Ivermectin For COVID: Insignificant Results In Treatment Of Mild Cases – WHO Recommends Use Only In Clinical Trials COVID-19 Science 02/04/2021 • Editorial team Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Community health worker distributes ivermectin – the mainstay treatment against onchocercisasis (river blindness) – for the past several decades. A recent trial of ivermectin, a mainstay treatment for the parasitic disease onchocerciasis for the past three decades, has failed to show significant impacts against COVID-19, a new study, published in JAMA, reports. The study by a group of researchers in Cali, Colombia found that the use of the antiparitic drug, typically used to treat onchocersiasis (river blindness) endemic to West Africa, did not not significantly shorten the durationof COVID symptoms in patients with mild disease. The study of some 400 people found that those trated with the drug had a resolution of symptoms in 10 days, on average, as compared to 12 days – but the two day difference was not deemed statistically significant. “Further trials of ivermectin as a treatment against COVID-19 are, however, still underway. The ANTICOV Consortium, for example, is considering adding ivermectin – in combination with another drug – as an additional arm of its ANTICOV series of clinical trials underway in Africa. The clinical trials, coordinated by DNDi, are testing the efficacy of different drugs as a potential treatment against mild to moderate cases of COVID-19.” In light of the inconclusive evidence, WHO, meanwhile, has issued a recommendation that use of ivermectin be limited to clinical trials, until more data is available. This recommendation, which applies to patients with COVID-19 of any disease severity, is now part of WHO’s guidelines on COVID-19 treatments. Ivermectin is a broad spectrum anti-parasitic agent, included in WHO essential medicines list, and a mainstay of treatment against river blindness for the past four decades or more. Following the breakthrough discovery of efficacy in trials conducted by WHO in the 1970s, it was put into widespread use in West Africa, where river blindness is endemic, under programmes of preventative, mass community administration of the drug once a year. Only in the past several years has a new treatment for river blindness, moxidectin emerged, which shows promise of even greater efficacy against onchocerciasis. Ivermectin is also used for the tratment of scabies, strongyloidiasis and other diseases caused by soil transmitted helminthiasis. Ivermectin is traditionally used against onchocerciasis and scabies The current WHO guidance on ivermectin was issued following a review of the evidence by an international panel of experts. The group reviewed pooled data from 16 randomized controlled trials (total enrolled 2407), including both inpatients and outpatients with COVID-19. They determined that the evidence on whether ivermectin reduces mortality, need for mechanical ventilation, need for hospital admission and time to clinical improvement in COVID-19 patients is of “very low certainty,” due to the small sizes and methodological limitations of available trial data, including small number of events. The panel did not look at the use of ivermectin to prevent COVID-19, which is outside of scope of the current guidelines. Other WHO recommendations on COVID-19 treatments include: Strong recommendation for the use systemic corticosteroids (e.g. dexemethesone) for severe or critically ill COVID-19 patients; with a conditional recommendation against their use in patients with mild/moderate COVID-19; Conditional recommendation for the use of low dose anticoagulants in hospitalized patients (this recommendation is part of the clinical management guidelines). We suggest the use of low dose anticoagulants rather than higher doses, unless otherwise indicated; Conditional recommendation against administering remdesivir in addition to usual care; Strong recommendation against the use of hydroxychloroquine or chloroquine for treatment of COVID-19 of any severity; Strong recommendation against administering lopinavir/ritonavir for treatment of COVID-19 of any severity. Updated on 6 April 2020. Image Credits: Mectizan Donation Programme, Sarang. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.