Ivermectin cuts duration, says ICDDR,B

Manzur H Maswood | Published: 00:09, Dec 08,2020


Anti-parasitic medicine ivermectin has shown promises against COVID-19 in a clinical trial in Bangladesh.

Patients receiving a five-day course of ivermectin have shown an early viral clearance and improvements in blood biomarkers compared to two other groups, according to findings from the clinical trial by the ICDDR,B.

The ICDDR,B disseminated the results of the study that evaluated the safety and efficacy of ivermectin alone or ivermectin in combination with antibiotic doxycycline for the treatment of confirmed mild cases of COVID-19 at three hospitals in Dhaka.

‘Ivermectin shows promise against COVID-19,’ said ICDDR,B scientist Wasif Ali Khan, who is the principal investigator of the study.

Wasif said that the study showed that early intervention with ivermectin might lead to faster viral clearance during COVID-19 onset.

The randomised, double-blind, placebo-controlled trial, carried out on 68 hospitalised patients with COVID-19 in Dhaka, evaluated orally administered ivermectin alone (12mg once a day for 5 days), ivermectin single dose (12mg) in combination with doxycycline (200mg stat doxycycline on day 1 followed by 100mg 12-hourly for next 4 days) compared with placebo.

The distribution of the study patients was 22 in the group getting ivermectin alone, 23 in the group getting ivermectin and doxycycline, and 23 in the group getting placebo.

The hospitals that participated in the study, conducted during July-September, were Mugda Medical College Hospital, Kurmitola General Hospital and Dhaka Medical College Hospital.

The study demonstrated that patients in the 5-day ivermectin group were 77 per cent more likely to have early viral clearance on day 14 compared with those who received ivermectin and doxycycline (61 per cent) and placebo (39 per cent).

The research also showed that on the third day 18 per cent of the patients in the group treated with ivermectin alone began to show viral clearance compared to ivermectin plus doxycycline (3 per cent) and placebo (3 per cent), while on the seventh day the extent of viral clearance stood at 50 per cent, 30 per cent and 13 per cent respectively.

The odds of improvement in clinical status with the 5-day treatment with ivermectin alone versus ivermectin plus doxycycline and placebo were also favourable, trending toward reduction of severity of infection indicated by improvement in the blood biomarkers, the study showed.

The C-reactive protein (CRP), Lactate Dehydrogenase (LDH) and Ferritin levels notably dropped from the baseline on day 7 in the ivermectin-alone group compared to other two groups.

Among the study samples, 53 per cent had diabetes, 41 per cent had hypertension and 25 per cent had bronchial asthma.

No pregnant or lactating mother and child were included in the study. No side effects were reported and none of the samples died.

‘The anti-parasitic drug is found to be safe and has shown, at best, a modest benefit for mild coronavirus,’ Wasif said.

A large randomised controlled clinical trial of ivermectin treatment, he said, is needed to recommend this medicine as a cure for COVID-19.

Dhaka Medical College Hospital medicine professor Ahmedul Kabir, who was the co-principal investigator, said that ivermectin definitely showed promising results but ‘it would be a wrong message if we say that ivermectin is the medicine that cures COVID-19’.

‘It can be included in the national guideline for clinical trial only, not as a treatment,’ he said, adding that the sample size was small, which was a drawback.

Ahmedul, who is also a member of the COVID-19 treatment guideline committee, said that the study, however, determined that 12mg ivermectin a day would be an ideal dose.

ICDDR,B acting executive director Tahmeed Ahmed said that while there was no confirmed medicine for COVID-19, the study finding of the virus load decreasing due to the use of ivermectin came as a positive message.

‘We need to conduct a large-scale study,’ he said.

Nazmul Hassan, managing director of Beximco Pharmaceuticals that funded the study, said that following the study findings ivermectin should not be consumed on one’s own without a doctor’s prescription.

‘We have noticed that remdesivir was randomly used although it was meant for emergency use only on prescription by doctors,’ he cautioned.

‘Don’t start buying ivermectin personally, rather let the doctor decide,’ he added.

The study findings have been published in the International Journal of Infectious Diseases. These could be accessed at the following address: https://www.ijidonline.com/article/S1201-9712(20)32506-6/fulltext  

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