New Microbes and New Infections, volume 43, September 2021
The five authors conclude that ivermectin (IVM) is effective in both treatment and prevention of COVID-19. They write that it cuts mortality of the disease by somewhere between 20 and 67%. “Six of seven meta-analyses of IVM treatment RCTs reporting in 2021 found notable reductions in COVID-19 fatalities, with a mean 31% relative risk of mortality vs. controls.” The authors are not saying it’s a miracle cure for everyone.
Preventative doses reduce the incidence of symptomatic COVID-19 between 20% (150 microgram/kg weekly) and 50% (12 mg dose (~150 microgram/kg) given once for 42 days of coverage).
We have plenty FDA-approved drugs with similar efficacy numbers.
How does IVM work? “A likely biological mechanism has been indicated to be competitive binding with SARS-CoV-2 spike protein sites….”
A few excerpts:
Recently, Dr Satoshi Omura, the Nobel co-laureate for the discovery of IVM, and colleagues conducted a comprehensive review of IVM clinical activity against COVID-19, concluding that the preponderance of the evidence demonstrated major reductions in mortality and morbidity. Our review of that evidence, updated with consideration of several new studies, supports the same conclusion.
IVM has been used safely in 3.7 billion doses worldwide since 1987 and is well tolerated even at much greater doses than the standard single dose of 200 μg/kg. It has been used in randomized controlled trials for COVID-19 treatment at cumulative doses of 1500 μg/kg, 1600 μg/kg and 3000 μg/kg over 4 or 5 days with only small percentages of mild or transient adverse effects.
Why not RTWT? Note the Peruvian experience. Also see the post-post-postscript (PPPS) and post-post-post-postscripts (PPPPS) below if you want to be totally and uncomfortably mystified.
Steve Parker, M.D.
PS: One of the five authors (TJB) “is a principal in Topelia Therapeutics (Ventura, California), which seeks to commercialize cost-effective treatments for COVID-19, including IVM. All other authors report no conflicts of interest.” Some of you will also discount the reliability of this article because P.A. McCullough is one of the authors.
PPS: One thing I noticed while reading some of the references for the main article is that some investigators define COVID-19 infection as a positive PCR or a new positive antibody test, regardless of symptoms. Do you care much if you feel fine but one of those tests are positive? Most folks don’t. (I’ll admit those tests may have some clinical and public health research applications. Remember that if the cycle threshold on the PCR test is set too high (over 25-30?), the test is wildly inaccurate. Next time you get a COVID-19 PCR test, ask for the cycle threshold. You won’t get an answer.
PPPS: One of the pre-print articles cited by the authors was withdrawn by the publisher (Research Square) In July 2021 and is under investigation (by the publisher, I guess). Click for details at The Guardian.
PPPPS: From Cochrane July 28, 2021:
“Based on the current very low- to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID-19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use of ivermectin for treatment or prevention of COVID-19 outside of well-designed randomized trials.”
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