All India Institute of Medical sciences, Bhubaneswar.
Additional Professor.
J Pharm Pharm Sci. 2020;23:462-469. doi: 10.18433/jpps31457.
The current management of COVID-19 is mostly limited to general supportive care and symptomatic treatment. Ivermectin is a broad-spectrum anti-parasitic drug used widely for the treatment of onchocerciasis and lymphatic filariasis. Apart from its anti-parasitic effect it also exhibits antiviral activity against a number of viruses both in vitro and in vivo. Hence, we conducted this systematic review and meta-analysis to assess the currently available data on the therapeutic potential of ivermectin for the treatment of COVID-19 as add on therapy. A total of 629 patients were included in the 4 studies and all were COVID-19 RT-PCR positive. Among them, 397 patients received ivermectin along with usual therapy. The random effect model showed the overall pooled OR to be 0.53 (95%CI: 0.29 to0.96) for the primary outcome (all-cause mortality) which was statistically significant (P=0.04). Similarly, the random effect model revealed that adding ivermectin led to significant clinical improvement compared to usual therapy (OR=1.98, 95% CI: 1.11 to 3.53, P=0.02). However, this should be inferred cautiously as the quality of evidence is very low. Currently, many clinical trials are on-going, and definitive evidence for repurposing this drug for COVID-19 patients will emerge only in the future.
目前对 COVID-19 的治疗主要限于一般支持性护理和对症治疗。伊维菌素是一种广谱抗寄生虫药物，广泛用于治疗盘尾丝虫病和淋巴丝虫病。除了抗寄生虫作用外，它还表现出对多种病毒的体外和体内抗病毒活性。因此，我们进行了这项系统评价和荟萃分析，以评估伊维菌素作为附加治疗治疗 COVID-19 的治疗潜力的现有数据。共有 629 名患者纳入了 4 项研究，所有患者均为 COVID-19 RT-PCR 阳性。其中，397 名患者接受了伊维菌素联合常规治疗。随机效应模型显示，主要结局（全因死亡率）的总体汇总 OR 为 0.53（95%CI：0.29 至 0.96），具有统计学意义（P=0.04）。同样，随机效应模型表明，与常规治疗相比，添加伊维菌素可显著改善临床症状（OR=1.98，95%CI：1.11 至 3.53，P=0.02）。然而，由于证据质量非常低，因此应该谨慎推断。目前，许多临床试验正在进行中，只有在未来才能为 COVID-19 患者重新利用这种药物提供明确的证据。
