Ivermectin: Still on a Losing Streak as COVID-19 Treatment

WASHINGTON — There have been no variations in reduction from mild-to-moderate COVID-19 signs for sufferers on ivermectin versus placebo, in accordance with the continued ACTIV-6 trial.

Amongst >1,000 vaccinated and unvaccinated sufferers, the median time to restoration was 12 days for these within the ivermectin group and 13 days within the placebo group, reported Matthew McCarthy, MD, of Weill Cornell Medication in New York Metropolis, at IDWeek.

Because of this, the hazard ratio for enchancment in time to restoration was 1.07 (95% credible interval 0.96-1.17, posterior P=0.91), McCarthy and colleagues said in JAMA, the place the outcomes had been concurrently printed.

He famous that the present trial was carried out throughout Delta and Omicron variant surges within the nation (June 23, 2021 via Feb. 4, 2022).

McCarthy mentioned through the presentation that therapy with two different repurposed brokers — the antidepressant fluvoxamine (Luvox) and the inhaled steroid fluticasone — didn’t supply considerably higher outcomes than placebo. “We noticed no vital variations in reduction of mild-to-moderate signs between members taking ivermectin, fluticasone, or fluvoxamine and members taking placebo. There was no distinction noticed within the variety of hospitalizations or deaths between sufferers taking ivermectin, fluticasone, or fluvoxamine and members taking placebo. There have been no security issues recognized in any arm,” he said.

“These outcomes are per what we have now seen in different trials with these brokers,” mentioned IDWeek session co-moderator Adarsh Bhimraj, MD, of Houston Methodist.

“This can be a large platform trial,” he advised MedPage At present. “It is energy is within the numbers of sufferers included, and that it was carried out later within the pandemic which is extra related to us now, and it’s also concordant with different research.”

Bhimraj said that “there have been no surprises with these outcomes of ACTIV-6, which…is sweet,” including that research exhibiting which remedies don’t work have as a lot worth as those who show which remedies do work.

He additionally identified that “throughout all these trials with these completely different brokers, the security alerts are usually not that unhealthy.”

McCarthy’s group reported that there have been 10 hospitalizations or deaths within the ivermectin group and 9 within the placebo group (1.2% vs 1.2%, HR 1.1, 95% CrI 0.4-2.6). The commonest critical adversarial occasions had been COVID-19 pneumonia with 5 circumstances within the ivermectin group and 7 within the placebo group, together with venous thromboembolism (one and 5 circumstances, respectively). There was one loss of life within the ivermectin group.

For the ivermectin arm of ACTIV-6, 814 folks had been on ivermectin (400 μ6/kg) and 774 folks had been on placebo, each day for 3 days. Lower than half reported receiving at the least two doses of a SARS-CoV-2 vaccine. Median affected person age was 48, 57% had been girls, and about 80% had been white. There have been 656 sufferers within the fluticasone arm and 621 on placebo. A couple of third of the sufferers had not had any COVID vaccine. Median age was about 46, 63% had been girls, and about 80% had been white. Lastly, there have been 674 sufferers on fluvoxamine and 624 sufferers on placebo. About two-thirds had acquired at the least two doses of the vaccine. That they had a median age of 48 years, 58% had been girls, and about 80% had been white.

McCarthy and colleagues acknowledged that “the inclusion standards permit[s] for a broad research inhabitants, this research failed to realize the extent of illustration desired for underrepresented populations when it comes to racial and ethnic variety,” which was a research limitation.

Nonetheless, they concluded that the “findings don’t assist the usage of ivermectin in sufferers with gentle to reasonable COVID-19…this research provides to the rising proof that there’s not a clinically related therapy impact of ivermectin at this dose and period.”