Retracted: Meta-analysis of Randomized Trials of Ivermectin to Treat SARS-CoV-2 Infection

Abstract

Ivermectin is an antiparasitic drug being investigated for repurposing against SARS-CoV-2. Ivermectin showed in-vitro activity against SARS-COV-2 at high concentrations. This meta-analysis investigated ivermectin in 24 randomized clinical trials (3328 patients) identified through systematic searches of PUBMED, EMBASE, MedRxiv and trial registries. Ivermectin was associated with reduced inflammatory markers (C-Reactive Protein, d-dimer and ferritin) and faster viral clearance by PCR. Viral clearance was treatment dose- and duration-dependent. In 11 randomized trials of moderate/severe infection, there was a 56% reduction in mortality (Relative Risk 0.44 [95%CI 0.25-0.77]; p=0.004; 35/1064 (3%) deaths on ivermectin; 93/1063 (9%) deaths in controls) with favorable clinical recovery and reduced hospitalization. Many studies included were not peer reviewed and a wide range of doses were evaluated. Currently, WHO recommends the use of ivermectin only inside clinical trials. A network of large clinical trials is in progress to validate the results seen to date.

Meta-analytic magic, ivermectin, and socially responsible reporting

“…The review by Hill et al [3] placed the study by Niaee et al, [10] which enrolled patients with varying disease severity, in their mild COVID-19 group, generating a group of 'mild to moderate' disease. This analysis leaves the effect size significant for this group after removing the study by Elgazzar et al, [7] but based on a very small numbers of events; overall, the mortality benefit is not statistically significant.…”

“…Two were published in the American Journal of Therapeutics [1,2] and two are preprints in journals in the Oxford University Press stable. [3,4] The fifth is a recently released Cochrane review. [5] In three of the five reviews, the summary reports mortality benefits using very positive language despite low-quality evidence rendering such a conclusion highly uncertain.…”

COVID-19: an ‘extraterrestrial’ disease?

“…This point was already promoted by Dr A. Fauci as a conclusion of the flu pandemics of 2008-2009(Morens et al, 2008. Evidence is now emerging as for the potential effectiveness of re-purposed drugs (ivermectine (Hill et al, 2021), amantadine (Cortés-Borra and Aranda-Abreu, 2021), cofloctol (Belouzard et al, 2021)), nutritional supplementation (Alzaabi et al, 2021;Margolin et al, 2021), and new molecules (e.g. Plitidepsin (Varona et al, 2021)) at early stages of disease.…”

Ivermectin for COVID-19 in Peru: 14-fold reduction in nationwide excess deaths, p<0.002 for effect by state, then 13-fold increase after ivermectin use restricted

“…3 with more than 20 randomized clinical trials (RCTs) conducted for such IVM treatments. 3,43,44 Seven of eight meta-analyses of these IVM treatment RCTs reporting in 2021, all done using Cochrane analysis methodology, found significant [44][45][46][47][48] or possible 49,50 indications of IVM efficacy, with a mean 0.33 relative risk (RR) of mortality vs. controls. The eighth meta-analyses reported no efficacy for IVM, specifying a value of RR=1.1 for mortality, 51 but corrected that to RR=0.37 (a 63% mortality reduction) in a revised version after fixing switched treatment and control values for one key RCT.…”