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Clinical Summary

Ivermectin Beneficial in Improving COVID-19 Outcomes, Suggests Meta-analysis

Takeaway

  • A meta-analysis showed a 56% reduction in mortality along with improved viral clearance and clinical recovery in patients receiving ivermectin vs standard of care (control) treatment for SARS-CoV-2 infection.

Why this matters

  • Findings provide combined results of published and unpublished randomised controlled trials (RCTs) to inform current guidelines on the use of ivermectin for SARS-CoV-2 infection.

Study details

  • UK researchers conducted a meta-analysis of 24 RCTs including 3328 patients with SARS-CoV-2 infection.
  • Primary outcome: all-cause mortality from randomisation to the end of follow-up.
  • Funding: Rainwater Foundation.

Key results

  • Ivermectin vs control showed:
    • reduced mortality risk (risk ratio [RR], 0.44; 95% CI, 0.25-0.77; P=.004; I2=43%);
    • improved viral clearance at day 7 (RR, 1.35; 95% CI, 1.05-1.75; P=.02; I2=56%); and
    • improved clinical recovery (RR, 1.29; 95% CI, 1.12-1.47; P=.0003; I2=80%).
  • Among patients with mild/moderate infection, ivermectin reduced the risk of mortality by 70% (RR, 0.30; 95% CI, 0.15-0.58; P=.0004) vs control.
  • Ivermectin vs control reduced:
    • time to viral clearance (mean difference, −3 days; P=.003; I2=95%);
    • time to clinical recovery (mean difference, −1.58 days; P=.01; I2=86%); and
    • length of hospitalisation (mean difference, −4.27 days; P=.05; I2=97%).

Limitations

  • Included studies differed in dosage and treatment duration.
  • Many included trials were not peer-reviewed.
  • The standard of care used as the control arm varied between studies.
 

Hill A, Garratt A, Levi J, Falconer J, Ellis L, McCann K, Pilkington V, Qavi A, Wang J, Wentzel H. Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection. Open Forum Infect Dis. 2021 Jul 20 [Epub ahead of print]. doi: 10.1093/ofid/ofab358. View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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