Meta-Analyses Do Not Establish Improved Mortality With Ivermectin Use in COVID-19

Rothrock, Steven G.; Weber, Kurt; Giordano, Philip; Barneck, Mitchell D.

doi:10.1097/mjt.0000000000001461

Cited by 12 publications

(29 citation statements)

References 57 publications

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“…Contrary to claims, 1 inclusion criteria were stated in “Methods” section, 2 the a priori protocol, 5 and implicitly in the “Design” column of Table 1, 2 indicating the quasi-randomized trials.…”

Section: Methodsmentioning

confidence: 99%

“…Rothrock et al 1 made a similarly fallacious argument regarding inclusion of trials making multiple comparisons. The review team 2 only extracted data for outcomes for our comparison of “ivermectin” versus “no ivermectin.” Whether the primary sources overanalyze their data or not is immaterial.…”

Section: Statistical Power Randomization and Imbalance Of Covariatesmentioning

confidence: 99%

“…These criticisms 1 would condemn the entire library of systematic reviews or evidence syntheses. This is at odds with evidence synthesis being at the top of the hierarchical pyramid of research evidence.…”

Section: Statistical Power Randomization and Imbalance Of Covariatesmentioning

confidence: 99%

“…The “Commentary” by Rothrock et al 1 includes a critique of our Systematic Review 2 and Letter. 3 They also introduce a misleading account of ivermectin safety and proposals for individual participant data (IPD) in meta-analysis that are impractical in a health emergency.…”

mentioning

confidence: 99%

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Re: “Commentary” by Rothrock et al. “Meta-Analyses Did Not Establish Improved Mortality With Ivermectin Use in COVID-19”

Bryant¹,

Lawrie²,

Fordham³

et al. 2021

American Journal of Therapeutics

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Section: Methodsmentioning

confidence: 99%

Section: Statistical Power Randomization and Imbalance Of Covariatesmentioning

confidence: 99%

Section: Statistical Power Randomization and Imbalance Of Covariatesmentioning

confidence: 99%

mentioning

confidence: 99%

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Re: “Commentary” by Rothrock et al. “Meta-Analyses Did Not Establish Improved Mortality With Ivermectin Use in COVID-19”

Bryant¹,

Lawrie²,

Fordham³

et al. 2021

American Journal of Therapeutics

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“…Another limitation is that SFK does not report the indication for the prescription or dispensation, so it is possible that some of the dispensations were not related to scabies. For example, ivermectin could also be prescribed as a drug against COVID-19, while it is proven not to be effective [15,16]. This could explain the sudden rise of ivermectin dispensations at the end of 2021.…”

Section: Plos Onementioning

confidence: 99%

Increasing incidence of reported scabies infestations in the Netherlands, 2011–2021

et al. 2022

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Introduction Several Public Health Services and general practitioners in the Netherlands observed an increase in scabies in the Netherlands. Since individual cases of scabies are not notifiable in the Netherlands, the epidemiological situation is mostly unknown. To investigate the scabies incidence in the Netherlands, we described the epidemiology of scabies between 2011 and 2021. Methods Two national data sources were analysed descriptively. One data source obtained incidence data of scabies (per 1,000 persons) of persons consulting in primary care from 2011–2020. The other data source captured the number of prescribed scabicides in the Netherlands from 2011–2021. To describe the correlation between the incidence of diagnoses and the number of dispensations between 2011 and 2020, we calculated a correlation coefficient. Results The incidence of reported scabies has increased by more than threefold the last decade (2011–2020), mainly affecting adolescents and (young) adults. This was also clearly reflected in the fivefold increase in dispensations of scabicide medication during 2011–2021. The incidence and dispensations were at an all-time high in 2021. We found a strong correlation between the reported incidence and the number of dispensations between 2011 and 2020. Conclusions More awareness on early diagnosis, proper treatment and treatment of close contacts is needed.

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Ivermectin for preventing and treating COVID-19

Popp

Reis

Schießer

et al. 2022

Cochrane Database of Systematic Reviews

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Background Ivermectin, an antiparasitic agent, 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 early stages of infection. Currently, evidence on ivermectin for prevention of SARS‐CoV‐2 infection and COVID‐19 treatment is conflicting. Objectives To assess the efficacy and safety of ivermectin plus standard of care compared to standard of care plus/minus 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), WHO COVID‐19 Global literature on coronavirus disease, and HTA database weekly to identify completed and ongoing trials without language restrictions to 16 December 2021. Additionally, we included trials with > 1000 participants up to April 2022. Selection criteria We included randomized controlled trials (RCTs) comparing ivermectin to standard of care, placebo, or another proven intervention for treatment of people with confirmed COVID‐19 diagnosis, irrespective of disease severity or treatment setting, and for prevention of SARS‐CoV‐2 infection. Co‐interventions had to be the same in both study arms. For this review update, we reappraised eligible trials for research integrity: only RCTs prospectively registered in a trial registry according to WHO guidelines for clinical trial registration were eligible for inclusion. Data collection and analysis We assessed RCTs for bias, using the Cochrane RoB 2 tool. We used GRADE to rate the certainty of evidence for outcomes in the following settings and populations: 1) to treat inpatients with moderate‐to‐severe COVID‐19, 2) to treat outpatients with mild COVID‐19 (outcomes: mortality, clinical worsening or improvement, (serious) adverse events, quality of life, and viral clearance), and 3) to prevent SARS‐CoV‐2 infection (outcomes: SARS‐CoV‐2 infection, development of COVID‐19 symptoms, admission to hospital, mortality, adverse events and quality of life). Main results We excluded seven of the 14 trials included in the previous review version; six were not prospectively registered and one was non‐randomized. This updated review includes 11 trials with 3409 participants investigating ivermectin plus standard of care compared to standard of care plus/minus placebo. No trial investigated ivermectin for prevention of infection or compared ivermectin to an intervention with proven efficacy. Five trials treated participants with moderate COVID‐19 (inpatient settings); six treated mild COVID‐19 (outpatient settings). Eight trials were double‐bli...

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Meta-Analyses Do Not Establish Improved Mortality With Ivermectin Use in COVID-19

Cited by 12 publications

References 57 publications

Re: “Commentary” by Rothrock et al. “Meta-Analyses Did Not Establish Improved Mortality With Ivermectin Use in COVID-19”

Re: “Commentary” by Rothrock et al. “Meta-Analyses Did Not Establish Improved Mortality With Ivermectin Use in COVID-19”

Increasing incidence of reported scabies infestations in the Netherlands, 2011–2021

Ivermectin for preventing and treating COVID-19

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