Can Ivermectin be used to treat COVID-19 (coronavirus)?
Medically reviewed by Melisa Puckey, BPharm. Last updated on Dec 29, 2020.
Can Ivermectin be used to treat COVID-19 (coronavirus)?
- Ivermectin has been trialled in treating the coronavirus SARS-CoV-2, which is the virus that causes COVID-19.
- An in vitro trial has shown ivermectin reduces the number of cell-associated viral RNA by 99.8 % in 24 hours. An in vitro study is when they study cells in a laboratory and not in a living organism.
- More studies are now needed to be done using ivermectin on people or animals to see how well ivermectin works against COVID-19. This is in vivo testing.
- Ivermectin is currently a FDA approved medicine for treatment of intestinal worms, Strongyloides stercoralis and Onchocerca volvulus. It has been established as safe for human use.
What is Ivermectin?
- Ivermectin is currently used to treat parasite infections such as intestinal worms, lice and mites.
- Recently ivermectin has also been studied to treat a range of viruses.
How does Ivermectin work on COVID-19?
- For the SARS-CoV-2 virus to make you sick, it has to first infect your cells.
- Then while inside the cell, the virus makes heaps of copies of itself, so it can spread around your body.
- The virus also has ways of reducing the way your body fights the infection.
- During the infection of the cell, some viral proteins go into the cell nucleus, and from here they can decrease the body’s ability to fight the virus, which means the infection can get worse.
- To get into the nucleus the viral proteins need to bind a cargo transporter which lets them in.
- Ivermectin can block the cargo transporter, so the viral proteins can’t get into the nucleus. This is how the scientists believe Ivermectin works against SARS-CoV-2 virus.
- By taking Ivermectin, it means the body can fight the infection like normal, because its antiviral response hasn’t been reduced by the viral proteins.
Is Ivermectin an approved medicine by the FDA?
Ivermectin tablets (Stromectol) is an approved medicine by the FDA for use in intestinal worms Strongyloides stercoralis and Onchocerca volvulus
Ivermectin intended for animal use should not be taken by humans
Ivermectin cream 1% is approved for rosacea
Ivermectin tablets are also used off-label for a number of other conditions.
ICON Clinical Study Results
The ICON study, which was a multihospital retrospective cohort study, involved 280 patients, 173 patients were treated with at least one oral dose of 200 μg/kg ivermectin and 107 patients had no ivermectin treatment. Patients could also be treated with hydroxychloroquine, azithromycin, or both.
The results from this study showed that:
- Overall mortality was significantly lower for the ivermectin group (15%) compared to the usual treatment group (25.2%) using figures from the unmatched cohort.
- Mortality for the subgroup of patients who had severe pulmonary involvement was lower in the ivermectin treatment group (38.8%) compared to the usual treatment group (80.7%) from the unmatched cohort.
- There was no significant difference between the two treatment groups regarding successful extubation rates of mechanically ventilated patients. Successful extubation is when the patient has had the breathing tube that has been used for mechanical ventilation removed and they can successfully breath on their own.
- Length of hospital stay was not significantly different between the ivermectin treatment group and the regular treatment group.
For secondary analysis of the results propensity score matching was performed, which is when the researcher matches a person in the treatment group to a person in the non-treatment group who has similar characteristics. This reduces the effects of confounding and selection bias.
- For the propensity matched cohort figures the mortality was significantly lower in the ivermectin treatment group compared to the regular treatment group (13.3% vs 24.5%; odds ratio, 0.47; 95% confidence interval, 0.22-0.99; P < .05).
The study noted that “Interpretation of these findings are tempered by the limitations of the retrospective design and the possibility of confounding” and that “Further studies in appropriately designed randomized trials are recommended before any conclusions can be made.”
What happens next?
We will be waiting for the results of more clinical trials in patients to see how well ivermectin works in treating COVID-19. They will be testing what could be an effective dose of ivermectin and whether ivermectin decreases the symptoms, time for recovery and death rate from COVID-19.
As Ivermectin is already a FDA approved medicine we already know that it has been established as safe for human use when used at the standard dose.
- Clinical trials in the laboratory (in vitro) on ivermectin show that ivermectin reduces the number of cell-associated viral RNA by 99.8 % in 24 hours, for the SARS-CoV-2 which is the virus that causes COVID-19.
- More studies are needed to see if these positive results will be the same in human testing (in vivo) and whether ivermectin will decrease the symptoms, time for recovery and death rate from COVID-19.
- Ivermectin is already a FDA approved medicine for some types of intestinal worms
- It is known that ivermectin has a good safety profile at standard dosing levels.
- Ivermectin Medication Information: https://www.drugs.com/ivermectin.html
- Ivermectin Professional Information: https://www.drugs.com/ppa/ivermectin-systemic.html
- Ivermectin is a specific inhibitor of importin α/β-mediated nuclear import able to inhibit replication of HIV-1 and dengue virus: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327999/
- The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129059/
- Use of Ivermectin Is Associated With Lower Mortality in Hospitalized Patients With Coronavirus Disease 2019: https://pubmed.ncbi.nlm.nih.gov/33065103/
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