MedCram reviewed Ivermectin for Covid in April of 2020 showing that Ivermectin prevented replication of SARS-CoV2 in vitro. But made it clear that this was only in a test tube!
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We later reviewed (2 years later) data in humans showing it didn't work.
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Since then numerous trials have confirmed this with different doses:
Key U.S. trials:
1) ACTIV-6, ivermectin 400 µg/kg daily x 3 days — JAMA 2022
U.S. decentralized, double-blind, randomized placebo-controlled trial at 93 U.S. sites. Ivermectin did not significantly improve time to recovery, and hospitalization/death was essentially identical: 1.2% vs 1.2%.
2) ACTIV-6, higher-dose ivermectin up to 600 µg/kg daily x 6 days — JAMA 2023
Also U.S., double-blind, randomized, placebo-controlled. Median recovery was 11 days with ivermectin vs 12 days with placebo, but the posterior probability of reducing symptoms by more than 1 day was <0.1%, and urgent care/ED/hospitalization/death was 5.5% vs 5.8%. Authors concluded it did not support ivermectin use.
3) COVID-OUT — NEJM 2022
U.S. phase 3 randomized, double-blind, placebo-controlled factorial trial of metformin, ivermectin, and fluvoxamine. For ivermectin, the adjusted odds ratio for the primary composite outcome was 1.05, and for hospitalization/death was 0.73 with a very wide CI crossing 1; the trial concluded none of the three drugs prevented hypoxemia, ED visit, hospitalization, or death.
The closest “positive” ivermectin signal in a rigorous recent community trial is not U.S. and not placebo-controlled: the UK PRINCIPLE trial was open-label and found a small symptom-duration signal, but the authors still said the findings did not support ivermectin use for COVID-19.