Studies that randomized participants to ivermectin or a matched placebo had the greatest impact on the Panel’s recommendation. The Panel’s recommendation is primarily informed by adequately powered, randomized trials of ivermectin that reported clinical outcomes. The Panel recommends against the use of ivermectin for the treatment of COVID-19 ( AIIa).The Panel reviewed additional studies, but these studies are not summarized in Table 7b because they have study design limitations or results that make them less definitive and informative. Summaries of the studies that informed the COVID-19 Treatment Guidelines Panel’s (the Panel) recommendation can be found in Table 7b. The safety and efficacy of ivermectin for the prevention and treatment of COVID-19 have been evaluated in clinical trials and observational cohorts. ![]() 3 However, pharmacokinetic and pharmacodynamic studies suggest that achieving the plasma concentrations necessary for the antiviral efficacy detected in vitro would require administration of doses up to 100-fold higher than those approved for use in humans. Ivermectin has been shown to inhibit replication of SARS-CoV-2 in cell cultures. Proposed Mechanism of Action and Rationale for Use in Patients With COVID-19 1,2 Ivermectin is not approved by the FDA for the treatment of any viral infection. 1 For these indications, ivermectin has been widely used and is generally well tolerated. ![]() Ivermectin is a Food and Drug Administration (FDA)-approved antiparasitic drug used to treat several neglected tropical diseases, including onchocerciasis, helminthiases, and scabies.
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