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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 46% Improvement Relative Risk Mortality (b) 67% primary Ventilation 64% Ivermectin for COVID-19  Rajter et al.  LATE TREATMENT Is late treatment with ivermectin beneficial for COVID-19? PSM retrospective 280 patients in the USA Lower mortality with ivermectin (p=0.045) Rajter et al., Chest, October 2020 Favors ivermectin Favors control

Use of Ivermectin is Associated with Lower Mortality in Hospitalized Patients with COVID-19 (ICON study)

Rajter et al., Chest, doi:10.1016/j.chest.2020.10.009
Oct 2020  
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Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020
*, now known with p < 0.00000000001 from 102 studies, recognized in 22 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Retrospective 280 hospitalized patients showing lower mortality with ivermectin (13.3% vs 24.5%), propensity matched odds ratio OR 0.47 [0.22-0.99], p=0.045.
This is the 12th of 102 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 560 quintillion).
49 studies are RCTs, which show efficacy with p=0.00000038.
risk of death, 46.0% lower, RR 0.54, p = 0.045, treatment 13 of 98 (13.3%), control 24 of 98 (24.5%), NNT 8.9, adjusted per study, odds ratio converted to relative risk, PSM.
risk of death, 66.9% lower, RR 0.33, p = 0.03, treatment 26 of 173 (15.0%), control 27 of 107 (25.2%), NNT 9.8, adjusted per study, odds ratio converted to relative risk, multivariate, primary outcome.
risk of mechanical ventilation, 63.6% lower, RR 0.36, p = 0.10, treatment 4 of 98 (4.1%), control 11 of 98 (11.2%), NNT 14, matched cohort excluding intubated at baseline.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rajter et al., 13 Oct 2020, retrospective, propensity score matching, USA, peer-reviewed, 6 authors, dosage 200μg/kg single dose.
This PaperIvermectinAll
Use of Ivermectin Is Associated With Lower Mortality in Hospitalized Patients With Coronavirus Disease 2019
Juliana Cepelowicz Rajter, MD, FCCP Michael S Sherman, MD Naaz Fatteh, PharmD, BCPS Fabio Vogel, PharmD Jamie Sacks, MD Jean-Jacques Rajter
Chest, doi:10.1016/j.chest.2020.10.009
BACKGROUND: Ivermectin was shown to inhibit severe acute respiratory syndrome coronavirus 2 replication in vitro, which has led to off-label use, but clinical efficacy has not been described previously. RESEARCH QUESTION: Does ivermectin benefit hospitalized coronavirus disease 2019 (COVID-19) patients? STUDY DESIGN AND METHODS: Charts of consecutive patients hospitalized at four Broward Health hospitals in Florida with confirmed COVID-19 between March 15 and May 11, 2020, treated with or without ivermectin were reviewed. Hospital ivermectin dosing guidelines were provided, but treatment decisions were at the treating physician's discretion. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included mortality in patients with severe pulmonary involvement, extubation rates for mechanically ventilated patients, and length of stay. Severe pulmonary involvement was defined as need for FIO 2 $ 50%, noninvasive ventilation, or invasive ventilation at study entry. Logistic regression and propensity score matching were used to adjust for confounders. RESULTS: Two hundred eighty patients, 173 treated with ivermectin and 107 without ivermectin, were reviewed. Most patients in both groups also received hydroxychloroquine, azithromycin, or both. Univariate analysis showed lower mortality in the ivermectin group (15.0% vs 25.2%; OR, 0.52; 95% CI, 0.29-0.96; P ¼ .03). Mortality also was lower among ivermectin-treated patients with severe pulmonary involvement (38.8% vs 80.7%; OR, 0.15; 95% CI, 0.05-0.47; P ¼ .001). No significant differences were found in extubation rates (36.1% vs 15.4%; OR, 3.11; 95% CI, 0.88-11.00; P ¼ .07) or length of stay. After multivariate adjustment for confounders and mortality risks, the mortality difference remained significant (OR, 0.27; 95% CI, 0.09-0.80; P ¼ .03). One hundred ninety-six patients were included in the propensity-matched cohort. Mortality was significantly lower in the ivermectin group (13.3% vs 24.5%; OR, 0.47; 95% CI, 0.22-0.99; P < .05), an 11.2% (95% CI, 0.38%-22.1%) absolute risk reduction, with a number needed to treat of 8.9 (95% CI, 4.5-263). INTERPRETATION: Ivermectin treatment was associated with lower mortality during treatment of COVID-19, especially in patients with severe pulmonary involvement. Randomized controlled trials are needed to confirm these findings.
Author contributions: J. C. R., lead author, had full access to all of the data in the study and contributed to the study design, data collection and interpretation, and writing of manuscript. M. S. S. provided data analysis and interpretation and contributed to writing of the manuscript. N. F. contributed to data collection and literature search. F. V. contributed to the study design and data collection. J. S. contributed to data collection and data organization. J.-J. R., corresponding author, contributed substantially to the study design, data analysis and interpretation, and the writing of the manuscript. Financial/nonfinancial disclosures: None declared. Other contributions: The authors thank Edward Gracely, PhD, for his support and advice with the statistical analysis, and William Rifkin, MD, for reviewing the manuscript.
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Late treatment
is less effective
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