Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial

Mahmud, Reaz; Rahman, Motlabur; Alam, Iftikher; Ahmed, Kazi Gias Uddin; Kabir, Ahmedul; Sayeed, S K Jakaria Been; Rassel, Mohammad Aftab; Monayem, Farhana Binte; Islam, Shahidul; Islam, Mohammad Monirul; Barshan, Anindita Das; Hoque, M M; Mallik, MU; Yusuf, Abdullah; Hossain, Mohammad Zaid

doi:10.1177/03000605211013550

Cited by 88 publications

(72 citation statements)

References 25 publications

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“…Mahmud et al (15) found lower 14 th day RTPCR positivity rate in intervention group (7.6%) (received tablet ivermectin 12mg on day 1 and tablet doxycycline 100mg twice daily for 5 days) compared to the placebo group (20.0%) which was unlike our observations. However, due to the use of different intervention and day of RTPCR testing, results of Mahmud et al (15) and our study is not completely comparable. Moreover, it has been suggested that prolonged viral RNA shedding may continue for weeks after recovery leading to a false positive RT-PCR report even though the patient may not be infectious anymore (26).…”

Section: Discussioncontrasting

confidence: 81%

“…Considering use of ivermectin in treatment of COVID-19 patients, several randomised controlled trials (RCTs) documented its beneficial role either as an additional monotherapy or in combination with doxycycline irrespective of severity of the disease (13)(14)(15). COVID-19 patients treated with ivermectin reported to have decreased duration of symptoms, days to COVID negativity (DTN), lower viral load, mortality rate and higher SPO2%, platelet count and improvement of other prognostic laboratory parameters (13)(14)(15)(16)(17). A metanalysis (18) and several prior observational studies (19)(20)(21) have also documented similar observations.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, most prior RCTs either used a 5-day oral regimen (13,14) or a parenteral regimen (17) of ivermectin. Other RCTs used either a single oral dose of ivermectin alone (16) or in combination with doxycycline (15). Therefore, the effect of a two consecutive day oral ivermectin regimen in COVID-19 is yet to be explored by any RCT.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Ivermectin as a Potential Treatment for Mild to Moderate COVID-19: A Double-Blind Randomized Placebo Controlled Trial in Eastern India

et al. 2021

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Background: There has been a growing interest in ivermectin ever since it was reported to have an in-vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This trial was conducted to test the efficacy of ivermectin in mild and moderate coronavirus disease 19 (COVID-19). Methods: A double blind, parallel, randomised, placebo-controlled trial conducted among adult COVID-19 patients with mild to moderate disease severity on admission in a COVID dedicated tertiary healthcare of eastern India. Enrolment was done between 1st August and 31st October 2020. On day 1 and 2 post enrolment, patients in the intervention arm received ivermectin 12 mg while the patients in the non-interventional arm received placebo tablets. Results: About one-fourth (23.6%) of the patients in the intervention arm and one-third (31.6%) in the placebo arm were tested reverse transcriptase polymerase chain reaction (RTPCR) negative for SARS-CoV-2 on 6th day. Although this difference was found to be statistically insignificant [rate ratio (RR): 0.8; 95% confidence interval (CI): 0.4-1.4; p=0.348]. All patients in the ivermectin group were successfully discharged. In comparison the same for the placebo group was observed to be 93%. This difference was found to be statistically significant (RR: 1.1; 95% CI; 1.0-1.2; p=0.045). Conclusions: Inclusion of ivermectin in treatment regimen of mild to moderate COVID-19 patients could not be said with certainty based on our study results as it had shown only marginal benefit in successful discharge from the hospital with no other observed benefits.

