New Delhi: Amid the rising coronavirus cases in the country, one drug that has almost become a household name is – Ivermectin. However, the medical fraternity is divided on its use amid lack of strong evidence of its success in treating COVID-19. Also Read - From July 1, No E-Pass Required For Travellers to Visit Himachal Pradesh | Check Details
Ivermectin is mainly prescribed for patients with mild to moderate infection. With the second wave raging upon us, there was a huge surge in demand for these drugs. Dr Chandrashekhar T, Chief Intensivist, Fortis Hiranandani Hospital, Vashi has now cleared the air around its use, points to consider and more. Also Read - 3 Key Characteristics of Delta Plus Variant in India to Watch Out For, Advises Union Health Ministry
Recently, World Health Organisation (WHO) issued guidelines saying Ivermectin should only be used on COVID19 patients in clinical trial settings. The UN health agency said there was a “very low certainty of evidence” on Ivermectin’s effects on mortality, need for hospital admission and getting rid of the virus from the body. After which, many state governments in India have rejected its use for COVID19 patients. Also Read - Planning a Trip to Dubai? All You Need to Know About The Latest COVID Guidelines, Rules And More
The mechanism of action has not been explained here; this has caused confusion and worry among patients and providers alike.
But Dr Chandrashekhar says that there is enough evidence that show the effectiveness of Ivermectin. He says, “A study published in the American Journal of Therapeutics clearly mentions of a large majority of randomized and observational controlled trials of Ivermectin that reported repeatedly on the large magnitude improvements in clinical outcomes.”
“Numerous prophylaxis trials demonstrate that regular Ivermectin use leads to large reductions in transmission. Moreover, a comprehensive review of the available efficacy data as of December 12, 2020, taken from in-vitro, animal, clinical, and real-world studies. all show the above impacts of Ivermectin in COVID19,” he adds.
According to Dr Chandrashekhar, here are few points worth considering:
- Since 2012, multiple in-vitro studies have demonstrated that Ivermectin inhibits the replication of many viruses, including Influenza, Zika, Dengue, and others.
- Ivermectin inhibits SARS-CoV-2 replication and binding to host tissue through several observed and proposed mechanisms.
- Ivermectin has anti-inflammatory properties that prevents viral replication.
- Clinical studies of the efficacy of Ivermectin in hospitalized patients show favorable outcomes.
- Exposure prophylaxis studies that showcase Ivermectin’s ability to prevent transmission of COVID19.
- Ivermectin hastens recovery and prevents deterioration in patients with mild to moderate disease, treated early after symptoms.
- The World Health Organization has long included Ivermectin on its “List of Essential Medicines”.
- However, there are studies that suggest the need for controlled studies to better test efficacy in Vexing Syndrome.
Having said that, the doctor explains that anything used in excess or abused is harmful to health, and rightly so. He is of the view that providers need to be careful while prescribing these drugs as they are still under review. “The best way is to be wise and not let panic take precedence over our logical reasoning. Most of these repurposed drugs have their own pros and cons when used for COVID19, this needs to be explained to the patients while prescribing it,” Dr Chandrashekhar says.
He further adds, “We have to be cautious but wise too. Let us all make an informed choice an ensure that we all come out of this crisis stronger and more empowered.”
(Disclaimer: The views expressed here are solely of the author, Dr Chandrashekhar T, Chief Intensivist, Fortis Hiranandani Hospital, Vashi)