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0 0.5 1 1.5 2+ Progression, xray, day 6 0% Improvement Relative Risk Progression, xray, day 3 67% Recovery, combined sy.. 39% Recovery, day 3, cough 70% Recovery, day 3, sore throat 14% Recovery, day 3, runny nose 67% Recovery, day 6, cough 50% Recovery, WHO-CPS 0% no CI Ct improvement 6% primary Ivermectin  FINCOV  EARLY TREATMENT  RCT Is early treatment with ivermectin + niclosamide beneficial for COVID-19? RCT 60 patients in Thailand (December 2022 - February 2023) Improved recovery with ivermectin + niclosamide (not stat. sig., p=0.19) Siripongboonsitti et al., J. Infection.., Mar 2024 Favors ivermectin Favors control

A Randomized Trial to Assess the Acceleration of Viral Clearance by the Combination Favipiravir/Ivermectin/Niclosamide in Mild-to-Moderate COVID-19 Adult Patients (FINCOV)

Siripongboonsitti et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2024.03.030, FINCOV, TCTR20230403007
Mar 2024  
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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.
RCT 60 low-risk outpatients, median age 31, with mild to moderate COVID-19 showing no significant differences with combined favipiravir/ivermectin/niclosamide treatment compared to favipiravir alone. There was limited room for improvement with almost no progression and no hospitalization, ICU admission, supplemental oxygen, or mortality.
The combined group showed significantly improved visual analog scale (VAS) scores for cough, runny nose, and diarrhea from day 3.
Authors note that "the WHO-CPS were significantly decreased among FPV/IVM/NCL vs FPV alone on day 10", however the degree of improvement cannot be determined based on the values reported.
Authors state that "All data generated or analyzed during this study are included in this published article", which is incorrect - only summary statistics are published. The trial registration states that data will not be made available. This raises concerns, especially given many inconsistencies in the published data:
- E gene and ORF1 a/b gene day 1 Ct values are different between Table S1 and Table S3.
- Figure S1 shows 25% >= 38.5, however no number of 30 patients is 25%, and this does not match Table 2 (at most 23.3% >= 38.5).
- The first three calculations in section 3.3 all show p = 0.515, an unusual match for different calculations.
- "the FPV/IVM/NCL group had 0.62 cycles per day fewer than did the FPV group" does not match the data.
- Table 1 shows 30% loss of taste in the control group, however Table S2 shows a Q3 VAS score of 0, which is inconsistent.
- The abstract reference to significant differences for sore throat does not match the results in Table S6.
Not releasing data is a change from earlier COVID-19 trials by the same main author: TCTR20210615002 and TCTR20210609001 both indicate that individual patient level data would be available.
The trial was registered retrospectively. Discussion of prior research is very biased, however this may be required for publication. There were more patients with fever, anosmia, and loss of taste at baseline in the combined group. The adverse events reported show none of the expected side effects of ivermectin at the dose used.
This is the 49th COVID-19 RCT for ivermectin, which collectively show efficacy with p=0.00000038.
This is the 102nd COVID-19 controlled study for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 560 quintillion).
This study is excluded in the after exclusion results of meta analysis: data consistency issues, very low risk patients/variants with almost no progression, all patients received known effective antiviral, baseline differences.
risk of progression, no change, RR 1.00, p = 1.00, treatment 1 of 30 (3.3%), control 1 of 30 (3.3%), chest xray progression, day 6.
risk of progression, 66.7% lower, RR 0.33, p = 1.00, treatment 0 of 30 (0.0%), control 1 of 30 (3.3%), NNT 30, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), chest xray progression, day 3.
risk of no recovery, 39.4% lower, RR 0.61, p = 0.19, treatment 30, control 30, combined symptoms.
risk of no recovery, 70.0% lower, RR 0.30, p = 0.048, treatment 30, control 30, mid-recovery, day 3, cough.
risk of no recovery, 14.3% lower, RR 0.86, p = 0.38, treatment 30, control 30, mid-recovery, day 3, sore throat.
risk of no recovery, 66.7% lower, RR 0.33, p = 0.41, treatment 30, control 30, inverted to make RR<1 favor treatment, mid-recovery, day 3, runny nose.
risk of no recovery, 50.0% lower, RR 0.50, p = 0.32, treatment 30, control 30, inverted to make RR<1 favor treatment, day 6, cough.
