Posted on 08/04/2021 4:43:38 PM PDT by gas_dr
Background
Ivermectin, an antiparasitic agent used to treat parasitic infestations, inhibits the replication of viruses in vitro. The molecular hypothesis of ivermectin's antiviral mode of action suggests an inhibitory effect on severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) replication in the early stages of infection. Currently, evidence on efficacy and safety of ivermectin for prevention of SARS‐CoV‐2 infection and COVID‐19 treatment is conflicting.
Objectives
To assess the efficacy and safety of ivermectin compared to no treatment, standard of care, placebo, or any other proven intervention for people with COVID‐19 receiving treatment as inpatients or outpatients, and for prevention of an infection with SARS‐CoV‐2 (postexposure prophylaxis).
Search methods
We searched the Cochrane COVID‐19 Study Register, Web of Science (Emerging Citation Index and Science Citation Index), medRxiv, and Research Square, identifying completed and ongoing studies without language restrictions to 26 May 2021.
Selection criteria
We included randomized controlled trials (RCTs) comparing ivermectin to no treatment, standard of care, placebo, or another proven intervention for treatment of people with confirmed COVID‐19 diagnosis, irrespective of disease severity, treated in inpatient or outpatient settings, and for prevention of SARS‐CoV‐2 infection.
Co‐interventions had to be the same in both study arms.
We excluded studies comparing ivermectin to other pharmacological interventions with unproven efficacy.
Data collection and analysis
We assessed RCTs for bias, using the Cochrane risk of bias 2 tool. The primary analysis excluded studies with high risk of bias. We used GRADE to rate the certainty of evidence for the following outcomes 1. to treat inpatients with moderate‐to‐severe COVID‐19: mortality, clinical worsening or improvement, adverse events, quality of life, duration of hospitalization, and viral clearance; 2. to treat outpatients with mild COVID‐19: mortality, clinical worsening or improvement, admission to hospital, adverse events, quality of life, and viral clearance; (3) to prevent SARS‐CoV‐2 infection: SARS‐CoV‐2 infection, development of COVID‐19 symptoms, adverse events, mortality, admission to hospital, and quality of life.
Main results
We found 14 studies with 1678 participants investigating ivermectin compared to no treatment, placebo, or standard of care. No study compared ivermectin to an intervention with proven efficacy. There were nine studies treating participants with moderate COVID‐19 in inpatient settings and four treating mild COVID‐19 cases in outpatient settings. One study investigated ivermectin for prevention of SARS‐CoV‐2 infection. Eight studies had an open‐label design, six were double‐blind and placebo‐controlled. Of the 41 study results contributed by included studies, about one third were at overall high risk of bias.
Ivermectin doses and treatment duration varied among included studies.
We identified 31 ongoing and 18 studies awaiting classification until publication of results or clarification of inconsistencies.
Ivermectin compared to placebo or standard of care for inpatient COVID‐19 treatment
We are uncertain whether ivermectin compared to placebo or standard of care reduces or increases mortality (risk ratio (RR) 0.60, 95% confidence interval (CI) 0.14 to 2.51; 2 studies, 185 participants; very low‐certainty evidence) and clinical worsening up to day 28 assessed as need for invasive mechanical ventilation (IMV) (RR 0.55, 95% CI 0.11 to 2.59; 2 studies, 185 participants; very low‐certainty evidence) or need for supplemental oxygen (0 participants required supplemental oxygen; 1 study, 45 participants; very low‐certainty evidence), adverse events within 28 days (RR 1.21, 95% CI 0.50 to 2.97; 1 study, 152 participants; very low‐certainty evidence), and viral clearance at day seven (RR 1.82, 95% CI 0.51 to 6.48; 2 studies, 159 participants; very low‐certainty evidence). Ivermectin may have little or no effect compared to placebo or standard of care on clinical improvement up to 28 days (RR 1.03, 95% CI 0.78 to 1.35; 1 study; 73 participants; low‐certainty evidence) and duration of hospitalization (mean difference (MD) −0.10 days, 95% CI −2.43 to 2.23; 1 study; 45 participants; low‐certainty evidence). No study reported quality of life up to 28 days.
