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All Studies   Meta Analysis    Recent:   

Ivermectin as a SARS-CoV-2 Pre-Exposure Prophylaxis Method in Healthcare Workers: A Propensity Score-Matched Retrospective Cohort Study

Morgenstern et al., Cureus, doi:10.7759/cureus.17455 (date from preprint), NCT04832945
Apr 2021  
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Hospitalization 80% Improvement Relative Risk Case 74% primary Ivermectin  Morgenstern et al.  Prophylaxis Is prophylaxis with ivermectin beneficial for COVID-19? PSM retrospective 542 patients in Dominican Republic Fewer cases with ivermectin (p=0.008) c19ivm.org Morgenstern et al., Cureus, April 2021 Favorsivermectin Favorscontrol 0 0.5 1 1.5 2+
Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020
 
*, now with p < 0.00000000001 from 104 studies, recognized in 23 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments. c19ivm.org
Propensity matched retrospective prophylaxis study of healthcare workers in the Dominican Republic showing significantly lower cases with treatment, and no hospitalization with treatment (versus 2 in the PSM matched control group). The cases with treatment were mostly in the first week, with only one case in the second and third weeks, and none in the fourth week. There were no severe side effects. In post-hoc analysis, as the treatment group discontinued treatment over time, their protection also decreased. NCT04832945 (history).
This is the 49th of 104 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 1 sextillion).
51 studies are RCTs, which show efficacy with p=0.00000015.
risk of hospitalization, 80.0% lower, RR 0.20, p = 0.50, treatment 0 of 271 (0.0%), control 2 of 271 (0.7%), NNT 136, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), PSM.
risk of case, 74.0% lower, RR 0.26, p = 0.008, treatment 5 of 271 (1.8%), control 18 of 271 (6.6%), NNT 21, adjusted per study, PSM, multivariate Cox regression, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Morgenstern et al., 16 Apr 2021, retrospective, propensity score matching, Dominican Republic, peer-reviewed, 16 authors, dosage 200μg/kg weekly, trial NCT04832945 (history).
This PaperIvermectinAll
Ivermectin as a SARS-CoV-2 Pre-Exposure Prophylaxis Method in Healthcare Workers: A Propensity Score-Matched Retrospective Cohort Study
Jose Morgenstern, Jose N Redondo, Alvaro Olavarria, Isis Rondon, Santiago Roca, Albida De Leon, Juan Canela, Johnny Tavares, Miguelina Minaya, Oscar Lopez, Ana Castillo, Ana Placido, Rafael Cruz, Yudelka Merette, Marlenin Toribio, Juan Francisco
Cureus, doi:10.7759/cureus.17455
Background: Ivermectin is a drug that has been shown to be active against coronavirus disease 19 (COVID-19) in previous studies. Healthcare personnel are highly exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Therefore, we decided to offer them ivermectin as a pre-exposure prophylaxis (PrEP) method. Purpose: Primary outcome was to measure the number of healthcare workers with symptomatic SARS-CoV-2 infection and a positive reverse transcription polymerase chain reaction (RT-PCR) COVID-19 test in the ivermectin group and in the control group. Secondary outcome was to measure the number of sick healthcare workers with a positive RT-PCR COVID-19 test whose condition deteriorated and required hospitalization and/or an Intensive Care Unit (ICU), or who died, in the ivermectin group and in the control group. Material and methods: This observational and retrospective cohort study was carried out in two medical centers,
Additional Information Disclosures Human subjects: Consent was obtained or waived by all participants in this study. Grupo Rescue Ethics Committee issued approval ME-GRUR-328-2020. This study was submitted for consideration, comment, guidance and approval to the Grupo Rescue Ethics Committee before the Ivermectin pre-exposure prophylaxis started. . Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
References
Behera, Patro, Singh, Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: a matched case-control study, PLoS One, doi:10.1371/journal.pone.0247163
Biber, Mandelboim, Harmelin, Favorable outcome on viral load and culture viability using Ivermectin in early treatment of non-hospitalized patients with mild COVID-19 -a double-blind, randomized placebo-controlled trial, PREPRINT, doi:10.1101/2021.05.31.21258081
Bryant, Lawrie, Dowswell, Fordham, Mitchell et al., Ivermectin for prevention and treatment of COVID-19 infection: a systematic review, meta-analysis, and trial sequential analysis to inform clinical guidelines, Am J Ther, doi:10.1097/MJT.0000000000001402
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
Chahla, Ruiz, Ortega, A randomized trial -intensive treatment based in ivermectin and iota-carrageenan as pre-exposure prophylaxis for COVID-19 in healthcare agents, PREPRINT, doi:10.1101/2021.03.26.21254398
Guzzo, Furtek, Porras, Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects, J Clin Pharmacol, doi:10.1177/009127002237994
Kory, Meduri, Varon, Iglesias, Marik, Review of the emerging evidence demonstrating the efficacy of ivermectin in the prophylaxis and treatment of COVID-19, Am J Ther, doi:10.1097/MJT.0000000000001377
Krolewiecki, Lifschitz, Moragas, Antiviral effect of high-dose ivermectin in adults with COVID-19: a proof-of-concept randomized trial, EClinicalMedicine, doi:10.1016/j.eclinm.2021.100959
Lespine, Alvinerie, Sutra, Pors, Chartier, Influence of the route of administration on efficacy and tissue distribution of ivermectin in goat, Vet Parasitol, doi:10.1016/j.vetpar.2004.11.028
Morgenstern, Redondo, León, The use of compassionate ivermectin in the management of symptomatic outpatients and hospitalized patients with clinical diagnosis of Covid-19 at the Centro Medico Bournigal and at the Centro Medico Punta Cana, Grupo Rescue, Dominican Republic, from May 1 to, J Clin Trials, doi:10.1016/S0140-6736(07)61602-X
Muñoz, Ballester, Antonijoan, Safety and pharmacokinetic profile of fixed-dose ivermectin with an innovative 18mg tablet in healthy adult volunteers, PLoS Negl Trop Dis, doi:10.1371/journal.pntd.0006020
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