Ivermectin – a promising drug in the treatment of Covid-19
by Sabine Vuilleumier-Koch, M.D.
(6. April 2021) Research is being conducted worldwide into substances that could lead to prophylaxis and effective treatment of Covid-19. Its results are little known to the public – so far, the focus of media interest has been on the known protective measures, the lockdown and vaccination. Broader testing is now also permitted. From a medical point of view, it is urgently necessary to add the option of prophylaxis and therapy.
With all the existing measures, there will always be sick people in need of treatment. Covid-19, like other infectious diseases, should become – or already is – a preventable and treatable disease.
After outlining current research efforts and applications of ivermectin – together with other medications – on Covid-19 patients, the history of its discovery and use to date will be highlighted.
Ivermectin and Covid-19
Today, ivermectin is being intensively researched for the prophylaxis of Covid-19 and its treatment, and it is already being used in various countries. In Switzerland, it has so far been approved by Swissmedic, the Swiss Agency for Therapeutic Products, as an ointment against rosacea, a skin disease. Some pharmacies offer ivermectin among their speciality products for the treatment of scabies (caused by mites). In Germany and France, it is available in tablet form.
In experiments in vitro (outside a living organism), ivermectin has shown potent effects against the Sars-CoV-2 coronavirus. Australian experts described in a scientific journal in April 2020 that ivermectin reduces the virus in cell cultures by a factor of 5000 within 48 hours and thus virtually eliminates it completely. They concluded that ivermectin needed to be further investigated for its benefit in humans.1
Many trials with persons at risk and Covid patients have been conducted since then and are being continuously evaluated.2 The update of 31 March 2021 summarises: "100% of the 49 studies to date show positive effects." The studies, designed to test the prophylactic effect, the effect in early and later stages of the disease, were conducted with a total of 15,752 patients. It is concluded that especially the use in prevention and treatment at an early stage is very successful. Also an article in “Paris Match”, from 5 January 2021, acknowledges the summed up results available to date.3
Three initiatives for approval and use of ivermectin
1) Under the name "Tratamiento temprano",4 a programme for the prophylaxis and treatment of Covid-19 with ivermectin is running in various Latin American countries (Peru, Dominican Republic, Brazil, Mexico, and others). The main goal is to prevent a worsening of the disease and thereby hospitalisation. The measures taken so far in the fight against the virus (social distancing, hygiene measures, mass testing, isolation and quarantine, increasing hospital capacities, etc.) are to be supplemented. Regarding vaccinations, it is noted that they produce temporary immunity to the coronavirus and might not be provided for everyone.
Latin American initiative (screenshot homepage)
On 30 May 2020, the initiators of the project launched an appeal to the public to come forward and be treated with ivermectin if they experience symptoms of Covid-19. They note that ivermectin has proven to be very effective in stopping the replication (multiplication) of the virus, as shown in hundreds of testimonials from doctors around the world. It is a drug known for more than 30 years, therefore its benefits and safety are well recognised. It has very few side effects – even at high doses. It is not patented, which means there is no monopoly on its production and thus very economical.
At the end of December 2020, a researcher from the University of Liverpool presented a compilation of trial results from the above mentioned countries. In the conference of a company promoting the development of a long-acting ivermectin preparation, he pointed out an 83 per cent reduction in mortality. Other endpoints of the trials, such as elimination of the virus, patient recovery from the disease and hospitalisation time, were also much better than in the control group.5
If one wishes to see the full presentation, the curt information appears: "! This video has been removed because it violates Youtube's terms of use." (screen-shot from 21.3.2021)
2) Dr Pierre Kory answered questions from members of the "Senate Committee on Homeland Security and Governmental Affairs" in the US Senate in Washington on 8 December 2020. He is a member of the FLCCC Alliance (Frontline Covid19 Critical Care Alliance), a group of highly experienced critical care physicians currently practising in various American hospitals who have published a total of more than 1,000 scientific articles and have made it their mission to develop a treatment protocol for Covid-19. Dr Kory presented a compilation of RCTs (randomised controlled trials, the "gold standard" of studies) demonstrating exceptional efficacy of ivermectin for prophylaxis and treatment of Covid-19. His emphatic demand was that the NIH (National Institutes of Health, part of the US Department of Health and Human Services) review these data and approve ivermectin for this indication. He can no longer bear to see people dying miserably from Covid-19 when it has been proven with "mountains of evidence" that these patients can be helped.6 The FLCCC also published a compilation of the growing evidence of the benefits of ivermectin in the prophylaxis and treatment of Covid-19 at the end of January 2021.7 Depending on the stage of the infection, ivermectin is supplemented with the addition of vitamin D3, vitamin C, anticoagulants, antibiotic, and others.