risk of no recovery, no change, RR 1.00, p = 0.61, treatment 30, control 30, WHO-CPS.
relative Ct improvement, 6.1% better, RR 0.94, p = 0.75, treatment median 9.15 IQR 9.7 n=30, control median 8.59 IQR 8.239999999999995 n=30, E gene, mid-recovery, day 5, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Siripongboonsitti et al., 29 Mar 2024, Randomized Controlled Trial, Thailand, peer-reviewed, 5 authors, study period 7 December, 2022 - 3 February, 2023, dosage 600μg/kg days 1-5, this trial uses multiple treatments in the treatment arm (combined with niclosamide) - results of individual treatments may vary, trial TCTR20230403007 (FINCOV).
This PaperIvermectinAll
A Randomized Trial to Assess the Acceleration of Viral Clearance by the Combination Favipiravir/Ivermectin/Niclosamide in Mild-to-Moderate COVID-19 Adult Patients (FINCOV)
M.D Taweegrit Siripongboonsitti, Kriangkrai Tawinprai, M.D Panisadee Avirutnan, Ph.D. e Kunlakanya Jitobaom, Prasert Auewarakul
Background: The efficacy of the viral clearance and clinical outcomes of favipiravir (FPV) in outpatients being treated for coronavirus disease 2019 (COVID-19) is unclear. Ivermectin (IVM), niclosamide (NCL), and FPV demonstrated synergistic effects in vitro for exceed 78% inhibiting severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) replication. Methods: A phase 2, open-label, 1:1, randomized, controlled trial was conducted on Thai patients with mild-to-moderate COVID-19 who received either combination FPV/IVM/NCL therapy or FPV alone to assess the rate of viral clearance among individuals with mild-to-moderate COVID-19. Results: Sixty non-high-risk comorbid patients with mild-to-moderate COVID-19 were randomized; 30 received FPV/IVM/NCL, and 30 received FPV alone. Mixed-effects multiple linear regression analysis of the cycle threshold value from SARS-CoV-2 PCR demonstrated no statistically significant differences in viral clearance rates between the combined FPV/IVM/NCL therapy group and the FPV-alone group. World Health Organization Clinical Progression scores and symptomatic improvement did not differ between arms on days 3, 6, and 10, and no adverse J o u r n a l P r e -p r o o f events were reported. No patients required hospitalization, intensive care unit admission, or supplemental oxygen or died within 28 days. C-reactive protein on day 3 was lower in the FPV/IVM/NCL group. Conclusion: Viral clearance rates did not differ significantly between the FPV/IVM/NCL combination therapy and FPV-alone groups of individuals with mild-to-moderate COVID-19, although the combined regimen demonstrated a synergistic effect in vitro. No discernible clinical benefit was observed. Further research is required to explore the potential benefits of FVP beyond its antiviral effects.
Conflicts of Interest The authors declare that they have no competing interests. J o u r n a l P r e -p r o o f
Abd-Elsalam, Noor, Badawi, Khalaf, Esmail et al., Clinical study evaluating the efficacy of ivermectin in COVID-19 treatment: A randomized controlled study, J Med Virol, doi:10.1002/jmv.27122
Abdulamir, Gorial, Saadi, Maulood, Hashim et al., A randomised controlled trial of effectiveness and safety of Niclosamide as add on therapy to the standard of care measures in COVID-19 management, Ann Med Surg (Lond), doi:10.1016/j.amsu.2021.102779
Audus, Knaub, Guillot, Schaeffer, The effect of protein binding on ivermectin uptake by bovine brain microvessel endothelial cells, Vet Res Commun, doi:10.1007/bf01839186
Backer, Sjöbring, Sonne, Weiss, Hostrup et al., A randomized, double-blind, placebo-controlled phase 1 trial of inhaled and intranasal niclosamide: A broad spectrum antiviral candidate for treatment of COVID-19, Lancet Reg Health Eur, doi:10.1016/j.lanepe.2021.100084
