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Naggie, Susanna; Boulware, David R.; Lindsell, Christopher J.; Stewart, Thomas G.; Slandzicki, Alex J.; Lim, Stephen C.; Cohen, Jonathan; Kavtaradze, David; Amon, Arch P.; Gabriel, Ahab; Gentile, Nina; Felker, G. Michael; Jayaweera, Dushyantha; McCarthy, Matthew W.; Sulkowski, Mark; Rothman, Russell L.; Wilson, Sybil; DeLong, Allison; Remaly, April; Wilder, Rhonda; Collins, Sean; Dunsmore, Sarah E.; Adam, Stacey J.; Thicklin, Florence; [...]

Effect of Higher-Dose Ivermectin for 6 Days vs Placebo on Time to Sustained Recovery in Outpatients With COVID-19 : A Randomized Clinical Trial : A Randomized Clinical Trial

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  • Medientyp: E-Artikel
  • Titel: Effect of Higher-Dose Ivermectin for 6 Days vs Placebo on Time to Sustained Recovery in Outpatients With COVID-19 : A Randomized Clinical Trial : A Randomized Clinical Trial
  • Beteiligte: Naggie, Susanna; Boulware, David R.; Lindsell, Christopher J.; Stewart, Thomas G.; Slandzicki, Alex J.; Lim, Stephen C.; Cohen, Jonathan; Kavtaradze, David; Amon, Arch P.; Gabriel, Ahab; Gentile, Nina; Felker, G. Michael; Jayaweera, Dushyantha; McCarthy, Matthew W.; Sulkowski, Mark; Rothman, Russell L.; Wilson, Sybil; DeLong, Allison; Remaly, April; Wilder, Rhonda; Collins, Sean; Dunsmore, Sarah E.; Adam, Stacey J.; Thicklin, Florence; [...]
  • Erschienen: American Medical Association (AMA), 2023
  • Erschienen in: JAMA
  • Sprache: Englisch
  • DOI: 10.1001/jama.2023.1650
  • ISSN: 0098-7484
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Importance</jats:title><jats:p>It is unknown whether ivermectin, with a maximum targeted dose of 600 μg/kg, shortens symptom duration or prevents hospitalization among outpatients with mild to moderate COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the effectiveness of ivermectin at a maximum targeted dose of 600 μg/kg daily for 6 days, compared with placebo, for the treatment of early mild to moderate COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Design, Setting, and Participants</jats:title><jats:p>The ongoing Accelerating COVID-19 Therapeutic Interventions and Vaccines 6 (ACTIV-6) platform randomized clinical trial was designed to evaluate repurposed therapies among outpatients with mild to moderate COVID-19. A total of 1206 participants older than 30 years with confirmed COVID-19 experiencing at least 2 symptoms of acute infection for less than or equal to 7 days were enrolled at 93 sites in the US from February 16, 2022, through July 22, 2022, with follow-up data through November 10, 2022.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Participants were randomly assigned to receive ivermectin, with a maximum targeted dose of 600 μg/kg (n = 602) daily, or placebo (n = 604) for 6 days.</jats:p></jats:sec><jats:sec><jats:title>Main Outcomes and Measures</jats:title><jats:p>The primary outcome was time to sustained recovery, defined as at least 3 consecutive days without symptoms. The 7 secondary outcomes included a composite of hospitalization, death, or urgent/emergent care utilization by day 28.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 1206 randomized participants who received study medication or placebo, the median (IQR) age was 48 (38-58) years, 713 (59.1%) were women, and 1008 (83.5%) reported receiving at least 2 SARS-CoV-2 vaccine doses. The median (IQR) time to sustained recovery was 11 (11-12) days in the ivermectin group and 11 (11-12) days in the placebo group. The hazard ratio (posterior probability of benefit) for improvement in time to recovery was 1.02 (95% credible interval, 0.92-1.13; <jats:italic>P</jats:italic> = .68). Among those receiving ivermectin, 34 (5.7%) were hospitalized, died, or had urgent or emergency care visits compared with 36 (6.0%) receiving placebo (hazard ratio, 1.0 [95% credible interval, 0.6-1.5]; <jats:italic>P</jats:italic> = .53). In the ivermectin group, 1 participant died and 4 were hospitalized (0.8%); 2 participants (0.3%) were hospitalized in the placebo group and there were no deaths. Adverse events were uncommon in both groups.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Relevance</jats:title><jats:p>Among outpatients with mild to moderate COVID-19, treatment with ivermectin, with a maximum targeted dose of 600 μg/kg daily for 6 days, compared with placebo did not improve time to sustained recovery. These findings do not support the use of ivermectin in patients with mild to moderate COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT04885530">NCT04885530</jats:ext-link></jats:p></jats:sec>