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Ivermectin is an oral drug used to treat parasitic infections. The World Health Organisation has warned against the general use of Ivermectin for the treatment of COVID-19

Goa on Monday announced that all citizens above 18 years will be given Ivermectin drug irrespective of their coronavirus status in a bid to bring down mortality.

State health minister Vishwajit Rane said patients will be given Ivermectin 12 mg for a period of five days as expert panels from the UK, Italy, Spain, and Japan have found a statistically significant reduction in mortality, time to recovery, and viral clearance in COVID-19 patients treated with this medicine.

The minister said this treatment would not prevent COVID-19 infection but it can help reduce the severity.

What is Ivermectin?

Ivermectin is an antiparasitic medication developed in 1975. As per The Conversation, the drug has been used since the 1980s to treat and prevent diseases related to parasites in humans, pets, and livestock, and works by paralysing invertebrate parasites. In Australia, it is mainly topically in creams and lotions for head lice.

 India Today reports that Ivermectin in tablet form has been approved by the US Food and Drug Administration (FDA) to treat intestinal strongyloidiasis and onchocerciasis (river blindness). It is also used to treat scabies.

Here’s what regulators say about it

However, the US FDA has not approved Ivermectin for COVID-19 treatment. “The FDA has not approved ivermectin for use in treating or preventing COVID-19 in humans. Ivermectin tablets are approved at very specific doses for some parasitic worms, and there are topical (on the skin) formulations for head lice and skin conditions like rosacea,” the FDA has said.

Similarly, European Medical Agency (EMA) has advised against the use of ‘ivermectin’ to treat COVID-19 patients. In March earlier this year, the EMA issued a statement saying it had “reviewed the latest evidence on the use of ivermectin for the prevention and treatment of COVID-19 and concluded that the available data do not support its use for COVID-19 outside well-designed clinical trials.”

Even the Union ministry of health and family welfare had also opted out from including Ivermectin in its official Clinical Management Protocol for COVID-19  last year. Experts of the central government’s joint monitoring group and the Indian Council of Medical Research’s COVID-19 task force held a meeting to deliberate upon the issue and decided not to include Ivermectin in the clinical management protocol “because of lack of sufficient evidence on its efficacy based on randomised trials held in India and abroad,” news agency PTI had reported, citing ministry sources.

What does WHO say about it?

The World Health Organisation (WHO) has recommended against the general use of Ivermectin for COVID-19 treatment. Dr Soumya Swaminathan, WHO chief scientist, said safety and efficacy are important when using any drug for a new indication, which is why it recommends against using Ivermectin.

A similar warning has also been issued by German healthcare and life sciences giant Merck, whose statement Dr Swaminathan attached to her tweet. Merck said its scientists continue to “carefully examine findings of all available and emerging studies of ‘ivermectin’ for treatment of COVID-19 “.

In February, the german Ivermectin manufacturer also said its analysis did not find evidence showing the drug’s efficacy against COVID-19 .

“To date, our analysis has identified: no scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies; no meaningful evidence for clinical activity or efficacy in patients with COVID-19 disease, and a concerning lack of safety data in the majority of studies,” Merck said in a statement.

However, some studies suggest the opposite.

Regular dose of Ivermectin may cut risk of COVID-19 , claims study

A review of available data – published in the May-June issue of the American Journal of Therapeutics – claims ‘ivermectin’ can help end the pandemic.

“We conducted the most comprehensive review of the available data on ivermectin,” said Pierre Kory, president and chief medical officer of the Front Line COVID-19 Critical Care Alliance (FLCCC), a group of medical and scientific experts, which led the study.

“We applied the gold standard to qualify the data reviewed before concluding that ivermectin can end this pandemic,” Kory said in a statement.

A focus of the study was on the 27 controlled trials available in January 2021, 15 of which were randomised controlled trials (RCT’s).

The authors found a large, statistically significant reduction in mortality, time to recovery, and viral clearance in COVID-19 patients treated with ivermectin.

To evaluate the efficacy of ivermectin in preventing COVID-19 , three RCTs and five observational controlled trials including almost 2,500 patients were analysed.

All studies reported that ivermectin significantly reduces the risk of contracting COVID-19 when used regularly, the authors said.

Experts seek tweak in administration protocol

The Goa government’s decision to administer ivermectin to all the people above 18 years as a preventive treatment amid the COVID-19 pandemic has prompted medical experts to question the efficacy of the five-day duration of the drug regimen while Congress questioned whether such recommendation was approved by the Centre or the WHO.

Dr Vinayak Buvaji, who heads the Goa chapter of the Indian Medical Association (IMA), told PTI on Tuesday that the treatment should not be given for a short period of five days but should ideally be continued till the pandemic is brought under control.

“The ideal regimen of ivermectin is to administer it on the first, third and seventh day and then continue it once a week till the pandemic is brought under control. Giving the tablets only for five days will not be impactful,” Dr Buvaji said.

He also advised against giving the same quantity of the dose to all the people. “The people weighing below 60 kg should be given the 12 mg dose of ivermectin while those above 60 kg should be given the 18 mg dose,” he said.

Dr Buvaji said the IMA would write to the state Health Department to change the proposed ivermectin dose protocol. The state government had said the drug will be given to the people through its chain of health centres.

Former IMA president of Goa and BJP’s medical cell chief Dr Shekhar Salkar, however, said the focus of the ivermectin programme was to prevent deaths.

When pointed out that ivermectin was banned by the US FDA, Salkar said the tablets do not have any side effect. “The first principle of medical science is that medicine should not harm. These tablets won’t cause any harm, but they will help to save the lives due to the (COVID-19) infection,” he said.

Dr Salkar said such a step was required as the case positivity rate in Goa has touched 50 percent. “The IMA will support the government for recommending Ivermectin treatment,” he said.

Meanwhile, the opposition Congress has asked whether the state government has obtained approval from the Union government for recommending the use of ivermectin to its people.

With inputs from PTI

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