Ivermectin compared to placebo or standard of care for outpatient COVID‐19 treatment
We are uncertain whether ivermectin compared to placebo or standard of care reduces or increases mortality up to 28 days (RR 0.33, 95% CI 0.01 to 8.05; 2 studies, 422 participants; very low‐certainty evidence) and clinical worsening up to 14 days assessed as need for IMV (RR 2.97, 95% CI 0.12 to 72.47; 1 study, 398 participants; very low‐certainty evidence) or non‐IMV or high flow oxygen requirement (0 participants required non‐IMV or high flow; 1 study, 398 participants; very low‐certainty evidence). We are uncertain whether ivermectin compared to placebo reduces or increases viral clearance at seven days (RR 3.00, 95% CI 0.13 to 67.06; 1 study, 24 participants; low‐certainty evidence). Ivermectin may have little or no effect compared to placebo or standard of care on the number of participants with symptoms resolved up to 14 days (RR 1.04, 95% CI 0.89 to 1.21; 1 study, 398 participants; low‐certainty evidence) and adverse events within 28 days (RR 0.95, 95% CI 0.86 to 1.05; 2 studies, 422 participants; low‐certainty evidence). None of the studies reporting duration of symptoms were eligible for primary analysis. No study reported hospital admission or quality of life up to 14 days.
Ivermectin compared to no treatment for prevention of SARS‐CoV‐2 infection
We found one study. Mortality up to 28 days was the only outcome eligible for primary analysis. We are uncertain whether ivermectin reduces or increases mortality compared to no treatment (0 participants died; 1 study, 304 participants; very low‐certainty evidence). The study reported results for development of COVID‐19 symptoms and adverse events up to 14 days that were included in a secondary analysis due to high risk of bias. No study reported SARS‐CoV‐2 infection, hospital admission, and quality of life up to 14 days.
Authors' conclusions
Based on the current very low‐ to low‐certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID‐19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.
Thanks for the link to Annie!
But that aside, corona viruses evolve so quickly it seems likely they will evolve around Ivermectin as fast as it did around the vaccines
Vaccines are designed with a specific virus in mind. The action of Ivermectin is more general, so if it works it’s likely to work with the variants.
Given that the virus mutates quickly, it’s likely that a variant that evades vaccines appears among vaccinated people.
The study is accurate by all medical standards. I though prefer the antidotal evidence for effectiveness. Oh, I’m also a pharmacist and frontline fill ivermectin and associated meds. I have first hand observations and follow up contact with patients that have been treated. For some, it doesn’t seem to matter and for others, it appears to help.... but was it the drug? There are too many mitigating factors to say ABSOLUTELY ivermectin made a difference. This person may have had a good outcome anyway w/o using the drug.
So, please, refrain from accusing someone of basically being a “¥^§$=/@#”. And also, the cost MAY be $10 if it is covered by your insurance. Cash is $300+ !!
I respect Cochrane. They seem to be more comprehensive in their analysis. I wish they would analyze VAERS reports. All the paranoid control freaks, political hacks, antivaxxers, media dupes, people with money in the game, quack m.d.s, on both sides of this issue is starting to get to be a terminal mass with no light but lots of heat.
The thing that worries me is the guy who gets up one morning with symptoms and then decides to self-medicate instead of seeking proper help.
If you take ivermectin or hydroxychloroquine to try and prevent infection and still get sick then you know it was not adequate in your case and you seek immediate professional attention.
It’s the delay that scares me... early treatment is important with covid.
Meanwhile in other news:
Finnish Firm Scores US Patent for Nasal Spray Drug That Includes Hydroxychloroquine & Ivermectin
https://freerepublic.com/focus/f-chat/3982046/posts
Stange if they use it in nasal spray , if it does not work against Covid-19.
