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

Ivermectin is an antiparasitic drug being investigated for repurposing against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Ivermectin showed in vitro activity against SARS-COV-2, but only at high concentrations. This meta-analysis investigated ivermectin in 23 randomized clinical trials (3349 patients) identified through systematic searches of PUBMED, EMBASE, MedRxiv, and trial registries. The primary meta-analysis was carried out by excluding studies at a high risk of bias. Ivermectin did not show a statistically significant effect on survival (risk ratio [RR], 0.90; 95% CI, 0.57 to 1.42; P =.66) or hospitalizations (RR, 0.63; 95% CI, 0.36 to 1.11; P =.11). Ivermectin displayed a borderline significant effect on duration of hospitalization in comparison with standard of care (mean difference, –1.14 days; 95% CI, –2.27 to –0.00; P =.05). There was no significant effect of ivermectin on time to clinical recovery (mean difference, –0.57 days; 95% CI, –1.31 to 0.17; P =.13) or binary clinical recovery (RR, 1.19; 95% CI, 0.94 to 1.50; P =.15). Currently, the World Health Organization 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. [ABSTRACT FROM AUTHOR]