Ivermectin in Adults With Severe COVID-19.

NCT ID: NCT04602507

Last Updated: 2022-01-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-10

Study Completion Date

2021-12-09

Brief Summary

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Since the onset of the disease, more than 40.5 million people have been diagnosed with COVID-19 and nearly 1.2 million people have died (October 21, 2020). There is no complete understanding of the pathogenesis of SARS-CoV-2 infection and to this day there is no specific therapy or vaccine available. Thus, patient care is based on symptomatic therapy and treatment of complications.

Ivermectin has been used for more than 30 years for the treatment of several diseases. More than one million doses of the drug are administered daily, particularly in low- and middle-income countries. Due to the low prevalence of adverse events with the use of this drug, ivermectin is considered to have a good safety profile and its potential benefit in other diseases is currently under investigation.

An in vitro study of ivermectin in SARS-CoV-2 in Australia showed a significant reduction of viral load in infected cells. Subsequently, a descriptive study of 704 critical patients with COVID-19 showed a reduction in mortality, hospitalization, and intensive care unit length-of-stay in those patients who received the drug. Unfortunately, this study was withdrawn by its authors, leaving more questions than answers.

Some countries in Latin America have authorized its use for the management of patients with COVID-19 even in the absence of solid evidence, and several other countries are conducting clinical trials to evaluate its efficacy for the treatment of moderate and severe disease.

Since there is no specific treatment for COVID-19 and the therapeutic options are scarce, the researchers believe it is completely plausible, urgent, and necessary to evaluate if ivermectin use reduces the risk of admission to an intensive care unit (ICU) in hospitalized adults with severe COVID-19. The proposal is a randomized, double-blind clinical trial, conducted at CES Clinic, Medellin-Colombia. The investigators will randomize 100 patients with severe, non-critical illness, into two groups, one group will receive ivermectin in addition to standard management and the other group will receive placebo plus standard management. Clinical outcomes to evaluate will be ICU admission, need for mechanical ventilation, length of hospital stay, days in the ICU and mechanical ventilation, and finally, the incidence of adverse events related to the intervention. The estimated time to complete the study is approximately five months.

Detailed Description

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Conditions

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Covid19 Severe Acute Respiratory Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Arm #1: 50 patients with routine care offered in the hospital plus ivermectin 400 µg/kg orally in a single dose.

Arm #2: 50 patients with routine care offered in the hospital plus placebo in a single dose.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Once the participant consents, staff will collect relevant demographic and clinical data from the clinical chart and a consecutive code from 001 to 100 will be assigned to each in order of arrival. 100 vials of ivermectin or placebo will be stored in the pharmaceutical service with a randomly assigned number from 001 to 100. After placement of medical order, the qualified nursing staff will dispense ivermectin or placebo. Blinded study physicians will carry on daily medical evaluation. Neither the researchers collecting data nor the analyzers will be aware of the patients' treatment arm.

To achieve blinding, a certified pharmaceutical laboratory produced a placebo identical in color, physical form, sensory perception (appearance, smell, and taste), packaging, and labeling to ivermectin.

Study Groups

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Intervention

50 patients with the routine care offered in the hospital plus ivermectin 400 µg/kg (2 drops per kg) orally in a single dose.

Group Type EXPERIMENTAL

Ivermectin

Intervention Type DRUG

Routinary care offered in the hospital plus ivermectin 400 µg/kg (2 drops per kg) orally in a single dose.

Control

50 patients with routine care offered in the hospital plus placebo orally (2 drops per kg) in a single dose.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Routinary care offered in the hospital plus placebo (2 drops per kg) orally in a single dose

Interventions

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Ivermectin

Routinary care offered in the hospital plus ivermectin 400 µg/kg (2 drops per kg) orally in a single dose.

Intervention Type DRUG

Placebo

Routinary care offered in the hospital plus placebo (2 drops per kg) orally in a single dose

Intervention Type OTHER

Other Intervention Names

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Intervention Control

Eligibility Criteria

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Inclusion Criteria

* Over 18 years old.
* Confirmed diagnosis of SARS-CoV-2 by polymerase chain reaction (PCR).
* Diagnosis of severe pneumonia according to criteria of the National Institute of Health and the Colombian Consensus (suspected respiratory infection, organ failure, arterial oxygen saturation (SaO2) ambient air \<90% or respiratory rate \> 30 resp/min) or diagnosis of acute respiratory distress syndrome according to criteria of the National Institute of Health and the Colombian Consensus (clinical findings, bilateral radiographic infiltrates, + oxygenation deficit as well: mild: 200 mmHg \< PaO2/FiO2 (fraction of inspired oxygen) \< 300 mm/Hg; moderate: 100 mm/Hg \< PaO2/FiO2 \< 200 mm/Hg and, severe: PaO2/FiO2 \< 100 mm/Hg).
* Less than 14 days since the onset of symptoms.
* Hospitalized in a general internal medicine ward, special care unit, or those designated for managing patients with COVID19.

Exclusion Criteria

* Pregnant or lactating women.
* Use of ivermectin in the two weeks before admission to the clinic
* Diseases affecting the blood-brain barrier (meningitis, encephalocranial trauma, acute subarachnoid hemorrhage)
* Limitation to understanding the explanations and giving consent, defined by the investigating physician.
* Patients with HIV/AIDS
* That the patient is participating in another clinical trial.
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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CES University

OTHER

Sponsor Role lead

Responsible Party

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Francisco Luis Ochoa-Jaramillo, MD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Francisco L Ochoa-Jaramillo, MD; MSc

Role: PRINCIPAL_INVESTIGATOR

CES University

Locations

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Clinica CES

Medellín, Antioquia, Colombia

Site Status

Countries

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Colombia

References

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Other Identifiers

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ECA-COVID-CES

Identifier Type: -

Identifier Source: org_study_id

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