Study Findings Do Not Support Use of Ivermectin for Mild COVID-19

The median time to resolution of COVID-19 symptoms was 10 days with ivermectin and 12 days with placebo.

The use of ivermectin does not appear to significantly shorten the duration of symptoms in patients with mild coronavirus disease 2019 (COVID-19), according to findings from a randomized clinical trial published in JAMA.

Ivermectin, an antiparasitic agent, continues to be widely used as a potential treatment for COVID-19 based on experimental studies showing antiviral activity during the early stages of other infections. To assess its effect on the duration of symptoms in patients with mild COVID-19, the study authors conducted a double-blind, randomized trial in a single site in Cali, Colombia (ClinicalTrials.gov: NCT04405843).

Using the state’s health department electronic database, study participants were selected if they had laboratory-confirmed COVID-19 with mild disease and symptom duration of 7 days or less. A total of 476 adults were enrolled and 400 (the primary analysis population; median age, 37 years; 58% women) were randomly assigned to receive ivermectin 300μg/kg of body weight/day for 5 days (n=200) or placebo (n=200). The primary outcome measure of the study was the time to complete resolution of COVID-19 symptoms within the 21-day follow-up period.

Among the 398 patients that completed the trial, results showed the median time to resolution of COVID-19 symptoms was 10 days (interquartile range [IQR], 9-13) for patients who received ivermectin and 12 days (IQR, 9-13) for those who received placebo (hazard ratio 1.07 [95% CI, 0.87-1.32]; P =.53). By day 21, symptoms had resolved for 82% of the ivermectin-treated group and 79% of the placebo group.

As for safety, adverse events were reported by 77% of the ivermectin group and 81.3% of the placebo group. Headache was the most common solicited adverse event (52% in the ivermectin group and 56% in the placebo group).

The authors noted several limitations of the trial including a change in study design 6 weeks in (the original outcome measure was meant to assess clinical deterioration), a lack of virological assessments, and a young study population. 

“The findings do not support the use of ivermectin for treatment of mild COVID-19, although larger trials may be needed to understand the effects of ivermectin on other clinically relevant outcomes,” the authors concluded.

Disclosure: Some authors have declared affiliations with or received funding from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.

Reference

López-Medina E, López P, Hurtado IC, et al. Effect of ivermectin on time to resolution of symptoms among adults with mild COVID-19. [Published online March 4, 2021]. JAMA doi:10.1001/jama.2021.3071.

This article originally appeared on MPR