Conv. Plasma
Nigella Sativa
Peg.. Lambda

All ivermectin studies
Meta analysis
Home COVID-19 treatment researchIvermectinIvermectin (more..)
Melatonin Meta
Bromhexine Meta Metformin Meta
Budesonide Meta
Cannabidiol Meta Molnupiravir Meta
Colchicine Meta
Conv. Plasma Meta
Curcumin Meta Nigella Sativa Meta
Ensovibep Meta Nitazoxanide Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Peg.. Lambda Meta
Fluvoxamine Meta Quercetin Meta
Hydroxychlor.. Meta Remdesivir Meta
Ivermectin Meta
Lactoferrin Meta

All Studies   Meta Analysis   Recent:  

Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials

Roman et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab591 (date from preprint)
Jun 2021  
  Source   PDF   All Studies   Meta AnalysisMeta
This is a severely flawed meta analysis. An open letter signed by 40 physicians detailing errors and flaws, and requesting retraction, can be found at See also
Authors cherry-pick to include only 4 studies reporting non-zero mortality and they initially claimed a mortality RR of 1.11 [0.16-7.65]. However, they reported incorrect values for Niaee et al., claiming an RR of 6.51 [2.18-19.45], when the correct RR for Niaee et al. is 0.18 [0.06-0.55]. After correction, their cherry-picked studies show >60% mortality reduction, however authors did not correct the conclusion.
Similarly, for viral clearance and NCT04392713 (history), they report 20/41 treatment, 18/45 control, whereas the correct day 7 clearance numbers are 37/41 and 20/45 (sum of clearance @72hrs and @7 days), or 17/41 and 2/45 @72 hrs.
The duration of hospital stay for Niaee et al. is also incorrectly reported, showing a lower duration for the control group.
All of the errors are in one direction - incorrectly reporting lower than actual efficacy for ivermectin. Authors claim to include all RCTs excluding prophylaxis, however they only include 10 of the 24 non-prophylaxis RCTs (28 including prophylaxis at the time of publication). Authors actually reference meta analyses that do include the missing RCTs, so they should be aware of the missing RCTs.
The PubMed search strategy provided is syntactically incorrect. For additional errors, see Also see
The authors state that they have no conflicts of interest on medRxiv, however Dr. Pasupuleti’s affiliation is Cello Health, whose website notes that they provide services such as “brand and portfolio commercial strategy for biotech and pharma”, and that their clients are "24 of the top 25 pharmaceutical companies”.
Only one of these errors has been partially fixed as of 5/29 - the Niaee RR was corrected, but the associated conclusion was not. Other errors have not been corrected. Comments on this article appear to be censored, with zero comments posted as of July 5.
7 meta analyses show significant improvements with ivermectin for mortality Bryant, Hariyanto, Kory, Lawrie, Nardelli, Zein, hospitalization Schwartz, recovery Kory, and cases Kory.
Currently there are 99 ivermectin for COVID-19 studies, showing 49% lower mortality [35‑60%], 29% lower ventilation [13‑42%], 38% lower ICU admission [14‑56%], 34% lower hospitalization [20‑45%], and 81% fewer cases [71‑87%].
Roman et al., 28 Jun 2021, peer-reviewed, 6 authors.
All Studies   Meta Analysis   Submit Updates or Corrections
This PaperIvermectinAll
Ivermectin for the Treatment of Coronavirus Disease 2019: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Yuani M Roman, Paula Alejandra Burela, Vinay Pasupuleti, Alejandro Piscoya, Jose E Vidal, Adrian V Hernandez
Clinical Infectious Diseases, doi:10.1093/cid/ciab591
Background. We systematically assessed benefits and harms of the use of ivermectin (IVM) in patients with coronavirus disease 2019 . Methods. Published and preprint randomized controlled trials (RCTs) assessing the effects of IVM on adult patients with COVID-19 were searched until 22 March 2021 in 5 engines. Primary outcomes were all-cause mortality rate, length of hospital stay (LOS), and adverse events (AEs). Secondary outcomes included viral clearance and severe AEs (SAEs). The risk of bias (RoB) was evaluated using the Cochrane Risk of Bias 2.0 tool. Inverse variance random effect meta-analyses were performed, with quality of evidence (QoE) evaluated using GRADE methods. Results. Ten RCTs (n = 1173) were included. The controls were the standard of care in 5 RCTs and placebo in 5. COVID-19 disease severity was mild in 8 RCTs, moderate in 1, and mild and moderate in 1. IVM did not reduce all-cause mortality rates compared with controls (relative risk [RR], 0.37 [95% confidence interval, .12-1.13]; very low QoE) or LOS compared with controls (mean difference, 0.72 days [95% confidence interval, −.86 to 2.29 days]; very low QoE). AEs, SAEs, and viral clearance were similar between IVM and control groups (low QoE for all outcomes). Subgroups by severity of COVID-19 or RoB were mostly consistent with main analyses; all-cause mortality rates in 3 RCTs at high RoB were reduced with IVM. Conclusions. Compared with the standard of care or placebo, IVM did not reduce all-cause mortality, LOS, or viral clearance in RCTs in patients with mostly mild COVID-19. IVM did not have an effect on AEs or SAEs and is not a viable option to treat patients with COVID-19.
