Single-dose oral ivermectin in mild and moderate COVID-19 (RIVET-COV): A single-centre randomized, placebo-controlled trial

Mohan, Anant; Tiwari, Pawan; Suri, Tejas M; Mittal, Saurabh; Patel, Ankit; Jain, Avinash; Velpandian, Thirumurthy; Das, Ujjalkumar; Pandey, Ravindra Mohan; Shelke, Sushil Suresh; Singh, Angel Rajan; Bhatnagar, Sushma; Masih, Shet; Mahajan, Siddharth; Dwivedi, Tanima; Sahoo, Biswajeet; Pandit, Anuja; Bhopale, Shweta; Vig, Saurabh; Gupta, Ritu; Madan, Karan; Hadda, Vijay; Gupta, Nishkarsh; Garg, Rakesh; Meena, Ved Prakash; Guleria, Randeep

doi:10.1016/j.jiac.2021.08.021

Cited by 40 publications

(30 citation statements)

References 18 publications

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“…A total of 4 RCTs, including 1125 COVID-19 patients, reported an incidence of patients recovered in their studies (Fig. 3 D) [ 19 , 37 , 38 , 42 ]. The pooled log OR was 0.11 (95% CI − 0.22–0.45) with low heterogeneity (I^2 = 13.84%, Tau = 0.02).…”

Section: Resultsmentioning

confidence: 99%

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Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients

Shafiee

Athar

Gargari

et al. 2022

Virol J

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Background We conducted a systematic review and meta-analysis to evaluate the efficacy of ivermectin for COVID-19 patients based on current peer-reviewed RCTs and to address disputes over the existing evidence. Methods MEDLINE (Pubmed), Scopus, Web of Science, Cochrane library, Google scholar and Clinicaltrials.gov were searched for RCTs assessing the efficacy of Ivermectin up to 20 February 2022. A systematic review and meta-analysis of studies was performed based on the PRISMA 2020 statement criteria. Results 19 and 17 studies were included in this systematic review and meta-analysis, respectively. There was no significant difference in progression to severe disease (log OR − 0.27 [95% CI − 0.61 to 0.08], I2 = 42.29%), negative RT-PCR (log OR 0.25 [95% CI − 0.18–0.68], I2 = 58.73%), recovery (log OR 0.11 [95% CI − 0.22–0.45], I2 = 13.84%), duration of hospitalization (SMD − 0.40 [95% CI − 0.85–0.06], I2 = 88.90%), time to negative RT-PCR (SMD − 0.36 [95% CI − 0.89–0.17], I2 = 46.2%), and viral load (SMD -0.17 [95% CI -0.45 to 0.12], I^2 = 0%). It is worth noting that, based on low-certainty evidence, ivermectin may possibly reduce mortality (log OR − 0.67 [95% CI − 1.20 to − 0.13], I2 = 28.96%). However, studies with a higher risk of bias were more likely to indicate positive effects on the efficacy of this drug, according to our subgroup analyses based on study quality. Conclusion Ivermectin did not have any significant effect on outcomes of COVID-19 patients and as WHO recommends, use of ivermectin should be limited to clinical trials.

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Section: Resultsmentioning

confidence: 99%

“…(Fig. 3 G) [ 20 , 42 ]. The pooled SMD was − 0.17 (95% CI − 0.45–0.12) with low heterogeneity (I^2 = 0%, Tau = 0.00) .…”

Section: Resultsmentioning

confidence: 99%

Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients

Shafiee

Athar

Gargari

et al. 2022

Virol J

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“…See Table 1 for more details. In the randomized controlled study in India ( n = 125) ( Mohan et al, 2021 ), patients hospitalized with mild to moderate COVID-19 were divided into three groups for a single oral formulation of IVM at a dose of 24 mg or 12 mg, or placebo in a 1:1:1 ratio, and it was ultimately found that the IVM group did not significantly increase negative RT-PCR responses. In a randomized controlled study conducted in Spain ( n = 24) ( Chaccour et al, 2021 ), patients received a single oral dose of IVM (400 μg/kg) and placebo, followed by RT-PCR, which revealed no difference in the proportion of PCR-positive patients between the IVM and control groups.…”

Section: Resultsmentioning

confidence: 99%

Is Ivermectin Effective in Treating COVID-19?