On 14 January 2021, just six days later, the National Institutes of Health again stated that there was insufficient data on ivermectin so far to make a case for or against its use in Covid-19 patients: the number of trial participants was too small, different doses had been used, the studies had not been double-blinded, other drugs had also been used, etc.8
The Johns Hopkins Bloomberg School of Public Health reported on 22 February 2021 that the number of deaths in the USA could reach the 500,000 mark on that day. Although the death toll has dropped markedly since late January and 63 million doses of vaccine have been administered so far, a return to normalcy for pandemic-weary Americans is not expected soon. According to the Washington Post, Anthony Fauci, head of the NIAID (National Institutes of allergies and infectious diseases) had said the day before that mask-wearing would continue until 2022.
3) In Switzerland, too, there is great resistance to the implementation of appropriate studies with ivermectin and its accelerated approval by Swissmedic. Thus, the well-founded proposal for a treatment of Covid-19 by Professor Paul Vogt, head of cardiac surgery at the University Hospital Zurich, including ivermectin, has not been implemented so far. In a letter to the responsible Federal Councillor Alain Berset in December 2020, Professor Vogt outlined drugs for a "cocktail" that specifically combats the effects of the virus at different levels. These drugs, together with a pulse oximeter, a simple device for measuring oxygen saturation in the blood, can be given to patients for treatment at home, thus avoiding hospitalisation in many cases. He also called for accelerated approval of the above drugs, as has been possible for vaccinations, and for appropriate trials to be conducted to test the proposed treatment. – His proposal was published in only one single newspaper… since then silence prevails in the country.9
It is time to act
The initiators of the Latin American "Tratamiento temprano" project maintain:
Despite the myriad benefits of this strategy (of treatment with ivermectin, author's note), there are certain "minority groups" who find its implementation disrupting:
(a) Some researchers: there are several ongoing trials of new drugs funded by big pharma. These trials require Covid-19 ailing patients. If patients take ivermectin too early, it complicates their trials. In controlled clinical trials or RCT's, an ethical dilemma arises when there is already an effective drug, but a new drug whose effectiveness is unknown is used to treat the disease. The initiators also stress that it is ethically questionable to give a placebo (a dummy drug with no active ingredient) to patients in a clinical trial when an effective drug could save them.
b) Some pharmaceutical companies: parts of the pharmaceutical industry have invested billions of dollars to develop drugs against Sars-CoV-2. A generic drug like ivermectin poses a serious threat to some multinational companies' sales projections.
The initiators of the "Tratamiento temprano" conclude with the call: it is time to act! In our globalised world, it will only be possible to get out of this crisis if a good proportion of countries incorporate ivermectin into their health protocols.
Proven for decades – history and use of ivermectin
Satoshi Omura, born in 1935 in Nirasaki/Japan into a farming family, was fascinated from the beginning by nature and what it can give people for their health and livelihood. He studied at the Faculty of Liberal Arts and Sciences at Yamanashi University and developed a great interest in organic chemistry. During further studies at Tokyo University of Education, he learned about the study of the chemical structure of organic compounds using nuclear magnetic resonance (NMR), then an innovative technology, now used on an everyday basis. He earned a doctorate in pharmaceutical sciences in 1968 and in chemistry in 1970.
