From Wikipedia: ‘During the 2020 COVID-19 pandemic, misinformation was widely spread claiming that ivermectin was beneficial for treating and preventing COVID-19. Such claims are not backed by good evidence.’
WHEN encountering an inexplicable anomaly in human behaviour, common rules of thumb can often give an insight. Oddly, though, these differ from country to country. For Americans it is ‘follow the money’. For Italians it is ‘cui bono?’ – who benefits? The nearest French rule is perhaps ‘cherchez la femme’.
Sometimes none of these help. Sometimes a perverse piece of human nature cannot be explained in terms of money, perquisites or feminine influence. The ivermectin mystery is one such.
Ivermectin is a generic prescription drug, discovered in 1975, developed by Merck and released in 1981. It is used to treat many types of parasite infestations in humans and animals. The researchers who created it were awarded the Nobel Prize for medicine in 2015. It is on the World Health Organisation’s List of Essential Medicines and is approved by the Federal Drug Administration (FDA) as an antiparasitic agent.
It can have very rare serious side effects. By 2020 four billion doses had been administered and 16 deaths are believed to have occurred as a consequence, or one in 250million doses. Although the figures are not directly comparable, the annual increased risk of death for a middle-aged man taking a standard (325 mg) aspirin every day to prevent heart disease and stroke is about one in ten thousand. This is about as risky as driving a car.
Ivermectin is therefore a very safe drug. However, the drug oversight establishment does not think so.
On March 22 this year the European Medicines Agency issued this statement:
‘EMA has 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.
‘In the EU, ivermectin tablets are approved for treating some parasitic worm infestations while ivermectin skin preparations are approved for treating skin conditions such as rosacea. Ivermectin is also authorised for veterinary use for a wide range of animal species for internal and external parasites.
‘Ivermectin medicines are not authorised for use in COVID-19 in the EU, and EMA has not received any application for such use.’
On May 3 the US Food and Drug Administration (FDA) issued this warning under the heading ‘Why You Should Not Use Ivermectin to Treat or Prevent COVID-19’:
‘There seems to be a growing interest in a drug called ivermectin to treat humans with COVID-19. Ivermectin is often used in the U.S. to treat or prevent parasites in animals. The FDA has received multiple reports of patients who have required medical support and beenhospitalized after self-medicating with ivermectin intended for horses.
‘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. Ivermectin is not an anti-viral (a drug for treating viruses).
‘The FDA has not reviewed data to support use of ivermectin in COVID-19 patients to treat or to prevent COVID-19; however, some initial research is underway. Taking a drug for an unapproved use can be very dangerous. This is true of ivermectin, too.’
The lack of official support for trials of the efficacy of ivermectin has meant that the typical number of subjects being tested (the ‘cohort’) is fairly small, usually about a hundred. To overcome this a meta-analysis can be undertaken, when the results of many trials are combined and assessed to determine if a trend can be seen. This has been done, most notably by @CovidAnalysis. A paper most recently updated yesterday surveyed 60 properly conducted studies, most with double-blind testing against placebos, with neither the participants nor the researcher knowing who had been given the drug until the trial was over. This report is a preprint, so it has not been peer-reviewed, but the results are conclusive: 93 per cent of the studies show a positive outcome from the administration of ivermectin, with deaths reduced by over 80 per cent.
So why have what might be called ‘Drug Central’ refused to acknowledge this mammoth body of evidence arising from without their bailiwicks? Perhaps because of human nature again. Here they are obeying another rule of thumb commonly seen when institutions encounter new external factors – ‘not invented here’. Perhaps this business school aphorism is also appropriate: ‘Hell hath no fury like a head-office scorned’.
In any event the virucidal properties of ivermectin and its safety have now been established beyond doubt, and we can expect it to be valuable in this role from henceforth. But unfortunately not, perhaps, against Covid-19.