Satyam Shakta Mani, El-Tanani Mohamed, Patni Mohamed Anas, Rehman Abdul, Wali Adil Farooq, Rangraze Imran Rashid, Babiker Rasha, Rabbani Syed Arman, El-Tanani Yahia, Rizzo Manfredi
Department of Pharmacology, RAK College of Medical Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates.
RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates.
Antibiotics (Basel). 2025 Apr 30;14(5):459. doi: 10.3390/antibiotics14050459.
: The COVID-19 pandemic necessitated the urgent exploration of therapeutic options, including drug repurposing. Anthelmintic drugs such as ivermectin and mebendazole have garnered interest due to their potential antiviral and immunomodulatory properties. However, conflicting evidence from randomized clinical trials (RCTs) necessitates a comprehensive meta-analysis to determine their efficacy and safety in COVID-19 management. : This meta-analysis evaluates the clinical efficacy of ivermectin and mebendazole in treating COVID-19 by analyzing their impact on viral clearance, symptom resolution, hospitalization duration, and safety profiles. Methods: A systematic search of Scopus, PubMed, Embase, and the Cochrane Library was conducted following PRISMA guidelines to identify RCTs published up to February 2025. Eligible studies included adult patients with confirmed COVID-19 who received ivermectin or mebendazole compared with a placebo or standard of care. Data extraction and risk of bias assessment were performed using the Cochrane Risk of Bias Tool. Statistical heterogeneity was evaluated using the I statistic, and pooled effect sizes were calculated for primary clinical outcomes. : Twenty-three RCTs ( = 12,345) were included, with twenty-one studies on ivermectin and two on mebendazole. The pooled analysis suggested no statistically significant improvement in viral clearance ( = 0.39), hospitalization duration ( = 0.15), or symptom resolution ( = 0.08) with ivermectin or mebendazole. However, individual studies indicated potential benefits, particularly for mebendazole, in reducing viral load and inflammation. Both drugs exhibited favorable safety profiles, with no significant increase in adverse events. : The promising propensities observed in selected studies underscore the potential of ivermectin and mebendazole as adjunct therapies for COVID-19. With well-established safety profiles, immunomodulatory effects, and affordability, these drugs present strong candidates for further exploration. Advancing research through well-designed, large-scale RCTs will help unlock their full therapeutic potential and expand treatment options in the fight against COVID-19.
2019冠状病毒病（COVID-19）大流行使得包括药物重新利用在内的治疗方案的紧急探索成为必要。伊维菌素和甲苯达唑等驱虫药物因其潜在的抗病毒和免疫调节特性而引起了关注。然而，随机临床试验（RCT）相互矛盾的证据使得有必要进行全面的荟萃分析，以确定它们在COVID-19治疗中的疗效和安全性。 本荟萃分析通过分析伊维菌素和甲苯达唑对病毒清除、症状缓解、住院时间和安全性的影响，评估其治疗COVID-19的临床疗效。方法：按照PRISMA指南，对Scopus、PubMed、Embase和Cochrane图书馆进行系统检索，以确定截至2025年2月发表的RCT。符合条件的研究包括确诊为COVID-19的成年患者，他们接受伊维菌素或甲苯达唑治疗，并与安慰剂或标准治疗进行比较。使用Cochrane偏倚风险工具进行数据提取和偏倚风险评估。使用I统计量评估统计异质性，并计算主要临床结局的合并效应量。 纳入了23项RCT（n = 12345），其中21项研究伊维菌素，2项研究甲苯达唑。汇总分析表明，伊维菌素或甲苯达唑在病毒清除（RR = 0.39）、住院时间（RR = 0.15）或症状缓解（RR = 0.08）方面没有统计学上的显著改善。然而，个别研究表明，特别是甲苯达唑在降低病毒载量和炎症方面可能有好处。两种药物都表现出良好的安全性，不良事件没有显著增加。 在选定研究中观察到的有前景的倾向突出了伊维菌素和甲苯达唑作为COVID-19辅助治疗的潜力。鉴于其已确立的安全性、免疫调节作用和可负担性，这些药物是进一步探索的有力候选药物。通过精心设计的大规模RCT推进研究将有助于释放它们的全部治疗潜力，并在抗击COVID-19中扩大治疗选择。
