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Ivermectin study #42   Meta Analysis
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Unresolved symptoms 85% Imp. Relative Risk, 95% CI Unresolved symptoms (b) 63% Virological cure 76% Virological cure (b) 57% Virological cure (c) 63% Virological cure (d) 41% Time to viral- 24% Time to viral- (b) 9% Hospitalization time 1% no CI Hospitalization time (b) -4% no CI Ahmed: A five day course of ivermectin for the treatm.. Favors ivermectin Favors control
12/2 Early treatment study
Ahmed et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.11.191 (Peer Reviewed)
A five day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness
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Small 72 patient RCT of ivermectin and ivermectin + doxycycline showing faster recovery with ivermectin. The ivermectin + doxycycline group uses only a single dose of ivermectin vs. 5 daily doses for the ivermectin group.
Hospitalization time in this study does not indicate symptomatic recovery time - discharge was related to PCR- status (with tests only done weekly after day 7).
Ivermectin group: 12mg daily for 5 days
Ivermectin + doxycycline: 12mg ivermectin single dose, 200mg doxycycline + 100mg bid 4 days
risk of unresolved symptoms, 85.0% lower, RR 0.15, p = 0.09, treatment 0 of 17 (0.0%), control 3 of 19 (15.8%), relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), day 7, fever, ivermectin (5 days).
risk of unresolved symptoms, 62.7% lower, RR 0.37, p = 0.35, treatment 1 of 17 (5.9%), control 3 of 19 (15.8%), day 7, fever, ivermectin (1 day) + doxycycline.
risk of no virological cure, 75.6% lower, RR 0.24, p = 0.03, treatment 11 of 22 (50.0%), control 20 of 23 (87.0%), adjusted per study, day 7, ivermectin (5 days).
risk of no virological cure, 56.5% lower, RR 0.43, p = 0.22, treatment 16 of 23 (69.6%), control 20 of 23 (87.0%), adjusted per study, day 7, ivermectin (1 day) + doxycycline.
risk of no virological cure, 63.0% lower, RR 0.37, p = 0.02, treatment 5 of 22 (22.7%), control 14 of 23 (60.9%), adjusted per study, day 14, ivermectin (5 days).
risk of no virological cure, 41.2% lower, RR 0.59, p = 0.19, treatment 9 of 23 (39.1%), control 14 of 23 (60.9%), adjusted per study, day 14, ivermectin (1 day) + doxycycline.
time to viral-, 23.6% lower, relative time 0.76, p = 0.02, treatment 22, control 23, ivermectin (5 days).
time to viral-, 9.4% lower, relative time 0.91, p = 0.27, treatment 23, control 23, ivermectin (1 day) + doxycycline.
hospitalization time, 1.0% lower, relative time 0.99, ivermectin, not symptomatic recovery time, PCR- with tests only weekly after day 7.
hospitalization time, 4.1% higher, relative time 1.04, ivermectin + doxycycline, not symptomatic recovery time, PCR- with tests only weekly after day 7.
Ahmed et al., 12/2/2020, Double Blind Randomized Controlled Trial, Bangladesh, South Asia, peer-reviewed, mean age 42.0, 15 authors, dosage 12mg days 1-5, the ivermectin + doxycycline group took only a single dose of ivermectin.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. For an individual study the most serious outcome may have a smaller number of events and lower statistical signficance, however this provides the strongest evidence for the most serious outcomes when combining the results of many trials.
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