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

Mohan et al., Journal of Infection and Chemotherapy, doi:10.1016/j.jiac.2021.08.021 (date from preprint), RIVET-COV, CTRI/2020/06/026001

Feb 2021

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Ivermectin for COVID-19

4th treatment shown to reduce risk in August 2020

^*, now known with p < 0.00000000001 from 102 studies, recognized in 22 countries.

Lower risk for mortality, ventilation, ICU admission, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine complementary and synergistic treatments. ^* >10% efficacy in meta analysis with ≥3 clinical studies.

4,100+ studies for 60+ treatments. c19ivm.org

RCT in India with low risk patients, comparing 24mg ivermectin, 12mg ivermectin, and placebo showing non-statistically significant improvements in recovery and PCR+ status (day 5 both arms, day 7 24mg only) with treatment, and showing greater improvement for the higher dose arm. Viral load decline was similar in all arms - absolute values are lower for ivermectin in a dose-dependent manner, however the baseline value for the ivermectin groups was lower, leaving less room for change. There were no deaths or use of mechanical ventilation. There were no serious adverse events. Note that our pre-specified protocol prioritizes clinical outcomes over PCR results.

Viral load measured by PCR may not accurately reflect infectious virus measured by viral culture. Porter show that viral load early in infection was correlated with infectious virus, but viral load late in infection could be high even with low or undetectable infectious virus. Assessing viral load later in infection may underestimate reductions in infectious virus with treatment.

This is the 16th of 49 COVID-19 RCTs for ivermectin, which collectively show efficacy with p=0.00000038.

This is the 35th of 102 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 560 quintillion).

1. Porter et al., The ratio between SARS-CoV-2 RNA viral load and culturable viral titer differs depending on stage of infection, medRxiv, doi:10.1101/2023.07.06.23292300.medrxiv.org, doi.org.

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risk of no discharge at day 14, 62.5% lower, RR 0.38, p = 0.27, treatment 2 of 40 (5.0%), control 6 of 45 (13.3%), NNT 12, 24mg.

risk of no discharge at day 14, 43.8% lower, RR 0.56, p = 0.49, treatment 3 of 40 (7.5%), control 6 of 45 (13.3%), NNT 17, 12mg.

risk of clinical worsening, 32.5% lower, RR 0.68, p = 0.72, treatment 3 of 40 (7.5%), control 5 of 45 (11.1%), NNT 28, 24mg.

risk of clinical worsening, 55.0% lower, RR 0.45, p = 0.44, treatment 2 of 40 (5.0%), control 5 of 45 (11.1%), NNT 16, 12mg.

risk of no viral clearance, 23.8% lower, RR 0.76, p = 0.18, treatment 21 of 40 (52.5%), control 31 of 45 (68.9%), NNT 6.1, day 5, 24mg, primary outcome.

risk of no viral clearance, 5.6% lower, RR 0.94, p = 0.82, treatment 26 of 40 (65.0%), control 31 of 45 (68.9%), NNT 26, day 5, 12mg.

risk of no viral clearance, 10.3% lower, RR 0.90, p = 0.65, treatment 20 of 36 (55.6%), control 26 of 42 (61.9%), NNT 16, day 7, 24mg.

risk of no viral clearance, 3.2% higher, RR 1.03, p = 1.00, treatment 23 of 36 (63.9%), control 26 of 42 (61.9%), day 7, 12mg.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Mohan et al., 2 Feb 2021, Double Blind Randomized Controlled Trial, India, peer-reviewed, 27 authors, study period 28 July, 2020 - 29 September, 2020, average treatment delay 5.0 days, dosage 400μg/kg single dose, 200μg/kg also tested, trial CTRI/2020/06/026001 (RIVET-COV).