The swamp is very afraid the truth will get a out.So they have to put out “uncertain” results like these.
Everyone knows it works, Dr, Pierre Kory designed the most effective proptocols on the use Of Ivermectin both and prophylaxis and early treatment for the Covid 19 infection. The inspiring fact also is that the therapy works against ALL VARIANTS of Covid 19. The vaccine does not.
All the paranoid control freaks, political hacks, antivaxxers, media dupes, people with money in the game, quack m.d.s, on both sides of this issue is starting to get to be a terminal mass with no light but lots of heat.
Dr Kory and others almost immediately had a successful treatment.
Very early it was clear that groups at higher risk have more stored iron. So it’s obvious to test something that removes iron from the body. Some claim Quercetin does so, and it was useful against a previous coronavirus. Recently, Italian researchers showed that it also works against the wuhan coronavirus.
The research with natural substances has been extremely slow. People with low vitamin K do worse, but there is very little research on that.
That’s the issue. It may have some limited usefulness it may not and it will take several studies over time to tease it out. What is clear is that it is. it the magic bullet that some seem to think it is
There you go posting an obvious conclusion. Be prepared for the wrath of people calling you fake and a liar.
The big problem with trying to study the effectiveness of any treatment for a weaponized virus that only has a 1:500 chance of death, for anyone under 75 and in reasonably good health, is that it is hard to determine if the treatment helped or if the patient would have recovered anyway.
Context is everything.
My own anecdote from January (before the vax were available), I saw my doc for an unrelated matter, and we had a brief chat about what he would recommend if I were to come down with the ‘rona. At the time, I was careing for an elderly relative in an assisted living facility, and the virus was just tearing through the place.
“Well, my first recommendation would be one of the monoclonals, as soon as you have symptoms”.
Great! I thought, problem solved!
“But the problem is, there’s limited availability, and you don’t meet the current criteria anyway...”
Long story short, and after I asked, he agreed that if the “mabs” weren’t available, he’d give me a scrip for ivermectin, with the warning that while he didn’t think it would hurt, he personally didn’t think it would do any good, either.
The point of this long-winded post being, when someone asks “does this stuff work”, we have to understand “compared to what?” Compared to waiting at home until your O2 sat is 84? I’ll take my chances with something that is unproven, but with a great safety profile. Compared to Lilly’s or Regeneron’s mabs? Yeah, I’ll have those.
Indeed hope that is true. I am in the 50 and younger group and deem it foolish to take a non-properly vetted treatment. I have obtained ivermectin and HCQ from telemed doctors and that is a fine - trust in the meds more than the ‘vaccines’ - but ultimately my trust does not rest on medicine. Cheers FRiend
Its quite a mess isn’t it?
How do you know that’s what you’re actually getting?
‘Overall, the reliable evidence available does not support the use ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.’
***************************
Replace the word ‘ivermectin’ with ‘any of the vaccines’ and you have an undeniable fact.
*** On the other hand, at least the trolls sure to swarm your post won’t have worms! ***
Not sure if I had worms or not, but I took ivermectin as a prophylaxis for Covid and by the second dose, fatigue which has plagued me for months, and what I hoped was allergies, or a summer cold/cough was gone. My O² stats which had been 96-97 are now 99.
I did the 1st dose, 48 hrs later, 2nd dose, and once weekly afterwards thing. I have only done the 1st, and 2nd dose, and in five days will begin the once a week for 3 weeks. I have an autoimmune blood disorder, and choose to eschew the “vaccines” for what I consider a more conservative route.
I was nervous about taking it, but am glad I did. YMMV.
Thanks for your anecdotal report, sock.
Glad to hear you are doing/feeling much better.
It’s a shame this proven, effective drug is difficult to obtain, in some places.
Do you really think the US Patent and Trademark Office evaluates the medical efficacy of these applications?
Good to read. Any chance you may have had COVID and didn’t know it?
Weeeheeeeheeeeeheeee!
I’m taking it too.
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