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Ivermectin meta
5/6 Early, Late, PrEP, PEP
Covid Analysis (Preprint) (meta analysis)
Ivermectin for COVID-19: real-time meta analysis of 53 studies
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• 98% of the 53 studies to date report positive effects (25 statistically significant in isolation).
• Random effects meta-analysis with pooled effects shows 81% and 85% improvement for early treatment and prophylaxis (RR 0.19 [0.10-0.39] and 0.15 [0.09-0.25]). Results are similar after exclusion based sensitivity analysis, with 83% and 87% improvement (RR 0.17 [0.11-0.25] and 0.13 [0.07-0.25]).
• 76% and 80% lower mortality is observed for all treatment delays and for early treatment (RR 0.24 [0.14-0.42] and 0.20 [0.06-0.60]).
• 96% of the 27 Randomized Controlled Trials (RCTs) report positive effects, with an estimated improvement of 74% and 83% for early treatment and prophylaxis (RR 0.26 [0.16-0.42] and 0.17 [0.05-0.61]).
• The probability that an ineffective treatment generated results as positive as the 53 studies to date is estimated to be 1 in 167 trillion (p = 0.000000000000006). It is extremely unlikely that the observed results could have occurred by chance.
• Heterogeneity arises from many factors including treatment delay, patient population, the effect measured, variants, and treatment regimens. The consistency of positive results across a wide variety of cases is remarkable. Heterogeneity is low when looking at specific cases, for example early treatment mortality.
• All data to reproduce this paper and the sources are in the appendix. See [Bryant, Hill, Kory, Lawrie, Nardelli] for other meta analyses, all with similar results confirming effectiveness.
ImprovementStudies AuthorsPatients
Early treatment 81% [61‑90%] 191771,962
Late treatment 43% [27‑56%] 201436,831
Prophylaxis 85% [75‑91%] 141088,789
Mortality 76% [58‑86%] 191577,292
RCTs only 64% [48‑76%] 272464,849
All studies 72% [64‑78%] 5342817,582
Evidence base used for other COVID-19 approvals
Remdesivir (USA)11,06331%
Casiri/imdevimab (USA)179966%
Budesonide (UK)11,77917%
Ivermectin evidence5317,582 72% [64‑78%]

Details of all 90 studies    Meta analysis
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