A systematic review of experimental evidence for antiviral effects of ivermectin and an in silico analysis of ivermectin's possible mode of action against SARS‐CoV‐2

Viral infections remain a major cause of economic loss with an unmet need for novel therapeutic agents. Ivermectin is putative antiviral compound; the proposed mechanism inhibition nuclear translocation viral proteins, facilitated by mammalian host importins, necessary process propagation infections. We systematically reviewed evidence applicability ivermectin against including SARS-CoV-2 regarding efficacy, mechanisms and selective toxicity. The genome was mined to determine potential location signals meta-analyses in vivo studies included all comparators over time, dose range replication multiple organs. inhibited many viruses those Flaviviridae, Circoviridae Coronaviridae families vitro. Real mock were identified SARS-CoV-2, target predicting sequestration bait importin β, stopping infected cells from reaching virus-resistant state. While pharmacokinetic evaluations indicate that could be toxic if applied based on vitro studies, shown Porcine circovirus piglets Suid herpesvirus mice. Overall standardized mean differences 95% confidence intervals versus controls −4.43 (−5.81, −3.04), p < 0.00001. Based current results, repurposing as agent promising. However, further work needed reconcile clinical efficacy. Developing additional should pursued emphasis pre-clinical trials validated models infection.