, 130 12mg ivermectin, and 130 placebo patients, showing no significant differences in outcomes. Lower ventilation and hospitalization was seen with treatment, in a dose-dependent manner, but not reaching statistical significance with the small number of events.
This is the 39th of 52 COVID-19 RCTs for ivermectin, which collectively show efficacy with p=0.00000021.
This is the 88th of 105 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 774 quintillion).
risk of mechanical ventilation, 66.9% lower, RR 0.33, p = 0.37, treatment 1 of 131 (0.8%), control 3 of 130 (2.3%), NNT 65, 24mg.
risk of mechanical ventilation, 33.3% lower, RR 0.67, p = 1.00, treatment 2 of 130 (1.5%), control 3 of 130 (2.3%), NNT 130, 12mg.
risk of hospitalization, 45.9% lower, RR 0.54, p = 0.22, treatment 6 of 131 (4.6%), control 11 of 130 (8.5%), NNT 26, 24mg, primary outcome.
risk of hospitalization, 27.3% lower, RR 0.73, p = 0.63, treatment 8 of 130 (6.2%), control 11 of 130 (8.5%), NNT 43, 12mg, primary outcome.
risk of no recovery, 38.9% lower, RR 0.61, p = 0.27, treatment 8 of 131 (6.1%), control 13 of 130 (10.0%), NNT 26, day 28, 24mg.
risk of no recovery, 30.8% lower, RR 0.69, p = 0.50, treatment 9 of 130 (6.9%), control 13 of 130 (10.0%), NNT 32, day 28, 12mg.
recovery time, no change, relative time 1.00, treatment 131, control 130, 24mg.
recovery time, no change, relative time 1.00, treatment 130, control 130, 12mg.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mirahmadizadeh et al., 23 Jun 2022, Double Blind Randomized Controlled Trial, placebo-controlled, Iran, peer-reviewed, 12 authors, study period 9 April, 2021 - 20 May, 2021, dosage 24mg single dose, 12mg and 24mg arms.
Efficacy of single‐dose and double‐dose ivermectin early treatment in preventing progression to hospitalization in mild COVID‐19: A multi‐arm, parallel‐group randomized, double‐blind, placebo‐controlled trial
Alireza Mirahmadizadeh, Ali Semati, Alireza Heiran, Mostafa Ebrahimi, Abdolrasool Hemmati, Mohammadreza Karimi, Souzan Basir, Marjan Zare, Antonio Charlys Da Costa, Mohammad Zeinali, Maryam Sargolzaee, Owrang Eilami
Respirology, doi:10.1111/resp.14318
Background and objective: Ivermectin is a known anti-parasitic agent that has been investigated as an antiviral agent against coronavirus disease 2019 (COVID-19). This study aimed to evaluate the efficacy of ivermectin in mild COVID-19 patients. Methods: In this multi-arm randomized clinical trial conducted between 9 April 2021 and 20 May 2021, a total of 393 patients with reverse transcription-PCR-confirmed COVID-19 infection and mild symptoms were enrolled. Subjects were randomized in a 1:1:1 ratio to receive single-dose ivermectin (12 mg), double-dose ivermectin (24 mg) or placebo. The primary outcome was need for hospitalization. Results: There was no significant difference in the proportion of subjects who required hospitalization between the placebo and single-dose ivermectin groups (absolute difference in the proportions: À2.3 [95% CI = À8.5, 4.1]) and between the placebo and double-dose ivermectin groups (absolute difference in the proportions: À3.9 [95% CI = À9.8, 2.2]). The odds of differences in mean change in severity score between single-dose ivermectin and placebo groups (OR difference = 1.005 [95% CI: 0.972, 1.040]; p = 0.762) and double-dose ivermectin and placebo groups (OR difference = 1.010 [95% CI: 0.974, 1.046]; p = 0.598) were not statistically significant. None of the six adverse events (including mild dermatitis, tachycardia and hypertension) were serious and required extra action. Conclusion: Single-dose and double-dose ivermectin early treatment were not superior to the placebo in preventing progression to hospitalization and improving clinical course in mild COVID-19.
CONFLICT OF INTEREST None declared. SUPPORTING INFORMATION Additional supporting information can be found online in the Supporting Information section at the end of this article. How to cite this article:
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