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Translation of e a-t 12/2021b


Once again: Ivermectin (DRIPONIN and others) against COVID-19?

We are still receiving inquiries about the benefits of ivermectin (DRIPONIN and others) against COVID-19, having in January 2021 felt that further, sufficiently large and well planned clinical studies were necessary (a-t 2021; 52: 6-7). Since then, several randomised studies on the intake of ivermectin against COVID-19 have been published in full (1-11), as a letter (12) or as a preprint (13-17).* More than half of them were negative in terms of their primary endpoint (1-5, 10, 14, 17) or based on the authors' assessment (6, 11). In some cases combinations were investigated (7, 12), fewer than 100 patients were evaluated (5, 8-10, 13, 16, 17), the studies were only carried out at a single site (2, 3, 5-7, 9, 13, 14) or they were not blinded (4, 9, 10, 12, 13, 15). A somewhat larger study published back in 2020 as a preprint that judged ivermectin to be "very effective" at treating COVID-19 has since then been withdrawn (20). There are considerable doubts about the data (21). A Cochrane Review of July 2021 does not consider there to be sufficient evidence for therapeutic or prophylactic use outside of well-designed clinical studies (22). Furthermore, overdoses and serious harmful effects have been reported in the USA after use of the antiparasitic drug, in some cases as a veterinary medicine (23, 24). The current guideline on inpatient treatment of patients with COVID-19 therefore strongly advises against treatment with ivermectin (25). Based on current knowledge**, we also advise against the use of ivermectin against COVID-19, -Ed.

* Of two other methodologically poor studies also described as "randomised", one is also referred to as "cross-sectional" (18) and in the other inclusion in the control group was terminated early during the recruitment stage (19).
** Larger studies are currently ongoing, including the American study ACTIV-6 (26) while the British PRINCIPLE study paused the investigation of ivermectin due to supply difficulties (27).

  (R = randomized study, M = meta-analysis)
R1MOHAN, A. et al.: J. Infect. Chemother. 2021; 27: 1743-9
R2VALLEJOS, R.E. et al.: BMC Infectious Diseases 2021; 21: 635 (11 pages)
R3LÓPEZ-MEDINA, E. et al.: JAMA 2021; 325: 1426-35
R4ABD-ELSALAM, S. et al.: J. Med. Virol. 2021; 93: 5833-8
R5OKUMUS, N. et al.: BMC Infectious Diseases 2021; 21: 411 (11 pages)
R6GALAN, L.E.B. et al.: Pathog. Glob. Health 2021; 105: 235-42
R7MAHMUD, R. et al.: J. Int. Med. Res. 2021; 49: 3000605211013550 (14 pages)
R8SHAHBAZNEJAD, L. et al.: Clin. Ther. 2021; 43: 1007-19
R9POTT-JUNIOR, H. et al.: Toxicol. Rep. 2021; 8: 505-10
R10KROLEWIECKI, A. et al.: EClinicalMedicine 2021; 37: 100959 (8 pages)
R11SEET, R.C.S. et al.: Int. J. Infect. Dis. 2021; 106: 314-22
R12CHAHLA, R.E. et al.: Am. J. Ther. 2021; 18: e6014
R13BUKHARI, K.H.S. et al.: medRxiv publ. online Febr. 2021; https://doi.org/10.1101/2021.02.02.21250840
R14GONZALEZ, J.L.B. et al.: medRxiv publ. online Febr. 2021; https://doi.org/10.1101/2021.02.18.21252037
R15CHAHLA, R.E. et al.: ResearchSquare publ. online May 2021; https://doi.org/10.21203/rs.3.rs-495945/v1
R16BIBER, A. et al.: medRxiv publ. online May 2021; https://doi.org/10.1101/2021.05.31.21258081
R17BUONFRATE, D. et al.: SSRN publ. online Sept. 2021; https://dx.doi.org/10.2139/ssrn.3918289
 18FAISAL, R. et al.: Professional Med. J. 2021; 28: 737-41
 19SHOUMAN, W.M. et al.: Journal of Clinical and Diagnostic Research 2021; 15: OC27-32
R20ELGAZZAR, A. et al.: Research Square, publ. online am 28 Dec. 2020; https://a-turl.de/alit
 21DAVEY, M.: The Guardian, 15 July 2021; https://a-turl.de/fb1x
M22POPP, M. et al.: Ivermectin for preventing and treating COVID-19. Cochrane Database of Systematic Reviews 2021, as at July 2021; access 2021; https://a-turl.de/2e7f
 23Centers for Disease Control and Prevention: Safety information, 26 Aug. 2021; https://a-turl.de/t2cv
 24TEMPLE, C. et al.: N. Engl. J. Med. 2021; 385: 2197-8
 25KLUGE, S. et al.: S3-Leitlinie – Empfehlungen zur stationären Therapie von Patienten mit COVID-19, as at Okt. 2021; https://a-turl.de/qesf
 26NAGGIE, S.: ClinicalTrials.gov, as at Dec. 2021; https://a-turl.de/n547

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