Supplementary Data Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding author. Note Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Ahmed, Karim, Ross, A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness, Int J Infect Dis
Amsden, Gregory, Michalak, Glue, Knirsch, Pharmacokinetics of azithromycin and the combination of ivermectin and albendazole when administered alone and concurrently in healthy volunteers, Am J Trop Med Hyg
Balshem, Helfand, Schünemann, GRADE guidelines: 3. Rating the quality of evidence, J Clin Epidemiol
Banerjee, Nandy, Dalai, Ahmed, The battle against COVID 19 pandemic: what we need to know before we "test fire" ivermectin, Drug Res
Barberia, Gómez, Political and institutional perils of Brazil's COVID-19 crisis, Lancet
Beltrán-Gonzalez, Gámez, Enciso, Efficacy and safety of ivermectin and hydroxychloroquine in patients with severe COVID-19. A randomized controlled trial, doi:10.1101/2021.02.18.21252037v1
Bhimraj, Morgan, Shumaker, Infectious Diseases Society of America guidelines on the treatment and management of patients with COVID-19, Infectious Diseases Society of America
Bryant, Lawrie, Dowswell, Ivermectin for prevention and treatment of COVID-19 infection: a systematic review and meta-analysis, Res Sq
Bukhari, Asghar, Perveen, Efficacy of ivermectin in COVID-19 patients with mild to moderate disease, doi:10.1101/2021.02.02.21250840v1
Caly, Druce, Catton, Jans, Wagstaff, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Res
Castañeda-Sabogal, Chambergo-Michilot, Toro-Huamanchumo, Outcomes of ivermectin in the treatment of COVID-19: a systematic review and metaanalysis, doi:10.1101/2021.01.26.21250420v1
Chaccour, Casellas, Blanco-Di Matteo, The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: a pilot, double-blind, placebo-controlled, randomized clinical trial, EClinicalMedicine
Chaccour, Hammann, Ramón-García, Rabinovich, Ivermectin and COVID-19: keeping rigor in times of urgency, Am J Trop Med Hyg
Chachar, Khan, Asif, Tanveer, Khaqan et al., Effectiveness of ivermectin in SARS-CoV-2/COVID-19 patients, Int J Sci
Garegnani, Madrid, Meza, Misleading clinical evidence and systematic reviews on ivermectin for COVID-19, BMJ Evid Based Med
Guzzo, Furtek, Porras, Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects, J Clin Pharmacol
Hamilton, None
Hartung, Knapp, A refined method for the meta-analysis of controlled clinical trials with binary outcome, Stat Med
Hill, Preliminary meta-analysis of randomized trials of ivermectin to treat SARSCoV-2 infection, Res Sq
Kalil, Treating COVID-19-off-label drug use, compassionate use, and randomized clinical trials during pandemics, JAMA
Kory, Meduri, Iglesias, WHO Working Group on the Clinical Characterization and Management of COVID-19 Infection. A minimal common outcome measure set for COVID-19 clinical research, Lancet Infect Dis
Kow, Merchant, Mustafa, Hasan, The association between the use of ivermectin and mortality in patients with COVID-19: a meta-analysis, Pharmacol Rep
Krolewiecki, Lifschitz, Moragas, pilot randomized, controlled, open label, multicentre trial
Lawrie, Ivermectin reduces the risk of death from COVID-19-a rapid review and meta-analysis in support of the recommendation of the Front Line COVID-19 Critical Care Alliance
López-Medina, López, Hurtado, Effect of ivermectin on time to resolution of symptoms among adults with mild COVID-19: a randomized clinical trial, JAMA
Macdonald, Loder, Abbasi, Living systematic reviews at the BMJ, BMJ
Martin, Robertson, Choudhary, Ivermectin: an anthelmintic, an insecticide, and much more, Trends Parasitol
Moher, Liberati, Tetzlaff, Altman, Group, Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement, PLoS Med
Niaee, Gheibi, Namdar, Ivermectin as an adjunct treatment for hospitalized adult COVID-19 patients: a randomized multi-center clinical trial, Res Sq
Padhy, Mohanty, Das, Meher, Therapeutic potential of ivermectin as add on treatment in COVID 19: a systematic review and meta-analysis, J Pharm Pharm Sci
Podder, Chowdhury, Sina, Haque, Outcome of ivermectin treated mild to moderate COVID-19 cases: a single-centre, open-label, randomized controlled study, IMC J Med Sci
Ravikirti, Pattadar, Raj, Ivermectin as a potential treatment for mild to moderate COVID-19-a double blind randomized placebo-controlled trial, doi:10.1101/2021.01.05.21249310v1
Saag, Misguided use of hydroxychloroquine for COVID-19: the infusion of politics into science, JAMA
Saidi, Nur, Al-Mandhari, Rabbat, Hafeez et al., Decisive leadership is a necessity in the COVID-19 response, Lancet
Scheufele, Hoffman, Neeley, Reid, Misinformation about science in the public sphere, Proc Natl Acad Sci U S A
Siemieniuk, Bartoszko, Ge, Drug treatments for COVID-19: living systematic review and network meta-analysis, BMJ
Sterne, Savović, Page, RoB 2: a revised tool for assessing risk of bias in randomised trials, BMJ
Sweeting, Sutton, Lambert, What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data, Stat Med
Veroniki, Jackson, Viechtbauer, Methods to estimate the between-study variance and its uncertainty in meta-analysis, Res Synth Methods
Walker, Hernandez, Kattan, Meta-analysis: its strengths and limitations, Cleve Clin J Med
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.
  or use drag and drop