Bernal, Da Silva, Musungaie, Kovalchuk, Gonzalez et al., Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients, N Engl J Med, doi:10.1056/NEJMoa2116044
Bhimraj, Morgan, Shumaker, Lavergne, Baden et al., Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19, Clin Infect Dis, doi:10.1093/cid/ciaa478
Bramante, Huling, Tignanelli, Buse, Liebovitz et al., Randomized trial of metformin, ivermectin, and fluvoxamine for COVID-19, N Engl J Med, doi:10.1056/NEJMoa2201662
Buonfrate, Chesini, Martini, Roncaglioni, Fernandez et al., High-dose ivermectin for early treatment of COVID-19 (COVER study): a randomised, doubleblind, multicentre, phase II, dose-finding, proof-of-concept clinical trial, Int J Antimicrob Agents, doi:10.1016/j.ijantimicag.2021.106516
Cai, Yang, Liu, Chen, Shu et al., Experimental treatment with favipiravir for COVID-19: an open-label control study, Engineering, doi:10.1016/j.eng.2020.03.007.JournalPre-proof
Cairns, Dulko, Griffiths, Golan, Cohen et al., Efficacy of niclosamide vs placebo in sars-cov-2 respiratory viral clearance, viral shedding, and duration of symptoms among patients with mild to moderate COVID-19: A phase 2 randomized clinical trial, JAMA Netw Open, doi:10.1001/jamanetworkopen.2021.44942
Caly, Druce, Catton, Jans, Wagstaff, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Res, doi:10.1016/j.antiviral.2020.104787
Chen, Huang, Cheng, Wu, Chen et al., Favipiravir versus arbidol for COVID-19: a randomized clinical trial, MedRxiv, doi:10.1101/2020.03.17.20037432
Doi, Ando, Kuwatsuka, Ishihara, Favipiravir, Favipiravir Observational Study Interim Report 3
Du, Chen, Favipiravir: pharmacokinetics and concerns about clinical trials for 2019-nCoV infection, Clin Pharmacol Ther, doi:10.1002/cpt.1844
Furuta, Komeno, Nakamura, Favipiravir (T-705), a broad spectrum inhibitor of viral RNA polymerase, Proc Jpn Acad, Ser B, doi:10.2183/pjab.93.027
Galan, Santos, Asato, Araújo, De Lima Moreira et al., Phase 2 randomized study on chloroquine, hydroxychloroquine or ivermectin in hospitalized patients with severe manifestations of SARS-CoV-2 infection, Pathog Glob Health, doi:10.1080/20477724.2021.1890887
Golan, Campos, Woolson, Cilla, Hanabergh et al., Favipiravir in patients with early mild-to-moderate COVID-19: a randomized controlled trial, Clin Infect Dis, doi:10.1093/cid/ciac712
Hammond, Leister-Tebbe, Gardner, Abreu, Wisemandle, Oral nirmatrelvir for high-risk, nonhospitalized adults with COVID-19, N Engl J Med, doi:10.1056/NEJMoa2118542
Hassanipour, Arab-Zozani, Amani, Heidarzad, Fathalipour et al., The efficacy and safety of Favipiravir in treatment of COVID-19: A systematic review and J o u r n a l P r e -p r o o f meta-analysis of clinical trials, Sci Rep, doi:10.1038/s41598-021-90551-6
Irie, Nakagawa, Fujita, Tamura, Eto et al., Population pharmacokinetics of favipiravir in patients with COVID-19, CPT Pharmacometrics Syst Pharmacol, doi:10.1002/psp4.12685
Ivashchenko, Dmitriev, Vostokova, Azarova, Blinow et al., AVIFAVIR for treatment of patients with moderate coronavirus disease 2019 (COVID-19): interim results of a phase II/III multicenter randomized clinical trial, Clin Infect Dis, doi:10.1093/cid/ciaa1176
Jeon, Ko, Lee, Choi, Byun et al., Identification of antiviral drug candidates against SARS-CoV-2 from FDA-approved drugs, Antimicrob Agents Chemother, doi:10.1128/aac.00819-20
Jitobaom, Boonarkart, Manopwisedjaroen, Punyadee, Borwornpinyo et al., Favipiravir and ivermectin show in vitro synergistic antiviral activity against SARS-CoV-2, Acta Virologica
Jitobaom, Boonarkart, Manopwisedjaroen, Punyadee, Borwornpinyo et al., Synergistic anti-SARS-CoV-2 activity of repurposed anti-parasitic drug combinations, BMC Pharmacol Toxicol, doi:10.1186/s40360-022-00580-8
Joshi, Parkar, Ansari, Vora, Talwar et al., Role of favipiravir in the treatment of COVID-19, Inter J Infect Dis, doi:10.1016/j.ijid.2020.10.069
