‘IVERMECTIN’ – Medicine for the dogs…  … or miracle cure?

‘IVERMECTIN’ – Medicine for the dogs…  … or miracle cure?

There have been a number of false claims with COVID-19 treatments, ranging from Hydroxychloriquine to the ‘herbal tea’ proposed by the Madagascan Government. But a new study from the University of Liverpool has yielded some highly encouraging results. According to the trials, ‘IVERMECTIN’ can dramatically reduce COVID-19 fatality rates.

But local health authorities are not eager to acknowledge the initial results of ‘IVERMECTIN’ as a drug against COVID-19.  This led to an outcry on Social Media which has been packed with anecdotal stories about doctors using Ivermectin with some success and laypeople advocating for the use of the drug. Some health workers have called on the government to allow the use of it, too. The SABC quoted Farida Amod, a specialist at the Lenmed Shifa hospital in Durban, who said Ivermectin could help reduce Covid-19 infections. But, to the dismay of its propagators, it has not been approved yet.

WHAT IS IVERMECTIN?

The South African [1] reports as follows:

The medication, which can be taken as a tablet or applied as a gel, is a widely used drug for the treatment and control of parasites in animals. It is also used to treat several tropical diseases in humans not commonly seen in South Africa – but it’s perhaps best known as an effective treatment against scabies and head lice.

In a meta-analysis presented by Dr Andrew Hill, of the Department of Pharmacology at the University of Liverpool (UK)  – which featured 11 randomised trials in 1452 patients – Ivermectin treatment was associated with:

  • Faster time to viral clearance.
  • Shorter duration of hospitalisation.
  • 43% higher rates of clinical recovery.
  • 83% improvement in survival rates.
  • Furthermore, the low cost of manufacturing the drug is also a major benefit raised by the researchers:

Today, there are equally as many compelling arguments for the use of ‘IVERMECTIN’  as there are against the use of the drug. 

FOR

Appearing as a witness on Dec. 8, 2020, before the Senate Committee on Homeland Security and Governmental Affairs—which held a hearing on “Early Outpatient Treatment: An Essential Part of a COVID-19 Solution”— Dr. Pierre Kory, President of the Frontline COVID-19 Critical Care Alliance (FLCCC), called for the government to swiftly review the already expansive and still rapidly emerging medical evidence on Ivermectin.

The video clip provides information that supports the use of the drug:

https://vimeo.com/502893336

Information provided by the Barcelona Institute for Global Health (ISGlobal) said that there were parts of the world where ‘IVERMECTIN’  was approved to treat specific health problems in humans, even though not yet approved for use against COVID-19.  This includes in the US where it was approved for use against the parasitic roundworm, Strongyloides stercoralis, and against river blindness caused by the parasitic worm, Onchocerca volvulus.

In Europe it was approved against lymphatic filariasis caused by filarial parasites, and against scabies caused by the human itch mite (Sarcoptes scabiei var. hominis), while in Australia it was approved for use against severe crusted scabies.

AGAINST

The Daily Mirror[2] reports that Dr Peter Oberem, CEO of South African animal health products provider, Afrivet, said that while a number of international scientific articles supported the theory that ‘IVERMECTIN’  could possibly prevent or cure COVID-19 infections, South Africa’s ivermectin products “are not registered as human medicine” and “have been tested for safety in animals, not humans”.

Oberem’s stance was echoed by the South African Health Products Regulatory Authority (SAHPRA) that confirmed in a statement that ‘IVERMECTIN’  was neither indicated nor approved by SAHPRA for use in humans.

Information on the US Food and Drug Administration’s (USFDA) website also discouraged people from using ‘IVERMECTIN’ to prevent or treat Covid-19.

Dr Tamara Kredo, a Senior Specialist Scientist of South African Medical Research Council, spoke with eNCA’s Shahan Ramkissoon and provided information why she feels the current studies and data are not convincing.  She explains that according to her assessment the trails are just not sufficient at the moment to come to a final conclusion.

https://www.youtube.com/watch?v=2q2IXSPqfJc

OFFICIAL RECOMMENDATION

An official website of the National Institutes of Health[3] reads as follows:

Ivermectin for the Treatment of COVID-19 (Last Updated: January 14, 2021)

Recommendation

The COVID-19 Treatment Guidelines Panel (the Panel) has determined that currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin for the treatment of COVID-19.

