Ivermectin 用於預防及治療新冠病毒的效果：系統性回顧及統合分析
【30秒重點】
- 伊維菌素要不要用在新冠，先和醫師討論，不要自行購買動物用藥來吃。
- 這是一份伊維菌素預防和治療新冠的系統性回顧和統合分析，資料搜尋到2021年4月25日。
- 研究評估伊維菌素在降低死亡率、次要結果和預防上的效果。
- 這篇文章只貼了摘要開頭，沒有列出結果數字。
2021/06/20
Ivermectin 最新報告：
Abstract
Background:
Repurposed medicines may have a role against the SARS-CoV-2 virus. The antiparasitic ivermectin, with antiviral and anti-inflammatory properties, has now been tested in numerous clinical trials.
Areas of uncertainty:
We assessed the efficacy of ivermectin treatment in reducing mortality, in secondary outcomes, and in chemoprophylaxis, among people with, or at high risk of, COVID-19 infection.
Data sources:
We searched bibliographic databases up to April 25, 2021. Two review authors sifted for studies, extracted data, and assessed risk of bias. Meta-analyses were conducted and certainty of the evidence was assessed using the GRADE approach and additionally in trial sequential analyses for mortality. Twenty-four randomized controlled trials involving 3406 participants met review inclusion.
Therapeutic Advances:
Meta-analysis of 15 trials found that ivermectin reduced risk of death compared with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73; n = 2438; I2 = 49%; moderate-certainty evidence). This result was confirmed in a trial sequential analysis using the same DerSimonian–Laird method that underpinned the unadjusted analysis. This was also robust against a trial sequential analysis using the Biggerstaff–Tweedie method. Low-certainty evidence found that ivermectin prophylaxis reduced COVID-19 infection by an average 86% (95% confidence interval 79%–91%). Secondary outcomes provided less certain evidence. Low-certainty evidence suggested that there may be no benefit with ivermectin for “need for mechanical ventilation,” whereas effect estimates for “improvement” and “deterioration” clearly favored ivermectin use. Severe adverse events were rare among treatment trials and evidence of no difference was assessed as low certainty. Evidence on other secondary outcomes was very low certainty.
Conclusions:
Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.
簡單說，效果卓著～
少數醫療人員信口開河...一開始便否定此藥效果。若我們都同意該讓科學說話，為何一口咬定？在未知之前，我們都該保持開放心態，不否認任何可能，這才是真醫學。
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