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Tuesday, March 19, 2024

Finally, ivermectin is peer reviewed

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"More evidence supporting the use of the repurposed drug has emerged."

 

The battle for the recognition of the anti-parasitic drug ivermectin as a possible prophylactic and even cure for COVID-19 is about to end. 

In the May-June 2021 edition (Volume 28 Issue3) of the prestigious American Journal of Therapeutics, a collaborative paper on the drug, entitled  “Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19” authored by a group of doctors and scientists led by Dr. Pierre Kory and Dr. Paul Marik, was finally given space. 

By publishing the paper, the journal’s panel of experts gave a seal of approval to the heroic efforts of these doctors and  scientists, most of whom are working on the frontlines and who are scouring the place for new ways — including the use of repurposed drugs — to treat the millions infected by this deadly virus. In a word, it has finally been peer reviewed, and with very encouraging results at that.  

As the paper’s abstract noted, immediately after COVID- 19 emerged in the US, health providers began reviewing whatever data were available anywhere, i.e., published peer reviewed studies,   manuscripts in pre print data servers, expert meta analyses, numerous epidemiological analyses of regions with ivermectin distribution campaigns, including those released by the Chinese doctors who first identified the DNA of this novel virus to line up potentially effective treatment options including repurposed therapeutic agents which could be accessed by all countries and peoples worldwide at the earliest possible opportunity.        

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It was not until the end of the third quarter last year, that the studies and discussions among experts produced some positive results, meaning a reproducible and definitive proof of efficacy in reducing the mortality from COVID-19, with the use of corticosteroids in moderate and even severe cases. By the fourth quarter, as cases surged worldwide, governments were pressed to proactively secure new ways and treatments for infected persons. In the United States, frontline caregivers like Kory and Marik started using ivermectin as part of their treatment protocol and petritioned the US FDA and CDC to include the same in their health guidance. 

After Kory and his group testified before the US Senate showing in no uncertain terms the benefits derived from the drug use and, coincidentally, reports of dramatic results in the reduction of infections in a number of South American countries like Paraguay, Peru and some provinces in Brazil also came to view. That moved the global medical authorities to finally take notice and seriously look into the situation. 

 Evidence has now emerged that indeed ivermectin has exhibited numerous antiviral and anti-inflammatory mechanisms with trial results reporting significant outcome benefits. As the paper noted, a large majority of randomized and observational controlled trials of ivermectin “are reporting repeated, large magnitude improvements in clinical outcomes. Numerous prophylaxis trials demonstrate that regular Ivermectin use leads to large reductions in transmission. Multiple, large ‘natural experiments’ occurred in regions that initiated ‘ivermectin distribution’ campaigns followed by tight, reproducible, temporally associated decreases in case counts and case fatality rates compared with nearby regions without such campaigns.”

Thus, the paper observed: “There is accumulating evidence that demonstrates both the safety and efficacy of ivermectin in the prevention and treatment of COVID-19. Large-scale epidemiologic analyses validate the findings of in vitro, animal, prophylaxis, and clinical studies. Epidemiologic data from regions of the world with widespread ivermectin use have demonstrated a temporally associated reduction in case counts, hospitalizations, and fatality rates.”

Given the continuing challenges faced by health care providers worldwide in providing appropriate interventions in Covid 19 patients and ivermectin’s long-standing safety record, low cost, and wide availability along with the consistent, reproducible, large magnitude of findings on transmission rates, need for hospitalization, and mortality, the authors proposed the widespread deployment in both prevention and treatment.

Unfortunately, the global medical authorities including the WHO and leading public health agencies have continued to stall or inject reservations on the use of this “wonder drug,” as it came to be known when the discoverers of the drug were given the Nobel Prize in Medicine. The US CDC’s most recent recommendation on the use of ivermectin in Covid 19 patients, merely said that “there was insufficient evidence to recommend for or against ivermectin in COVID-19.” What a downer, especially given the surges we are now experiencing in a lot of countries some of whom are now on their third or even fourth lockdowns.  

Despite these continuing obstacles, the fact that this review has finally found print in a very prestigious journal, coupled with the efforts of groups of concerned practitioners worldwide, there is now a snowballing initiative to get the PHAs and the WHO to move with all deliberate speed. 

In the Philippines, on President Duterte’s orders, the FDA has approved the petition of five (5) hospitals to prescribe ivermectin for “compassionate use”. In the United Kingdom, the British Ivermectin Recommendation Development Panel was recently coordinated by the Evidence-Based Medicine Consultancy Ltd to more rapidly formulate an ivermectin treatment guideline using the standard guideline development process followed by the WHO. 

As the paper enthusiastically reported: “On February 12, 2021, a meeting was held that included an international consortium of 75 practitioners, researchers, specialists, and patient representatives representing 16 countries and most regions of the world. This Recommendation Development Panel was presented the results of the meta-analysis of 18 treatment RCTs and 3 prophylaxis RCTs including more than 2500 patients along with a summary of the observational trials and the epidemiologic analyses related to regional ivermectin use. After a discussion period, a vote was held on multiple aspects of the data on ivermectin, according to standard WHO guideline development processes. The Panel found the certainty of evidence for ivermectin’s effects on survival to be strong and they recommended unconditional adoption for use in the prophylaxis and treatment of COVID-19.”

Concluding its submission, the authors wrote that “based on the totality of the trials and epidemiologic evidence presented in this review along with the preliminary findings of the Unitaid/WHO meta-analysis of treatment RCTs and the guideline recommendation from the international BIRD conference, ivermectin should be globally and systematically deployed in the prevention and treatment of COVID-19.” 

I truly hope that the scourge of COVID-19 will soon be conquered.

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