Ivermectin did not reduce Covid-19 hospitalizations in the largest trial to date
Ivermectin did not reduce Covid-19 hospitalizations in the largest trial to date

Ivermectin did not reduce Covid-19 hospitalizations in the largest trial to date

Researchers testing recycled drugs against Covid-19 found that ivermectin did not reduce hospital admissions, in the largest trial to date of the antiparasitic effect on the disease that drives the pandemic.

Ivermectin has received a lot of attention as a potential treatment of Covid-19 including from celebrities such as podcast host Joe Rogan. It has the most evidence shown to be ineffective against Covid-19 or have relied on poor quality data, said infectious disease researchers. Public health authorities and researchers have been saying for months that the drug has shown no benefit in treating the disease. Takes large doses of the drug is dangerous, the Food and Drug Administration has said.

The most recent trial of nearly 1,400 Covid-19 patients at risk for serious illness is the largest showing that those receiving ivermectin as a treatment did not perform better than those receiving placebo.

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“There was no indication that ivermectin is clinically useful,” said Edward Mills, one of the study’s lead researchers and professor of health sciences at Canada’s McMaster University in Hamilton, Ontario. Dr. Mills on Friday plans to present the results, which have been accepted for publication in a major peer-reviewed medical journal, at a public forum sponsored by the National Institutes of Health.

Dr. Mills and his colleagues looked at 1,358 adults who visited one of 12 clinics in the Minas Gerais region of Brazil with Covid-19 symptoms. The patients all had a positive rapid test for SARS-CoV-2 and were at risk of having a severe case of causes, including a history of diabetes, hypertension, cardiovascular disease, or lung disease.

Poster with the phrase ‘We have ivermectin’ at a pharmacy in Ceilândia, Brazil.


Photo:

Ricardo Jayme / AGIF / Associated Press

The researchers prescribed half of the patients a course of ivermectin pills for three days. The other half received a placebo. They tracked whether patients were admitted within 28 days. The researchers also looked at whether patients on ivermectin removed the virus from their bodies faster than those receiving placebo, whether their symptoms disappeared faster, whether they were in the hospital or on respirators for a shorter time, and whether there was any difference in death. tariffs for the two groups.

To make sure they were thorough, the researchers analyzed the data in three different ways. They looked at data from all patients; then analyzed data from patients receiving ivermectin or placebo 24 hours before admission; and in a third review, looked at data from patients who said they had adhered to their dosing schedule closely. In each scenario, they found that ivermectin did not improve patient outcomes.

“This is the first large, prospective study that really should help bring ivermectin to rest and give no credibility to its use for Covid-19,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor. College of Medicine, which reviewed the results.

Ivermectin is used primarily to treat patients with certain parasitic diseases. It has antiviral properties but has not been approved by the FDA to treat viral infections.

Given its antiviral prospects, researchers early in the pandemic believed so could be a candidate for the treatment of Covid-19. In June 2020, a group of researchers in Australia published a paper showing that large amounts of ivermectin could stop coronavirus replication in cell cultures. But there was a problem: to achieve that effect, a person had to take up to 100 times as much ivermectin as the dose approved for use in humans.

Some studies of ivermectin published in journals or on preprint servers prior to peer review has not shown any benefits, or worsening of Covid-19 symptoms, after using ivermectin. Some have shown some benefits, such as shorter time to symptom resolution, reduction of inflammation, faster viral clearance and lower death rates.

Ivermectin capsules, seen last year in the Philippines, where the drug was distributed in some places despite the lack of evidence to show that it prevents or cures Covid-19.


Photo:

rolex dela pena / Shutterstock

However, most studies show positive effects had significant limitations such as small sample sizes or poorly defined results, according to the NIH. Several studies of ivermectin have been withdrawn from publication, including a randomized controlled trial looking at 100 patients in Lebanon who were withdrawn by the journal Viruses due to problems with the statistical analysis, according to the journal. Researchers at NIH and Oxford University are also conducting major tests on the effectiveness of ivermectin, although the results have not been published.

Dr. Mills said ivermectin could improve outcomes in Covid-19 patients battling certain parasitic diseases at the same time. But based on his team’s results, he said, the drug does not appear to have any effect on Covid-19 itself.

Dr. Mills and his colleagues are also studying other drugs that could be used again to work against Covid-19. Such drugs can be useful because their side effects are well known and they can be cheaper to implement in poor countries than drugs such as

Merck

& Co. and Ridgeback Biotherapeutics LPs molnupiravir or

Pfizer Inc

‘s Paxlovid.

New studies give clues as to who may be more susceptible to prolonged Covid, a term for persistent Covid-19 symptoms. WSJ breaks down the science of long Covid and the state of treatment. Illustration: Jacob Reynolds for the Wall Street Journal

Merck said it has taken steps to make molnupiravir available in low- and middle-income countries, including allocating three million courses for distribution through auxiliary groups and awarding licenses to generic manufacturers. Pfizer said it was working to expand its supply chain and license the production of Paxlovid through a UN program.

Dr. Mills and his collaborators have looked at 11 recycled treatments for Covid-19, at least one of which has shown promise –fluvoxamine, which is commonly used to treat obsessive-compulsive disorder and depression. They published research in the Lancet Global Health in October, which showed that Covid-19 patients receiving fluvoxamine were less likely to require hospitalization than those who did not.

The researchers are looking at the effect in Covid-19 patients of combining fluvoxamine and an inhaled steroid, budesonide, as well as a drug called peginterferon lambda, which is used to treat chronic viral hepatitis.

Write to Sarah Toy at [email protected]

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