Ivermectin: Cara Kerja dan

Efektivitasnya sebagai Antiparasit

dan Antivirus COVID-19
M. ICHWAN

DEPARTMENT FARMAKOLOGI & TERAPEUTIK /PRODI MAGISTER ILMU BIOMEDIK

FAKULTAS KEDOKTERAN
UNIVERSITAS SUMATERA UTARA
IVERMECTIN
Broad Spectrum
Ivermectin sebagai Anti Parasit

Worms Sarcoptes scabei

IVERMECTIN & COVID 19
 Randomised trials of Ivermectin, n=1452
Study Country Daily dose Duration Sample Size Patients

Elgazzar et al Egypt 0.4 mg/kg 5 days 400 Mild to severe

Mahmud et al Bangladesh 0.2 mg/kg 1 day 363 Mild/ moderate

Niaee et al Iran 0.2 - 0.4 mg/kg 1-3 days 180 Mild / moderate

Hashim et al Iraq 0.2 mg/kg 2-3 days 140 Symptomatic

Chowdury Bangladesh 0.2 mg/kg 1 day 116 PCR positive

Ahmed et al Bangladesh 0.2 mg/kg 5 days 72 Mild to moderate
Podder et al Bangladesh 0.2 mg/kg 1 day 62 Mild

Chachar et al Bangladesh 0.2 mg/kg 7 days 50 Mild

Garrahan et al Argentina 0.6 mg/kg 5 days 45 Outpatients

Saint Spain 0.4 mg/kg 1 day 24 Moderate
Faster time to Viral Clearance
p<0.001 p<0.001 p=0.02 Ivermectin
14
12,7
12
12
Time to Viral Clearance (days)

Control
10 9,7
10

8
6
6
5

0
Egypt Elgazzar et al Egypt Elgazzar et al Severe Bangladesh Ahmed et al
Moderate
 Faster time to hospital discharge or
clinical recovery.
20
p<0.001 p<0.001 p=0.93 p=0.006 p<0.0001 p= n.s.
18
Time to Hospital Discharge/ Recovery (days )

16

14 Ivermectin

12

10
Control

0
Egypt Elgazzar et al Egypt Elgazzar et al Severe Bangladesh Ahmed et al Iran Niaee et al Iraq Hashim et al Bangladesh Podder et al
Moderate Patients Patients
Survival benefits in Ivermectin Trials
83% improvement in survival in randomized trials of ivermectin in COVID-19 patients
Reduction in death rate = 83% (95% C.I. 65%-92%), p<0.0001

Trial Ivermectin Control

Mahmoud (Bangladesh) 0/183 3/180

Elgazzar (Egypt) 2/200 24/200
Niaee (Iran) 4/120 11/60
Hashim (Iraq) 2/70 6/70

Total 8/573 (5%) 44/510 (17%)

Limitations

Potential for publication bias – are there other unpublished trials?

Several trials were open-label – potential for investigator bias

Range of doses and durations - Endpoints differ between trials

!!!!!!!!
Clinical trials of ivermectin in at least 21
countries worldwide
Conclusion

• Ivermectin has strong theoretical background in

Covid 19 treatment
• More Unbiased Clinical Trials necessary
• Dosage & Bioavailability ?
• Side effect and toxicity?