This Paper Ivermectin All

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

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

Journal of Infection and Chemotherapy, doi:10.1016/j.jiac.2021.08.021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

CONFLICTS OF INTEREST: None to declare

References

Ahmed, Karim, Ross, Hossain, Clemens et al., A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness, Int J Infect Dis IJID Off Publ Int Soc Infect Dis

Borghesi, Maroldi, COVID-19 outbreak in Italy: experimental chest X-ray scoring system for quantifying and monitoring disease progression, Radiol Med

Caly, Druce, Catton, Jans, Wagstaff, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Res

Chaccour, Casellas, Matteo, Pineda, Fernandez-Montero et al., The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial

Changeux, Amoura, Rey, Miyara, A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications, C R Biol

Chiu, Taub, Sestokas, Lu, Jacob, Comparative in vivo and in vitro metabolism of ivermectin in steers, sheep, swine, and rat, Drug Metab Rev

De, Cg, Gregianin, Burger, Continuous high-dose ivermectin appears to be safe in patients with acute myelogenous leukemia and could inform clinical repurposing for COVID-19 infection, Leuk Lymphoma

Dong, Du, Gardner, An interactive web-based dashboard to track COVID-19 in real time, Lancet Infect Dis

Guzzo, Furtek, Porras, Chen, Tipping et al., Tolerability, and Pharmacokinetics of Escalating High Doses of Ivermectin in Healthy Adult Subjects, Pharmacokinet Pharmacodyn

Heidary, Gharebaghi, Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen, J Antibiot

J O U R N A L P R E, -p r o o f

Krause, Buisson, Bertrand, Corringer, Galzi et al., Ivermectin: a positive allosteric effector of the alpha7 neuronal nicotinic acetylcholine receptor, Mol Pharmacol

Lespine, Alvinerie, Sutra, Pors, Chartier, Influence of the route of administration on efficacy and tissue distribution of ivermectin in goat, Vet Parasitol

Lifschitz, Virkel, Sallovitz, Sutra, Galtier et al., Comparative distribution of ivermectin and doramectin to parasite location tissues in cattle, Vet Parasitol

López-Medina, López, Hurtado, Dávalos, Ramirez et al., Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19: A Randomized Clinical Trial, JAMA

Mastrangelo, Pezzullo, Burghgraeve, Kaptein, Pastorino et al., Ivermectin is a potent inhibitor of flavivirus replication specifically targeting NS3 helicase activity: new prospects for an old drug, J Antimicrob Chemother

Omura, Crump, Ivermectin: panacea for resource-poor communities?, Trends Parasitol

Peña-Silva, Duffull, Steer, Jaramillo-Rincon, Gwee et al., Pharmacokinetic considerations on the repurposing of ivermectin for treatment of COVID-19, Br J Clin Pharmacol

Podder, Chowdhury, Sina, Haque, Outcome of ivermectin treated mild to moderate COVID-19 cases: a single-centre, open-label, randomised controlled study, IMC J Med Sci

Rahman, Iqbal, Islam, Niaz, Hussain et al., Comparison of Viral Clearance between Ivermectin with Doxycycline and Hydroxychloroquine with Azithromycin in COVID-19 Patients, J Bangladesh Coll Physicians Surg

Rajter, Sherman, Fatteh, Vogel, Sacks et al., Use of Ivermectin Is Associated With Lower Mortality in Hospitalized Patients With Coronavirus Disease, Chest

Rao, Manissero, Steele, Pareja, A Narrative Systematic Review of the Clinical Utility of Cycle Threshold Values in the Context of COVID-19, Infect Dis Ther

Samaha, Mouawia, Fawaz, Hassan, Salami et al., Effects of a Single Dose of Ivermectin on Viral and Clinical Outcomes in Asymptomatic SARS-CoV-2 Infected Subjects: A Pilot Clinical Trial in Lebanon, Viruses

Shu, Onwujekwe, Okonkwo, Do alcoholic beverages enhance availability of ivermectin?, Eur J Clin Pharmacol

Wagstaff, Sivakumaran, Heaton, Harrich, Jans, Ivermectin is a specific inhibitor of importin α/β-mediated nuclear import able to inhibit replication of HIV-1 and dengue virus, Biochem J

Wolff, Nee, Hickey, Marschollek, Risk factors for Covid-19 severity and fatality: a structured literature review, Infection

Yang, Atkinson, Wang, Lee, Bogoyevitch et al., The broad spectrum antiviral ivermectin targets the host nuclear transport importin α/β1 heterodimer, Antiviral Res

Zhou, Yu, Du, Fan, Liu et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, The Lancet

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