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Use of Ivermectin as a Potential Chemoprophylaxis for COVID-19 in Egypt: A Randomised Clinical Trial

Shouman et al., Journal of Clinical and Diagnostic Research, doi:10.7860/JCDR/2021/46795.14529, NCT04422561

Aug 2020

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Ivermectin for COVID-19

4th treatment shown to reduce risk in August 2020, now with p < 0.00000000001 from 105 studies, recognized in 23 countries.

Lower risk for mortality, ventilation, ICU, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments.

5,100+ studies for 112 treatments. c19ivm.org

PEP trial for asymptomatic close contacts of COVID-19 patients, 203 ivermectin patients and 101 control patients. 7.4% of contacts developed COVID-19 in the ivermectin group vs. 58.4% in the control group. Efficacy for symptomatic cases and severe cases is very similar. Adjusted results are provided only for symptomatic cases. See also1.

This is the 2nd of 52 COVID-19 RCTs for ivermectin, which collectively show efficacy with p=0.00000021.

This is the 4th of 105 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 774 quintillion).

Important missing comments or errors? Let us know.

risk of symptomatic case, 91.3% lower, RR 0.09, p < 0.001, treatment 15 of 203 (7.4%), control 59 of 101 (58.4%), NNT 2.0, adjusted per study, inverted to make RR<1 favor treatment, multivariate, primary outcome.

risk of severe case, 92.9% lower, RR 0.07, p = 0.002, treatment 1 of 203 (0.5%), control 7 of 101 (6.9%), NNT 16, unadjusted.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

1. trialsitenews.com, www.trialsitenews.com/zagazig-university-randomized-controlled-ivermectin-study-results-confirms-pi-hypothesis-drug-effective-against-covid-19/.www.trialsitenews.com/zagazig-university-randomized-controlled-ivermectin-study-results-confirms-pi-hypothesis-drug-effective-against-covid-19/.

Shouman et al., 28 Aug 2020, Randomized Controlled Trial, Egypt, peer-reviewed, 8 authors, study period 1 June, 2020 - 28 July, 2020, dosage 18mg days 1, 3, dose varies depending on weight - 40-60kg: 15mg, 60-80kg: 18mg, >80kg: 24mg, trial NCT04422561 (history).

This Paper Ivermectin All

Use of Ivermectin as a Potential Chemoprophylaxis for COVID-19 in Egypt: A Randomised Clinical Trial

Waheed M Shoumann, Dr Abdelmonem Awad Hegazy, Ramadan M Nafae, Moustafa I Ragab, Saad R Samra, Dalia Anas Ibrahim, Tarek H Al-Mahrouky, Ashraf E Sileem

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, doi:10.7860/jcdr/2021/46795.14529

Introduction: The rate of secondary attacks of SARS-COV-2 is high among household close contacts. Social distancing, isolation and infection control measures are important for preventing exposure to infection, but insufficient. Aim: The study aimed to evaluate possible role of oral ivermectin as a chemoprophylaxis in asymptomatic family close contacts with COVID-19 patients. Materials and Methods: A prospective interventional randomised open label-controlled study was conducted (registered at clinicaltrials.gov; NCT04422561) during June and July 2020. Two arms were designed according to use of ivermectin. In ivermectin arm, contacts received ivermectin according to Body Weight (BW) on day of the diagnosis of their index case. The non-intervention group received no treatment. Both groups were followed-up for two weeks for development of symptoms suggestive of COVID-19. Results: Ivermectin group included 203 contacts (to 52 index cases) aged 39.75±14.94 years; 52.2% were males. Nonintervention group included 101 contacts (to a total of 24 index cases) aged 37.69±16.96 years, 49.5% were males. Fifteen contacts (7.4%) developed COVID-19 in the ivermectin arm compared to 59 (58.4%) in the non-intervention arm (p<0.001). The protection rate for ivermectin was more prominent in contacts aged less than 60-year-old (6.2% infected compared to 58.7% if no treatment). Ivermectin in the protection against SARS-CoV-2 infection had an OR of 12.533 and 11.445 (compared to nontreatment) in both univariate and multivariate models, respectively. Side effects of ivermectin were reported in 5.4%; they were mild. Conclusion: Ivermectin is suggested to be a promising, effective and safe chemoprophylactic drug in management of COVID-19.

References

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Liu, Yan, Wan, Xiang, Le et al., from the pharmacokinetic point of view: Antiviral levels are not likely attainable with known dosing regimens, Biotechnology & Biotechnological Equipment, doi:10.1080/13102818.2020.1775118

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Morris-Jones, Oral ivermectin for infants and children under 15 kg appears to

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Therapeutics ; Medhat, Afro-Egypt, J Infect Endem Dis, doi:10.21608/AEJI.2020.93432

Vega, Vieitez, The pharmacokinetics and interactions of ivermectin in humans-A mini-review, AAPS J, doi:10.1208/s12248-007-9000-9

Vora, Arora, Behera, Tripathy, White paper on Ivermectin as a potential [11] therapy for COVID-19, Indian J Tuberc, doi:10.1016/j.ijtb.2020.07.031

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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment 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.

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