Lim, Hor, Tay, Jelani, Tan et al., Efficacy of ivermectin treatment on disease progression among adults with mild to moderate COVID-19 and comorbidities: The I-TECH randomized clinical trial, JAMA Intern Med, doi:10.1001/jamainternmed.2022.0189
López-Medina, López, Hurtado, Dávalos, Ramirez et al., Effect of ivermectin on time to resolution of symptoms among adults with mild COVID-19: A randomized clinical trial, JAMA, doi:10.1001/jama.2021.3071.JournalPre-proof
Marshall, Murthy, Diaz, Adhikari, Angus et al., A minimal common outcome measure set for COVID-19 clinical research, Lancet Infect Dis, doi:10.1016/S1473-3099(20)30483-7
Mohan, Tiwari, Suri, Mittal, Patel et al., Single-dose oral ivermectin in mild and moderate COVID-19 (RIVET-COV): A single-centre randomized, placebo-controlled trial, J Infect Chemother, doi:10.1016/j.jiac.2021.08.021
Naggie, Boulware, Lindsell, Stewart, Gentile et al., Effect of ivermectin vs placebo on time to sustained recovery in outpatients with mild to moderate COVID-19: A randomized clinical trial, JAMA, doi:10.1001/jama.2022.18590
Naggie, Boulware, Lindsell, Stewart, Slandzicki et al., Effect of higher-dose ivermectin for 6 days vs placebo on time to sustained recovery in outpatients with COVID-19: A randomized clinical trial, JAMA, doi:10.1001/jama.2023.1650
Peña-Silva, Duffull, Steer, Jaramillo-Rincon, Gwee et al., Pharmacokinetic considerations on the repurposing of ivermectin for treatment of COVID-19, Br J Clin Pharmacol, doi:10.1111/bcp.14476
Ravikirti, Pattadar, Raj, Agarwal, Biswas, Evaluation of ivermectin as a potential treatment for mild to moderate COVID-19: A double-blind randomized placebo controlled trial in Eastern India, J Pharm Pharm Sci, doi:10.18433/jpps32105.JournalPre-proof
Reis, Silva, Silva, Thabane, Milagres et al., Effect of early treatment with ivermectin among patients with COVID-19, N Engl J Med, doi:10.1056/NEJMoa2115869
Shrestha, Budhathoki, Khadka, Shah, Pokharel et al., Favipiravir versus other antiviral or standard of care for COVID-19 treatment: a rapid systematic review and metaanalysis, Virol J, doi:10.1186/s12985-020-01412-z
Singh, Weiss, Goodman, Fisk, Kulkarni et al., Niclosamide-A promising treatment for COVID-19, Br J Pharmacol, doi:10.1111/bph.15843
Siripongboonsitti, Muadchimkaew, Tawinprai, Issaranon, Meepholkij et al., Favipiravir treatment in non-severe COVID-19: promising results from multicenter propensity score-matched study (FAVICOV), Sci Rep, doi:10.1038/s41598-023-42195-x
Siripongboonsitti, Tawinprai, Cheirsilpa, Ungtrakul, Krisorakun et al., The real-world clinical outcomes of favipiravir treatment with telemedicine monitoring in preventing disease progression in mild to moderate COVID-19 patients: a retrospective cohort study, Medicina, doi:10.3390/medicina59061098
Trivedi, Lee, Meibohm, Applications of pharmacometrics in the clinical development and pharmacotherapy of anti-infectives, Expert Rev Clin Pharmacol, doi:10.1586/ecp.13.6
Udwadia, Singh, Barkate, Patil, Rangwala et al., Efficacy and safety of favipiravir, an oral RNA-dependent RNA polymerase inhibitor, in mild-to-moderate COVID-19: A randomized, comparative, open-label, multicenter, phase 3 clinical trial, Inter J Infect Dis, doi:10.1016/j.ijid.2020.11.142
Vallejos, Zoni, Bangher, Villamandos, Bobadilla et al., Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized, double-blind, placebo-controlled trial, BMC Infect Dis, doi:10.1186/s12879-021-06348-5
Watson, Kissler, Day, Grad, White, Characterizing SARS-CoV-2 Viral Clearance Kinetics to Improve the Design of Antiviral Pharmacometric Studies, Antimicrob Agents Chemother, doi:10.1128/aac.00192-22
Watson, Kisslerc, Daya, Gradc, Whitea, Optimal design for phase 2 studies of SARS-CoV-2 antiviral drugs, MedRxiv
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