TOGETHER trial (NEJM) finds ivermectin does not prevent COVID-19 hospitalization
The TOGETHER adaptive platform trial, published in the New England Journal of Medicine (online March 30, 2022), reported that among 1,358 high-risk outpatients in Brazil randomized to ivermectin (400 µg/kg daily for 3 days) or placebo, the composite of COVID-19 hospitalization or extended emergency-department observation was 14.7% vs 16.3% (relative risk 0.90, credible interval 0.70–1.16) — no statistically significant benefit, and none on any secondary outcome. The same month, the UK's PRINCIPLE trial posted preprint results likewise finding no meaningful benefit from ivermectin (noted here without a cited URL — the medRxiv preprint could not be fetched at ingest). Later 2022 trials (ACTIV-6, COVID-OUT) reached similar null results, and NIH guidelines recommend against ivermectin for COVID-19 outside clinical trials.
Primary quotes
“Treatment with ivermectin did not result in a lower incidence of medical admission to a hospital due to progression of Covid-19 or of prolonged emergency department observation among outpatients with an early diagnosis of Covid-19.”
Reis et al., NEJM (TOGETHER)
Flags / open questions
- •PRINCIPLE March 2022 result was a preprint (published 2023 in Journal of Infection); noted without URL (fetch blocked)
Linked sources
Related contentions
Unresolved. The efficacy question for ivermectin in COVID-19 is largely settled against benefit in the major RCTs, but the dispute over the tone and legality of the FDA's messaging — and over whether early dismissal distorted research and prescribing — remains contested in court (Apter v. HHS, revived by the Fifth Circuit in 2023 and later settled with the FDA removing the posts) and in public debate.