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Section: Discussioncontrasting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Evaluation of Ivermectin as a Potential Treatment for Mild to Moderate COVID-19: A Double-Blind Randomized Placebo Controlled Trial in Eastern India

et al. 2021

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“…Overall, based on the current literature, a 10-day combination therapy of IVM, doxycycline and zinc will not only improve symptoms [6,7] but also accelerate recovery from COVID-19. We have chosen a safe IVM dosage approved for parasites of 36mg over 10 days, and this dose has been shown to be both effective and safe in COVID-19 treatments [38].…”

Section: Discussionmentioning

confidence: 98%

Effectiveness of Ivermectin-Based Multidrug Therapy in Severe Hypoxic Ambulatory COVID-19 Patients

Hazan¹,

Davé²,

Gunaratne

et al. 2021

Preprint

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Ivermectin is a safe, inexpensive and effective early COVID-19 treatment validated in 20+ RCTs. Having developed combination therapies for Helicobacter pylori, we tested various COVID-19 combinations and describe the most effective. In 24 consecutive COVID-19 subjects with high risk features, hypoxia and untreated moderate-severe symptoms averaging 9 days, we trialed this novel combination comprising ivermectin, doxycycline, zinc, and Vitamins D and C. It was highly effective. All subjects resolved symptoms in 11 days on average, and oxygen saturation improved in 24hrs (87.4% to 93.1%, p=0.001). Hospitalizations and deaths were significantly fewer (p<0.002 or 0.05, respectively) than in background-matched controls from the CDC database. Triple combination therapy is safe and effective even in moderate-severe patients with hypoxia treated in the outpatient setting.

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“…Current evidence regarding the efficacy of ivermectin for the treatment of COVID-19 patients is still unclear [21,22], and the WHO recommends its use only for clinical studies [23]. Therefore, the aim of this study is to evaluate the efficacy of ivermectin in preventing hospitalizations in patients with COVID-19 (IVERCOR-COVID19) [24].…”

Section: Introductionmentioning

confidence: 99%

Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized, double-blind, placebo-controlled trial

Vallejos¹,

Zoni²,

Bangher³

et al. 2021

BMC Infect Dis

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Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has changed our lives. The scientific community has been investigating re-purposed treatments to prevent disease progression in coronavirus disease (COVID-19) patients. Objective To determine whether ivermectin treatment can prevent hospitalization in individuals with early COVID-19. Design, setting and participants: A randomized, double-blind, placebo-controlled study was conducted in non-hospitalized individuals with COVID-19 in Corrientes, Argentina. Patients with SARS-CoV-2 positive nasal swabs were contacted within 48 h by telephone to invite them to participate. The trial randomized 501 patients between August 19th 2020 and February 22nd 2021. Intervention Patients were randomized to ivermectin (N = 250) or placebo (N = 251) arms in a staggered dose, according to the patient’s weight, for 2 days. Main outcomes and measures The efficacy of ivermectin to prevent hospitalizations was evaluated as primary outcome. We evaluated secondary outcomes in relationship to safety and other efficacy end points. Results The mean age was 42 years (SD ± 15.5) and the median time since symptom onset to the inclusion was 4 days [interquartile range 3–6]. The primary outcome of hospitalization was met in 14/250 (5.6%) individuals in ivermectin group and 21/251 (8.4%) in placebo group (odds ratio 0.65; 95% confidence interval, 0.32–1.31; p = 0.227). Time to hospitalization was not statistically different between groups. The mean time from study enrollment to invasive mechanical ventilatory support (MVS) was 5.25 days (SD ± 1.71) in ivermectin group and 10 days (SD ± 2) in placebo group, (p = 0.019). There were no statistically significant differences in the other secondary outcomes including polymerase chain reaction test negativity and safety outcomes. Limitations Low percentage of hospitalization events, dose of ivermectin and not including only high-risk population. Conclusion Ivermectin had no significant effect on preventing hospitalization of patients with COVID-19. Patients who received ivermectin required invasive MVS earlier in their treatment. No significant differences were observed in any of the other secondary outcomes. Trial registration ClinicalTrials.gov NCT04529525.

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Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial

Cited by 88 publications

References 25 publications

Evaluation of Ivermectin as a Potential Treatment for Mild to Moderate COVID-19: A Double-Blind Randomized Placebo Controlled Trial in Eastern India

Evaluation of Ivermectin as a Potential Treatment for Mild to Moderate COVID-19: A Double-Blind Randomized Placebo Controlled Trial in Eastern India

Effectiveness of Ivermectin-Based Multidrug Therapy in Severe Hypoxic Ambulatory COVID-19 Patients

Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized, double-blind, placebo-controlled trial

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