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伊维菌素治疗轻度至中度 COVID-19 感染的疗效和安全性:一项随机、双盲、安慰剂对照试验。

Efficacy and safety of ivermectin in the treatment of mild to moderate COVID-19 infection: a randomized, double-blind, placebo-controlled trial.

机构信息

Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Dusit, Bangkok, Thailand.

出版信息

Trials. 2022 Aug 26;23(1):714. doi: 10.1186/s13063-022-06649-3.

Abstract

BACKGROUND

The emergent outbreak of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emphasized the requirement for therapeutic opportunities to overcome this pandemic. Ivermectin is an antiparasitic drug that has shown effectiveness against various agents, including SARS-CoV-2. This study aimed to assess the efficacy of ivermectin treatment compared with the standard of care (SOC) among people with mild to moderate COVID-19 symptoms.

METHODS

In this randomized, double-blind, placebo-controlled, single-center, parallel-arm, superiority trial among adult hospitalized patients with mild to moderate COVID-19, 72 patients (mean age 48.57 ± 14.80 years) were randomly assigned to either the ivermectin (n=36) or placebo (n=36) group, along with receiving standard care. We aimed to compare the negativity of reverse transcription polymerase chain reaction (RT-PCR) result at days 7 and 14 of enrolment as the primary outcome. The secondary outcomes were duration of hospitalization, frequency of clinical worsening, survival on day 28, and adverse events.

RESULTS

At days 7 and 14, no differences were observed in the proportion of PCR-positive patients (RR 0.97 at day 7 (p=0.759) and 0.95 at day 14 (p=0.813). No significant differences were found between the groups for any of the secondary endpoints, and no adverse events were reported.

CONCLUSION

No difference was found in the proportion of PCR-positive cases after treatment with ivermectin compared with standard care among patients with mild to moderate COVID-19 symptoms. However, early symptomatic recovery was observed without side effects.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05076253. Registered on 8 October 2021, prospectively.

摘要

背景

由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 引起的冠状病毒病 (COVID-19) 紧急爆发,强调了需要有治疗方法来克服这一大流行。伊维菌素是一种抗寄生虫药物,已显示出对包括 SARS-CoV-2 在内的各种病原体的有效性。本研究旨在评估伊维菌素治疗与标准治疗 (SOC) 在有轻度至中度 COVID-19 症状的人群中的疗效。

方法

在这项针对住院的有轻度至中度 COVID-19 的成年患者的随机、双盲、安慰剂对照、单中心、平行臂、优效性试验中,72 名患者(平均年龄 48.57±14.80 岁)被随机分配到伊维菌素(n=36)或安慰剂(n=36)组,同时接受标准治疗。我们旨在比较第 7 天和第 14 天的逆转录聚合酶链反应 (RT-PCR) 结果阴性率作为主要结局。次要结局是住院时间、临床恶化频率、第 28 天的生存率和不良事件。

结果

在第 7 天和第 14 天,PCR 阳性患者的比例没有差异(第 7 天的 RR 0.97(p=0.759)和第 14 天的 RR 0.95(p=0.813)。两组在任何次要终点均无显著差异,且无不良事件报告。

结论

在有轻度至中度 COVID-19 症状的患者中,与标准治疗相比,伊维菌素治疗后 PCR 阳性病例的比例没有差异。然而,观察到早期症状恢复,且无副作用。

试验注册

ClinicalTrials.gov NCT05076253。于 2021 年 10 月 8 日注册,前瞻性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c72/9419371/282b8b09df9a/13063_2022_6649_Fig1_HTML.jpg

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