Rationale

‘IVERMECTIN’  is an antiparasitic drug that is approved by the Food and Drug Administration (FDA) for the treatment of onchocerciasis and strongyloidiasis ‘IVERMECTIN’  is not FDA-approved for the treatment of any viral infection. In general, the drug is well tolerated. It is currently being evaluated as a potential treatment for COVID-19.

Antiviral and Anti-Inflammatory Effects of Ivermectin

Reports from in vitro studies suggest that ‘IVERMECTIN’  acts by inhibiting the host importin alfa/beta-1 nuclear transport proteins, which are part of a key intracellular transport process that viruses hijack to enhance infection by suppressing the host antiviral response.  In addition, ‘IVERMECTIN’  docking in vitro may interfere with the attachment of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein to the human cell membrane.

‘IVERMECTIN’  has been shown to inhibit the replication of SARS-CoV-2 in cell culture. However, pharmacokinetic and pharmacodynamic studies suggest that ‘IVERMECTIN’  doses up to 100-fold higher than those approved for use in humans would be required to achieve the plasma concentrations necessary to duplicate the drug’s antiviral efficacy in vitro.  Even though ‘IVERMECTIN’  appears to accumulate in lung tissue, with the doses used in most clinical trials, predicted systemic plasma and lung tissue concentrations are much lower than 2 µM, the half-maximal inhibitory concentration (IC50) against SARS-CoV-2 in vitro.

Ivermectin demonstrates potential anti-inflammatory properties in some in vitro studies, properties which have been postulated to be beneficial in the treatment of COVID-19.

Clinical Data

Since the last revision of the Ivermectin section of the Guidelines, the results of several randomized trials and retrospective cohort studies of ivermectin use in patients with COVID-19 have been published in peer-reviewed journals or made available as preliminary, non-peer-reviewed reports. Some clinical studies showed no benefits or worsening of disease after ‘IVERMECTIN’  use, whereas others reported shorter time to resolution of disease manifestations attributed to COVID-19, greater reduction in inflammatory markers, shorter time to viral clearance, or lower mortality rates in patients who received ivermectin than in patients who received comparator drugs or placebo.

However, most of the studies reported to date had incomplete information and significant methodological limitations, which make it difficult to exclude common causes of bias. The missing information and limitations include the following:

  • The sample size of most of the trials was small.
  • Various doses and schedules of ivermectin were used.
  • Some of the randomized controlled trials were open-label studies in which neither the participants nor the investigators were blinded to the treatment arms.
  • In addition to ivermectin or the comparator drug, patients also received various concomitant medications (e.g., doxycycline, hydroxychloroquine, azithromycin, zinc, corticosteroids), confounding assessment of the true efficacy or safety of ivermectin.
  • The severity of COVID-19 in the study participants was not always well described.
  • The study outcome measures were not always clearly defined.

Because of these limitations, the Panel cannot draw definitive conclusions about the clinical efficacy or safety of ‘IVERMECTIN’  for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin for the treatment of COVID-19.

CONCLUSION

Firstly, the Bible encourages Christians to “test all things” (1 Thessalonians 5:21).  Even though this is mentioned in the context of spiritual teaching, it also applies to life as a whole.  The Bible uses different phrases but the same concept:  : 

  • Prove all things; hold fast [to] that which is good; NET Bible
  • Examine all things; hold fast to what is good. New Heart English Bible
  • Test all things; hold firmly that which is good. Weymouth New Testament

It might be wise to wait for this new “miracle cure” to be examined, proven and tested before we join Social Media, for or against,  with an opinion void of substance.

Secondly, as much as we seek solutions and as desperate we are for answers, we need to guard against a “survivor bias”

“Survivor bias” is the inclination to only consider the “survivors” when analysing a situation because the “non-survivors” are taken out of the picture. When those who failed are removed from view, we only focus on the success stories, even though those who failed may be able to offer some important insight.

This is especially true for ‘IVERMECTIN’, and it is also important to understand that what worked for one individual might not work for the next. 

Desperate times necessitate desperate measures, but it might be wise to wait for more conclusive clinical studies from the experts before getting too excited.

[1] https://www.thesouthafrican.com/news/what-is-ivermectin-can-it-be-used-to-treat-covid-19/

[2] https://dailymirror.co.za/2021/01/05/public-warned-against-using-ivermectin-to-treat-covid-19/

[3] https://www.covid19treatmentguidelines.nih.gov/statement-on-ivermectin/

 

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