Lab and animal studies have suggested that the antiparasitic drug ivermectin has activity against SARS-CoV-2, the virus that causes COVID-19 but a clinical trial published recently in JAMA showed that early administration of ivermectin did not significantly shorten time to clinical improvement in 400 adults mildly ill with COVID-19.
Ivermectin, a widely used drug with a favorable safety profile, is thought to act at different protein-binding sites to reduce viral replication therefore Several countries have included ivermectin in their treatment guidelines.
However, a single-center, double-blind, randomized trial led by researchers from the Centro de Estudios en Infectologia Pediatrica in Cali, Colombia found ivermectin did not seem to “significantly improve” the time needed for symptoms to get better among patients with COVID-19.
The study used random sampling of coronavirus-positive patients to identify inpatients and outpatients with mild COVID-19 within the first 7 days after symptom onset from Jul 15 to Nov 30, 2020.
The median time to symptom resolution was 10 days in the 200 patients randomly assigned to receive ivermectin daily for 5 days, compared with 12 days in 198 patients receiving a placebo (interquartile range for both, 9 to 13 days; hazard ratio, 1.07). Twenty-one days after starting treatment, 82% in the ivermectin group and 79% receiving placebo were symptom-free.
Only 2% of patients in the ivermectin group and 3.5% in the placebo group experienced clinical deterioration of at least two points on an ordinal eight-point scale (absolute difference, -1.53). There were no significant differences between the two groups in the proportion of patients who needed more aggressive care (2% who received ivermectin vs 5% who received placebo; absolute difference, -3.05) or in the length of time that the escalated care was needed (median difference, 7 days).
There were no significant differences in the proportions of patients with fever (absolute difference between ivermectin and placebo, -2.61) or the length of the fever (absolute difference, -0.5 days). Ivermectin did not reduce emergency department or telemedicine visits.
The findings from this study do not support the use of ivermectin for the treatment of mild COVID-19. Perhaps larger trials may be needed to understand the effects of ivermectin on severe COVID-19, hospitalization, or other clinically relevant outcomes.
The US Food and Drug Administration also announced said that people should not use ivermectin to attempt to treat or prevent Covid-19. The drug is typically used to treat parasites, such as lice and scabies. According to the FDA, ivermectin is not an anti-viral (a drug for treating viruses), and taking large doses of this drug is dangerous and can cause serious harm. The FDA also warned people to not use medications intended for animals as drug preparations for animals are very different from those approved for humans.
Dr. Melvin Sanicas (@Vaccinologist) is a physician-scientist specializing in vaccines, infectious diseases, and global health.