Ivermectin

Ivermectin image from Wikipedia

An analysis published in Open Forum Infectious Diseases found a 56% reduced risk of mortality for COVID-19 patients taking the anti-parasitic drug ivermectin compared to standard of care or another therapy. The study pulled data from 24 randomized trials involving 3,328 patients with moderate to severe COVID-19.

The study also found that ivermectin was “associated with reduced inflammatory markers” and quicker viral clearance.

Ivermectin, a widely available inexpensive drug used to treat worm and scabies infections in humans and animals, has emerged as a COVID-19 treatment in several parts of the world. Its use, however, has been controversial. WHO has counseled against its use as a COVID-19 treatment outside of clinical trials. And Merck, an ivermectin manufacturer, released a statement in February saying there was no scientific evidence to support the use of ivermectin for COVID-19.

A study recently published in the American Journal of Therapeutics also found some benefits for ivermectin in treating COVID-19 with moderate-certainty evidence.

The data from the study published in Open Forum Infectious Diseases is unlikely to convince skeptics. Nine of the studies involved in the meta-analysis were preprints. Another six were previously unpublished.

One factor clouding the study results were the variability in the trials involved, which administered a range of ivermectin doses. The studies’ control arms also varied significantly. Some administered placebo while others used drugs ranging from hydroxychloroquine to lopinavir/ritonavir to standard of care. The duo of lopinavir and ritonavir has historically found use against HIV.

The study also acknowledged that there was no distinction between the numbers of ivermectin patients and controls with severe COVID-19. They did find a 70% improvement in survival among those with moderate COVID-19 infections, however. The study also found that ivermectin recipients were discharged from the hospital an average of 4.27 days earlier than patients not receiving the drug.

Future trials such as the UK-based PRINCIPLE outpatient trial involving over 5,000 patients could further clarify whether ivermectin deserves a role in the COVID-19 fight — especially in countries where vaccines are not widely available. The PRINCIPLE study is testing ivermectin and the antiviral Avigan (favipiravir) against standard of care.