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Iranian trial of efficacy and safety of Ivermectin in patients with mild and moderate COVID-19

Researchers at the Hormozgan University of Medical Sciences, Bandar Abbas, Iran are trialling the efficacy and safety of Ivermectin in patients with mild and moderate COVID-19, reports MedicalBrief.

 

Study details
The efficacy and safety of Ivermectin in patients with mild and moderate COVID-19: A structured summary of a study protocol for a randomized controlled trial

Fatemeh Sadat Hosseini, Alireza Malektojari, Sara Ghazizadeh, Mehdi Hassaniazad, Parivash Davoodian, Habib Dadvand, Amin Reza Nikpoor, Sara Nikoofal-Sahlabadi, Sara Kahoori, Mojtaba Sepandi, Soheil Hassanipour, Mohammad Fathalipour

Published in BMC Trials on 4 January 2021

Abstract

Objectives
We will evaluate the efficacy and safety of Ivermectin in patients with mild and moderately severe COVID-19.

Trial Design
This is a phase 3, single-center, randomized, open-label, controlled trial with a 2-arm parallel-group design (1:1 ratio).

Participants
The Severe Acute Respiratory Syndrome Departments of the Shahid Mohammadi Hospital, Bandar Abbas, Iran, will screen for patients age ≥ 20 years and weight ≥35 kg for the following criteria: Inclusion criteria for patients with mild COVID-19 symptoms (outpatients) 1. Diagnosed mild pneumonia using computed tomography (CT) and/or chest X-ray (CX-R) imaging, not requiring hospitalization. 2. Signing informed consent. Inclusion criteria for patients with moderate COVID-19 symptoms (inpatients) 1. Confirmed infection using PCR. 2. Diagnosed moderate pneumonia using CT and/or CXR imaging, requiring hospitalization. 3. Hospitalized ≤ 48 hours. 4. Signing informed consent. Exclusion criteria 1. Severe and critical pneumonia due to COVID-19. 2. Underlying diseases, including AIDS, asthma, loiasis, and severe liver and kidney disease. 3. Use of anticoagulants (warfarin) and ACE inhibitors (captopril). 4. History of drug allergy to Ivermectin. 5. Pregnancy or breastfeeding.

Intervention and comparator
Intervention groups: Outpatient and inpatient groups will receive the standard treatment regimen for mild and moderate COVID-19, based on the Iranian Ministry of Health and Medical Education’s protocol, along with oral Ivermectin (MSD Company, France) at a single dose of 0.2 mg/kg. Control groups: The outpatient group will receive hydroxychloroquine sulfate (Amin Pharmaceutical Company, Iran) at a dose of 400 mg twice a day for the first day and 200 mg twice a day for seven subsequent days. The inpatient group will receive 200/50 mg Lopinavir/Ritonavir (Heterd Company, India) twice a day for the seven days, plus five doses of 44 mcg Interferon beta-1a (CinnaGen, Iran) every other day. Other supportive and routine care will be the same in both outpatient and inpatient groups.

Main outcome
The primary outcomes are composite and include the improvement of clinical symptoms and need for hospitalization for outpatient groups, and the length of hospital stay until discharge, the need for ICU admission until discharge, and the need for mechanical ventilation for inpatient groups within seven days of randomization. The secondary outcome is the incidence of serious adverse drug reactions within seven days of randomization.

Randomisation
Patients in both outpatient (mild) and inpatient (moderate) groups will be randomized into the treatment and control groups based on the following method. A simple randomization method and table of random numbers will be used. If the selected number is even, the patient is allocated to the treatment group, and if it is odd, the patient is allocated to the control group in a 1:1 ratio.

Blinding (masking)
This is an open-label study, and there is not blinding. Numbers to be randomized (sample size) A total number of 120 patients (60 outpatients and 60 patients) will be randomized into two groups (30 patients in each of the intervention groups and 30 patients in each of the control groups).

 

[link url="https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-020-04988-7"]BMC Trials study (Open access)[/link]

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