2022

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Coronavirus disease 2019 was first discovered in December 2019 and subsequently became a global pandemic with serious political, economic, and social implications worldwide. We urgently need to find drugs that can be effective against COVID-19. Among the many observational studies, ivermectin has attracted the attention of many countries. Ivermectin is a broad-spectrum antiparasitic drug that also has some antiviral effects. We reviewed studies related to ivermectin for the treatment of COVID-19 over the last 2 years (2019.12–2022.03) via search engines such as PubMed, Web of Science, and EBSCOhost. Seven studies showed a lower mortality rate in the ivermectin group than in the control group, six studies found that the ivermectin group had a significantly fewer length of hospitalization than the control group, and eight studies showed better negative RT-PCR responses in the IVM group than in the control group. Our systematic review indicated that ivermectin may be effective for mildly to moderately ill patients. There is no clear evidence or guidelines to recommend ivermectin as a therapeutic agent for COVID-19, so physicians should use it with caution in the absence of better alternatives in the clinical setting, and self-medication is not recommended for patients.

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“…In the study conducted by Popp et al ., 50 the record on the presence of adverse reactions at 10, 14, and 28 days was not conclusive. Mohan et al ., 55 in their study, recorded a frequency of abdominal pain of 11.2%; they did not detect serious adverse events with doses of 12 and 24 mg of ivermectin. Cruciani et al ., 48 in his meta-analysis, describe an estimated frequency between 1% and 2%.…”

Section: Drug Used For Self-medication In Covid-19mentioning

confidence: 83%

Drug safety of frequently used drugs and substances for self-medication in COVID-19

Baracaldo-Santamaría

Pabón-Londoño

Rojas-Rodriguez

2022

Therapeutic Advances in Drug Safety

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During the COVID-19 pandemic, the behavior of self-medication has increased. The dissemination of misleading information regarding the efficacy of certain drugs or substances for the prevention and treatment of COVID-19 has been the major contributing factor for this phenomenon. Alongside with the increase in self-medication behavior, the inherent risks to this act such as drug–drug interactions, adverse events, drug toxicity, and masking of symptoms have also increased. Self-medication in the context of COVID-19 has led to drug misuse leading in some cases to the development of fatal adverse drug reactions. It is important that during this ongoing pandemic drugs with potential clinical efficacy against COVID-19 are adequately analyzed regarding their efficacy, safety, and monitoring. The aim of this review is to describe the available evidence regarding the efficacy, safety, and monitoring of the drugs and substances that have been shown to be frequently used for self-medication in patients with COVID-19 (hydroxychloroquine, non-steroidal anti-inflammatory drugs, ivermectin, azithromycin, vitamins, aspirin, and chlorine dioxide) to adequately characterize their risks, safe use, monitoring strategies, and to reinforce the concept that these substances should not be used for self-medication and require a medical prescription. Plain Language Summary Drug safety of frequently used drugs and substances for self-medication in COVID-19 Dissemination of information about potential COVID-19 treatments has led individuals to self-medicate and expose themselves to risks such as drug–drug interactions, side effects, antibiotic resistance, and misdiagnosis. There is a need to review the medical literature to evaluate the safety and efficacy of the drugs and substances commonly used by the population for the treatment and prevention of SARS CoV-2 infection. In this review, we included drugs that are frequently used for self-medication and commonly advertised such as ivermectin, hydroxychloroquine, chlorine dioxide, azithromycin, and non-steroidal anti-inflammatory drugs, among others. A brief introduction of the drug and its mechanism of action, followed by a summary of the efficacy in COVID-19 and safety, will be described for each drug in order to promote their responsible use.

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Single-dose oral ivermectin in mild and moderate COVID-19 (RIVET-COV): A single-centre randomized, placebo-controlled trial

Cited by 40 publications

References 18 publications

Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients

Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients

Is Ivermectin Effective in Treating COVID-19?

Drug safety of frequently used drugs and substances for self-medication in COVID-19

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