Small RCT comparing ivermectin 6mg & 12mg q84hr with lopinavir/ritonavir, showing a statistically significant and dose dependent effect of ivermectin on reducing the time to PCR-.
A twitter personality well known for negative attacks on ivermectin suggests that there are clinical results which should be prioritized here. The paper does not report mortality, hospitalization, progression, recovery, etc. The paper does report change in SpO
2 (Figure 3, ∆SpO
2), where a similar improvement with a smaller p value is seen with ivermectin, however this result is unadjusted and there are large differences between groups. Specifically, baseline SpO
2 is lower in the control group, giving the control group more room to improve, therefore the actual benefit of ivermectin is likely to be even larger than the benefit in ∆SpO
2 shown. The twitter personality would like to cherry pick an unadjusted individual symptom like cough, for which baseline values differ by ~2x.
Babalola et al., 1/6/2021, Double Blind Randomized Controlled Trial, Nigeria, Africa, peer-reviewed, baseline oxygen requirements 8.3%, 10 authors, dosage 12mg or 6mg q84h for two weeks, this trial compares with another treatment - results may be better when compared to placebo.
adjusted risk of viral+ at day 5, 63.9% lower, RR 0.36, p = 0.11, treatment 40, control 20, adjusted per study.
risk of no virological cure, 58.0% lower, RR 0.42, p = 0.01, treatment 20, control 20, 12mg - Cox proportional hazard model.
risk of no virological cure, 40.5% lower, RR 0.60, p = 0.12, treatment 20, control 20, 6mg - Cox proportional hazard model.
time to viral-, 49.2% lower, relative time 0.51, treatment 20, control 20, 12mg.
time to viral-, 34.4% lower, relative time 0.66, treatment 20, control 20, 6mg.
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.