Efficacy and safety of single-dose ivermectin in mild-to-moderate COVID-19: the double-blind, randomized, placebo-controlled CORVETTE-01 trial

Background

To investigate whether ivermectin inhibits SARS-CoV-2 proliferation in patients with mild-to-moderate COVID-19 using time to a negative COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) test.

Methods

CORVETTE-01 was a double-blind, randomized, placebo-controlled study (August 2020-October 2021) conducted in Japan. Overall, 248 patients diagnosed with COVID-19 using RT-PCR were assessed for eligibility. A single oral dose of ivermectin (200  μg/kg) or placebo was administered under fasting. The primary outcome was time to a negative COVID-19 RT-PCR test result for SARS-CoV-2 nucleic acid, assessed using stratified log-rank test and Cox regression models.

Results

Overall, 112 and 109 patients were randomized to ivermectin and placebo, respectively; 106 patients from each group were included in the full analysis set (male [%], mean age: 68.9%, 47.9 years [ivermectin]; 62.3%, 47.5 years [placebo]). No significant difference was observed in the occurrence of negative RT-PCR tests between the groups (hazard ratio, 0.96; 95% confidence interval [CI] 0.70-1.32; p = 0.785). Median (95% CI) time to a negative RT-PCR test was 14.0 (13.0-16.0) and 14.0 (12.0-16.0) days for ivermectin and placebo, respectively; 82.1% and 84% of patients achieved negative RT-PCR tests, respectively.

Conclusion

In patients with COVID-19, single-dose ivermectin was ineffective in decreasing the time to a negative RT-PCR test.

Clinical Trial Registration

ClinicalTrials.gov, NCT04703205.

Successful control of hemobilia secondary to metastatic liver cancer with transcatheter arterial embolization

A 54-yr-old man with multiple metastatic liver cancer was admitted to our hospital because of melena and intermittent colicky pain on the right upper abdomen. He underwent partial gastrectomy for gastric cancer 3 yr before the admission. Endoscopic examination of the duodenum on the 3rd hospital day showed active bleeding from the papilla of Vater, and diagnosis of hemobilia was done. Transcatheter arterial embolization controlled the bleeding successfully, and no rebleeding occurred until his death due to the advanced cancer 8 months later. We considered that the high vascularity of his metastatic tumor caused hemobilia. To the best of our knowledge, this is the first report of hemobilia by metastatic liver cancer treated successfully with transcatheter arterial embolization.