Ivermectin as a Treatment Modality in COVID-19 Patients: A Systematic Review and Meta-Analysis of Up-To-Date RCTs

The objective of this systematic review and meta-analysis is to assess the efficacy and safety of Ivermectin compared to placebo or standard of care for the treatment and prevention of COVID-19 disease. Literature search was carried out in PubMed, Scopus, and google scholar. Clinical trial registrie...

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Main Authors: Raghava Kalyan Maddukuri, Madhavi Latha Desimalla, Reshma Banavathu, Sai Pavan Kumar Arepalli
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Indian Journal of Community Medicine
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Online Access:https://journals.lww.com/10.4103/ijcm.ijcm_117_23
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author Raghava Kalyan Maddukuri
Madhavi Latha Desimalla
Reshma Banavathu
Sai Pavan Kumar Arepalli
author_facet Raghava Kalyan Maddukuri
Madhavi Latha Desimalla
Reshma Banavathu
Sai Pavan Kumar Arepalli
author_sort Raghava Kalyan Maddukuri
collection DOAJ
description The objective of this systematic review and meta-analysis is to assess the efficacy and safety of Ivermectin compared to placebo or standard of care for the treatment and prevention of COVID-19 disease. Literature search was carried out in PubMed, Scopus, and google scholar. Clinical trial registries (clinical trail.gov) and preprint servers (Medrxiv) were also searched for registered and preprint data respectively. Mortality, Clinical recovery, Clinical worsening, duration of hospital stay, and adverse events were considered as primary outcomes while viral clearance is considered as a secondary outcome. Revised Cochrane risk of bias assessment tool was used to assess the risk of bias. Random effect meta-analysis was carried out for all the outcomes. GRADE was used to rate the certainty of evidence. A total of 19 RCTs with 1111 patients were included in the analysis. Ivermectin use did was not associated with a reduction in the incidence of mortality, duration of hospitalization, clinical worsening, and incidence of adverse events nor it was associated with an increase in clinical improvement compared to either placebo or standard of care. Ivermectin also did not show any reduction in viral clearance compared to both placebo or standard of care and this was associated with substantial inconsistency. The overall certainty of the evidence was very low to low. Based on the very low to low certainty of the evidence, we consider Ivermectin ineffective in the management of COVID-19 disease, both as treatment and prophylaxis.
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publishDate 2025-01-01
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spelling doaj-art-2d2d517820ee43cb91fe4ed7e56012232025-02-06T05:32:49ZengWolters Kluwer Medknow PublicationsIndian Journal of Community Medicine0970-02181998-35812025-01-0150191910.4103/ijcm.ijcm_117_23Ivermectin as a Treatment Modality in COVID-19 Patients: A Systematic Review and Meta-Analysis of Up-To-Date RCTsRaghava Kalyan MaddukuriMadhavi Latha DesimallaReshma BanavathuSai Pavan Kumar ArepalliThe objective of this systematic review and meta-analysis is to assess the efficacy and safety of Ivermectin compared to placebo or standard of care for the treatment and prevention of COVID-19 disease. Literature search was carried out in PubMed, Scopus, and google scholar. Clinical trial registries (clinical trail.gov) and preprint servers (Medrxiv) were also searched for registered and preprint data respectively. Mortality, Clinical recovery, Clinical worsening, duration of hospital stay, and adverse events were considered as primary outcomes while viral clearance is considered as a secondary outcome. Revised Cochrane risk of bias assessment tool was used to assess the risk of bias. Random effect meta-analysis was carried out for all the outcomes. GRADE was used to rate the certainty of evidence. A total of 19 RCTs with 1111 patients were included in the analysis. Ivermectin use did was not associated with a reduction in the incidence of mortality, duration of hospitalization, clinical worsening, and incidence of adverse events nor it was associated with an increase in clinical improvement compared to either placebo or standard of care. Ivermectin also did not show any reduction in viral clearance compared to both placebo or standard of care and this was associated with substantial inconsistency. The overall certainty of the evidence was very low to low. Based on the very low to low certainty of the evidence, we consider Ivermectin ineffective in the management of COVID-19 disease, both as treatment and prophylaxis.https://journals.lww.com/10.4103/ijcm.ijcm_117_23covid-19gradeivermectinmeta-analysis
spellingShingle Raghava Kalyan Maddukuri
Madhavi Latha Desimalla
Reshma Banavathu
Sai Pavan Kumar Arepalli
Ivermectin as a Treatment Modality in COVID-19 Patients: A Systematic Review and Meta-Analysis of Up-To-Date RCTs
Indian Journal of Community Medicine
covid-19
grade
ivermectin
meta-analysis
title Ivermectin as a Treatment Modality in COVID-19 Patients: A Systematic Review and Meta-Analysis of Up-To-Date RCTs
title_full Ivermectin as a Treatment Modality in COVID-19 Patients: A Systematic Review and Meta-Analysis of Up-To-Date RCTs
title_fullStr Ivermectin as a Treatment Modality in COVID-19 Patients: A Systematic Review and Meta-Analysis of Up-To-Date RCTs
title_full_unstemmed Ivermectin as a Treatment Modality in COVID-19 Patients: A Systematic Review and Meta-Analysis of Up-To-Date RCTs
title_short Ivermectin as a Treatment Modality in COVID-19 Patients: A Systematic Review and Meta-Analysis of Up-To-Date RCTs
title_sort ivermectin as a treatment modality in covid 19 patients a systematic review and meta analysis of up to date rcts
topic covid-19
grade
ivermectin
meta-analysis
url https://journals.lww.com/10.4103/ijcm.ijcm_117_23
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