دورية أكاديمية
أعرض في EDS

Comparison of Trials Using Ivermectin for COVID-19 Between Regions With High and Low Prevalence of Strongyloidiasis: A Meta-analysis.

التفاصيل البيبلوغرافية
العنوان: Comparison of Trials Using Ivermectin for COVID-19 Between Regions With High and Low Prevalence of Strongyloidiasis: A Meta-analysis.
المؤلفون: Bitterman A; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York., Martins CP; Albert Einstein College of Medicine, Bronx, New York., Cices A; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York., Nadendla MP; University of Denver, Denver, Colorado.
المصدر: JAMA network open [JAMA Netw Open] 2022 Mar 01; Vol. 5 (3), pp. e223079. Date of Electronic Publication: 2022 Mar 01.
نوع المنشور: Comparative Study; Journal Article; Meta-Analysis; Systematic Review
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Endemic Diseases* , COVID-19 Drug Treatment*, Antiparasitic Agents/*therapeutic use , Antiviral Agents/*therapeutic use , COVID-19/*mortality , Ivermectin/*therapeutic use , Strongyloidiasis/*epidemiology, Humans ; Prevalence ; Randomized Controlled Trials as Topic ; Risk ; Strongyloidiasis/drug therapy
مستخلص: Importance: A widely cited meta-analysis of randomized clinical trials has claimed ivermectin as an effective treatment for prevention of mortality in COVID-19. However, an unrecognized interaction variable with the relative risk (RR) of mortality may substantially change the appropriate interpretation of this analysis.
Objective: To evaluate the association between regional prevalence of strongyloidiasis and ivermectin trial results for the outcome of mortality by testing the hypothesis that strongyloidiasis prevalence interacts with the RR of mortality.
Data Sources: Original meta-analysis as well as a manual review of all references in a dedicated ivermectin trial database (c19ivermectin) from January 1, 2019, to November 6, 2021.
Study Selection: Randomized clinical trials using ivermectin as a treatment for COVID-19 and reporting the outcome of mortality. Studies were excluded in the event of publications revealing suspected trial fraud and/or randomization failure.
Data Extraction and Synthesis: Study characteristics and RR estimates were extracted from each source. Estimates were pooled using random-effects meta-analysis. Differences by strongyloidiasis prevalence were estimated using subgroup meta-analysis and meta-regression. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed.
Main Outcomes and Measures: Relative risk of mortality in ivermectin trials in regions of high vs low strongyloidiasis prevalence and correlation coefficient of meta-regression analysis between RR of mortality and regional prevalence of strongyloidiasis.
Results: A total of 12 trials comprising 3901 patients were included in the analysis. Four trials (33%) took place in regions of high strongyloidiasis prevalence and 8 (67%) trials took place in regions of low strongyloidiasis prevalence. Ivermectin trials that took place in areas of low regional strongyloidiasis prevalence were not associated with a statistically significant decreased risk of mortality (RR, 0.84 [95% CI, 0.60-1.18]; P = .31). By contrast, ivermectin trials that took place in areas of high regional strongyloidiasis prevalence were associated with a significantly decreased risk of mortality (RR, 0.25 [95% CI, 0.09-0.70]; P = .008). Testing for subgroup differences revealed a significant difference between the results of groups with low and high strongyloidiasis prevalence (χ21 = 4.79; P = .03). The estimate for τ2 (the variance of the study effect sizes) was 0 (95% CI, 0.0000-0.2786), and the estimate for I2 (percentage of variability that is explained by between-study heterogeneity) was 0 (95% CI, 0-43.7%). The meta-regression analysis revealed an RR decrease of 38.83% (95% CI, 0.87%-62.25%) for each 5% increase in strongyloidiasis prevalence.
Conclusions and Relevance: In this meta-analysis of 12 trials including 3901 patients, strongyloidiasis prevalence was found to interact with the RR of mortality for ivermectin as a treatment for COVID-19. No evidence was found to suggest ivermectin has any role in preventing mortality among patients with COVID-19 in regions where strongyloidiasis was not endemic.
References: Evid Based Ment Health. 2019 Nov;22(4):153-160. (PMID: 31563865)
Parasitology. 2011 Sep;138(11):1331-40. (PMID: 21810305)
Infection. 2021 Jun;49(3):539-542. (PMID: 32910321)
BMJ Case Rep. 2017 Mar 22;2017:. (PMID: 28331018)
Int J Lab Hematol. 2021 Jul;43 Suppl 1:137-141. (PMID: 33289964)
JAMA. 2021 Apr 13;325(14):1426-1435. (PMID: 33662102)
J Pharm Pharm Sci. 2021;24:343-350. (PMID: 34265236)
PLoS Negl Trop Dis. 2014 Aug 14;8(8):e3018. (PMID: 25121962)
EClinicalMedicine. 2021 Sep;39:101054. (PMID: 34368662)
Intern Med J. 2018 Jul;48(7):872-875. (PMID: 29984512)
J Community Hosp Intern Med Perspect. 2021 Jan 26;11(1):69-71. (PMID: 33552419)
Can Commun Dis Rep. 2021 Jul 08;47(7-8):316-321. (PMID: 34667442)
Pathogens. 2020 Jun 13;9(6):. (PMID: 32545787)
BMC Infect Dis. 2021 Jul 2;21(1):635. (PMID: 34215210)
Infection. 2015 Dec;43(6):691-8. (PMID: 26008854)
Nat Med. 2021 Nov;27(11):1853-1854. (PMID: 34552263)
J Parasit Dis. 2019 Jun;43(2):167-175. (PMID: 31263320)
Trans R Soc Trop Med Hyg. 2008 Apr;102(4):314-8. (PMID: 18321548)
Am J Ther. 2021 Jun 21;28(4):e434-e460. (PMID: 34145166)
J Med Virol. 2021 Oct;93(10):5833-5838. (PMID: 34076901)
BMC Infect Dis. 2021 May 4;21(1):411. (PMID: 33947344)
Cochrane Database Syst Rev. 2019 Oct 3;10:ED000142. (PMID: 31643080)
JAMA. 2020 Aug 18;324(7):623-624. (PMID: 32761166)
Cochrane Database Syst Rev. 2016 Jan 18;(1):CD007745. (PMID: 26778150)
Gastroenterol Hepatol (N Y). 2011 Mar;7(3):194-6. (PMID: 21528049)
J Int Med Res. 2021 May;49(5):3000605211013550. (PMID: 33983065)
Clin Ther. 2021 Jun;43(6):1007-1019. (PMID: 34052007)
Am J Trop Med Hyg. 2020 Oct;103(4):1590-1592. (PMID: 32830642)
Gastroenterol Hepatol (N Y). 2011 Nov;7(11):766-8. (PMID: 22298975)
Travel Med Infect Dis. 2020 Nov - Dec;38:101906. (PMID: 33137493)
المشرفين على المادة: 0 (Antiparasitic Agents)
0 (Antiviral Agents)
70288-86-7 (Ivermectin)
تواريخ الأحداث: Date Created: 20220321 Date Completed: 20220328 Latest Revision: 20221207
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8938718
DOI: 10.1001/jamanetworkopen.2022.3079
PMID: 35311963
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2022.3079