SynthesisAmerican journal of therapeutics2021
Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines.
Synthesis in American journal of therapeutics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. Cited by 125 papers, 17 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
125 citing papers in PubMed, 17 syntheses or guidelines pooled it, 261 citations in OpenAlex.
- The role of ivermectin in the prevention and treatment of SARS-CoV-2 infection: a meta-analysis of randomized controlled trials.BMC infectious diseases · 2026Pooled it
- Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis.BMJ open respiratory research · 2023Pooled it
- Results of a systematic review and meta-analysis of early studies on ivermectin in SARS-CoV-2 infection.GeroScience · 2023Pooled it
- Quality of clinical evidence and political justifications of ivermectin mass distribution of COVID-19 kits in eight Latin American countries.BMJ global health · 2023Pooled it
- Discontinuation of Antihypertensive Drug Use Compared to Continuation in COVID-19 Patients: A Systematic Review with Meta-analysis and Trial Sequential Analysis.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2023Pooled it
- A Systematic Review of the Role of Purinergic Signalling Pathway in the Treatment of COVID-19.International journal of molecular sciences · 2023Pooled it
- Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2023Pooled it
- Systematic review and meta-analysis of ivermectin for treatment of COVID-19: evidence beyond the hype.BMC infectious diseases · 2022Pooled it
- Ivermectin for preventing and treating COVID-19.The Cochrane database of systematic reviews · 2022Pooled it
- Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients.Virology journal · 2022Pooled it
- Bias as a source of inconsistency in ivermectin trials for COVID-19: A systematic review. Ivermectin's suggested benefits are mainly based on potentially biased results.Journal of clinical epidemiology · 2022Pooled it
- Ivermectin for the Treatment of Coronavirus Disease 2019: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Pooled it
- Comparison of Trials Using Ivermectin for COVID-19 Between Regions With High and Low Prevalence of Strongyloidiasis: A Meta-analysis.JAMA network open · 2022Pooled it
- The military as a neglected pathogen transmitter, from the nineteenth century to COVID-19: a systematic review.Global health research and policy · 2021Pooled it
- COVID-19-Associated acute respiratory distress syndrome (CARDS): Mechanistic insights on therapeutic intervention and emerging trends.International immunopharmacology · 2021Pooled it
- Ivermectin for preventing and treating COVID-19.The Cochrane database of systematic reviews · 2021Pooled it
- Drug-Induced Liver Injury in COVID-19 Patients: A Systematic Review.Frontiers in medicine · 2021Pooled it
- Efficacy and safety of oral ivermectin in the treatment of mild to moderate Covid-19 patients: a multi-centre double-blind randomized controlled clinical trial.BMC infectious diseases · 2024Trial
- Favipiravir in the Treatment of Outpatient COVID-19: A Multicenter, Randomized, Triple-Blind, Placebo-Controlled Clinical Trial.Advances in respiratory medicine · 2023Trial
- The effect of ivermectin on the viral load and culture viability in early treatment of nonhospitalized patients with mild COVID-19 - a double-blind, randomized placebo-controlled trial.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Trial
65 more citing papers are in PubMed but not listed here.
Corrections and comments
- Expression of concern · 2022-02-07Concerns/Issues about Data · Concerns/Issues about Results and/or Conclusions ·
- Commented on by
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- Expression of concern
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRepurposed medicines may have a role against the SARS-CoV-2 virus. The antiparasitic ivermectin, with antiviral and anti-inflammatory properties, has now been tested in numerous clinical trials. AREAS OF UNCERTAINTY: We assessed the efficacy of ivermectin treatment in reducing mortality, in secondary outcomes, and in chemoprophylaxis, among people with, or at high risk of, COVID-19 infection. DATA SOURCES: We searched bibliographic databases up to April 25, 2021. Two review authors sifted for studies, extracted data, and assessed risk of bias. Meta-analyses were conducted and certainty of the evidence was assessed using the GRADE approach and additionally in trial sequential analyses for mortality. Twenty-four randomized controlled trials involving 3406 participants met review inclusion. THERAPEUTIC ADVANCES: Meta-analysis of 15 trials found that ivermectin reduced risk of death compared with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19-0.73; n = 2438; I2 = 49%; moderate-certainty evidence). This result was confirmed in a trial sequential analysis using the same DerSimonian-Laird method that underpinned the unadjusted analysis. This was also robust against a trial sequential analysis using the Biggerstaff-Tweedie method. Low-certainty evidence found that ivermectin prophylaxis reduced COVID-19 infection by an average 86% (95% confidence interval 79%-91%). Secondary outcomes provided less certain evidence. Low-certainty evidence suggested that there may be no benefit with ivermectin for "need for mechanical ventilation," whereas effect estimates for "improvement" and "deterioration" clearly favored ivermectin use. Severe adverse events were rare among treatment trials and evidence of no difference was assessed as low certainty. Evidence on other secondary outcomes was very low certainty.
conclusionsModerate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.