Efficacy and safety of ivermectin for the treatment of COVID-19: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 34570241 · doi:10.1093/qjmed/hcab247
What was done
Authors conducted a systematic review and random-effects meta-analysis of peer-reviewed randomized controlled trials (RCTs) and observational studies (OSs) published between January 1, 2020, and September 1, 2021, indexed in MEDLINE, EMBASE, and PubMed (PROSPERO CRD42021275302). Assessed outcomes included time to viral clearance, duration of hospitalization, mortality, incidence of mechanical ventilation, and adverse events. Risk of bias was evaluated using RoB2 and ROBINS-I, and evidence quality was graded using GRADE.
What was found
Seventeen studies were included (14 RCTs and 3 OSs). The abstract reports no numerical effect estimates (such as relative risks or odds ratios), confidence intervals, or total participant counts. Based on meta-analysis of RCTs, ivermectin was not associated with reductions in time to viral clearance, duration of hospitalization, mortality, or mechanical ventilation. Ivermectin did not significantly increase adverse events, and findings from observational studies agreed with the RCT results.
Why it matters
By restricting analysis strictly to peer-reviewed data, this review shows that clinical benefits suggested by earlier non-peer-reviewed preprints are not supported by peer-reviewed randomized trials.
Limits
The abstract reports no raw numerical effect sizes, confidence intervals, or total participant numbers. Most included RCTs had some concerns regarding risk of bias, observational studies had moderate risk of bias, and overall certainty of evidence was graded as very low to moderate.
Cited by
- contradicts In a systematic meta-analysis of ivermectin clinical trials for COVID-19, the only consistent finding across studies was a reduction in time to negative PCR (faster viral clearance).