Ivermectin holds promise for early Covid-19 recovery: icddr,b

Patients receiving a five-day course of ivermectin – a medication used to treat many types of parasite infestations – have shown an early viral clearance and improvements to blood biomarkers compared with other two groups, according to a new study.

The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) conducted the study on "Ivermectin and Doxycycline in Combination or Ivermectin Alone for the Treatment of Adult Bangladeshi Patients Hospitalised for Covid-19: a Randomised, Double-blind, Placebo-controlled Trial," between June and September.

Icddr,b Scientist Wasif Ali Khan, also principal investigator, disclosed the findings at a seminar at the Renaissance Dhaka Gulshan Hotel on Monday.

He said, "Although the study sample was small to derive a solid conclusion, the results provide evidence of potential benefit of the early intervention with ivermectin for the treatment of adult patients diagnosed with mild Covid-19. The findings also conform to other global studies on ivermectin as a treatment for Covid-19."

Icddr,b organised the seminar to share preliminary findings of the study that evaluated the safety and efficacy of ivermectin in combination with antibiotic doxycycline or ivermectin alone for the treatment of confirmed mild cases of Covid-19.

The randomised, double-blind, placebo-controlled trial evaluated orally-administered ivermectin alone (12mg, once daily for five days), ivermectin single dose (12mg) in combination with doxycycline (200mg stat doxycycline on day 1, followed by 100mg 12 hourly for next four days) compared with placebos, among 68 hospitalised patients with Covid-19 in Dhaka.

Patient distribution was 22, 23 and 23 in each group, respectively. The participating hospitals were: Mugda Medical College and Hospital, Kurmitola General Hospital, Dhaka, Bangladesh, and Dhaka Medical College & Hospital, Dhaka.

The study demonstrated that patients in the five-day ivermectin group were 77% more likely to have early viral clearance on day 14 compared to those who received ivermectin and doxycycline (61%) and a placebo (39%).

It also showed that on day three, 18% of the patients in the group treated with ivermectin alone began to show viral clearance compared to ivermectin plus doxycycline (3%) and a placebo (3%), while on day seven, it stood at 50%, 30% and 13%, respectively.

The odds of improvement in clinical status with the five-day treatment course of ivermectin versus ivermectin and doxycycline, and placebo were also favourable, trending toward reduction of severity of infection indicated by improvement in blood biomarkers.

The anti-parasitic drug is found to be safe and has shown, at best, a modest benefit for mild Covid-19 cases. The study findings were published in the International Journal of Infectious Diseases (IJID) on 2 December, 2020.

At this event, Nazmul Hassan, managing director of Beximco Pharmaceuticals Limited said, "We are pleased to support the clinical trial of ivermectin, which is an attempt to find an effective and affordable treatment to fight against the Covid-19 pandemic. We are happy that the treatment regimen shows promise and that will indeed strengthen our fight against Covid-19 and help avoid many untimely deaths."

Dr Tahmeed Ahmed, acting executive director at icddr,b, said, "It is extremely important to find an affordable and easy-to-use treatment option to fight against this pandemic in low- and middle-income countries like Bangladesh. We believe a larger clinical trial with ivermectin may help facilitate decision makers to include it in the Covid-19 treatment protocol and we are exploring for support."

Experts said a large-scale clinical trial will have to be carried out to reach a conclusion about the effectiveness of this drug in Covid-19 treatment. They suggested not taking the drug without physicians' advice.

Dr Ahmedul Kabir, professor of Department of Medicine at Dhaka Medical College, said, "This study does not mean that everyone should start taking this medicine right now. All medicines should be taken according to doctors' prescriptions and advice. This could be included with the National Guidelines and Protocols on Covid-19 treatment."