of ivermectin (picture http://satoshi-omura.info)
In 1974, Omura isolated Streptomyces, a group of soil bacteria already known for their antimicrobial properties. The antibiotic streptomycin – now used, among other things, in a combination preparation against tuberculosis – had been isolated from the bacteria in the 1950s. Omura skillfully isolated and cultivated a new strain of these bacteria in the laboratory. From thousands of different cultures, he selected 50 of the most promising with the intention of having them further investigated for their effectiveness against disease-causing microorganisms. He sent them to William C. Campbell, an expert in biology and parasitology who worked at the Merck Research Institute in the USA. Campbell was able to isolate the bioactive agent avermectin from the bacterial cultures and develop it into the optimised substance ivermectin. Ivermectin turned out to be very effective in people with parasitic infections. Together, Omura and Campbell had developed a new class of drugs with extraordinary efficacy against parasitic diseases. Their scientific discovery, significant for millions of people especially in poor countries, was recognised with the 2015 Nobel Prize in Physiology or Medicine.10
Mectizan Donation Programme
In 1981, the active substance ivermectin found its way onto the market. Studies had shown that it could be used for the prevention and treatment of river blindness. River blindness or onchocerciasis is caused by infestation of humans with the parasitic nematode onchocerca volvulus, which manifests itself in nodules under the skin. New blood vessels also form on the cornea and inflammations inside the eye as far as the optic nerve develop, that can lead to scarring and clouding of the cornea and blindness. – Ivermectin works by blocking chloride channels in muscle and nerve cells of the young worms, thereby paralysing and killing them.
In 1987, the US company Merck & Co. founded the Mectizan Donation Program (MDP). Mectizan is the trade name of ivermectin associated with the donation. The company describes its commitment with "as much as needed, for as long as needed". The programme is designed to ensure a survey of the medical, technical and administrative aspects of donating ivermectin to help control the disease in Latin America, Africa and Yemen. An estimated 205 million people are at risk of contracting river blindness every year, especially in Africa, and therefore in need of effective prophylaxis.
In 1998, the company expanded the programme to include ivermectin for the treatment of elephantiasis tropica. This disease, also known as lymphatic filariasis, occurs predominantly in tropical regions and is triggered, as a late consequence of various infections, by threadworms among other things. The worms enter the lymphatic system through the bite of a mosquito and cause a chronic inflammatory reaction with chronic lymphatic congestion, especially in the legs or scrotum, resulting in extreme enlargement of the organ and hardening of the skin over time.
The MDP is the longest running programme today that donates drugs for “Neglected Tropical Diseases”. Approximately 300 million treatments for the two diseases are administered annually by local distributors.11
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The use of ivermectin is hampered sv. On 31 March 2021, WHO advised in a statement,* that ivermectin for the treatment of Covid-19 should only be used in clinical trials. Due to the increasing international interest in ivermectin as a possible drug against Covid-19, a group of international experts had examined 16 double-blind studies. They had seen that the evidence for the benefit of its use was very uncertain, mainly due to the low numbers of participants in the studies. Prophylactic use was not investigated. The US Front Line Covid-19 Critical Care Alliance (FLCCC), a group of publishing, world-renowned critical care physicians and scientists, immediately reacted to this statement with a press release** (excerpt): "The latest WHO guidelines ignore several large clinical trials where ivermectin was proven to prevent mortality by more than 68 percent. If the WHO guidelines is followed, it will result in a further deprivation of a life-saving drug and will only prolong the pandemic as it will continue to threaten the health of the global population." In view of the currently again rising numbers of Covid-19 patients again, pressing questions arise: Why has no study been carried out by the decisive bodies in the past 12 months, which, from their point of view, allows clear statements to be made? Is no money being made available for this? Should the cheap drug ivermectin not be approved, in order not to have to limit the price of newly developed drugs? |
Conclusion
Since its discovery in the 1970s, ivermectin has saved hundreds of millions of people from severe disease or even brought it to a halt and has proven its good tolerability over this time. Its prophylactic and therapeutic efficacy against Sars-Cov-2 is continuously scientifically evaluated. The Sars-Cov-2 pandemic will not be the last pandemic to threaten human lives and bring entire economies to a standstill, despite the measures taken to date to combat it. It is paramount to protect the health of the population with the implementation of the hitherto positive findings on potent medicines – not just for a privileged few but for the benefit of all.
3 https://www.parismatch.com/Actu/Sante/Covid-19-l-ivermectine-une-piste-a-suivre-1719386
4 https://tratamientotemprano.org
6 https://Covid19criticalcare.com
9 https://www.tagblatt.ch/leben/Covid-19-anstatt-das-virus-auszurotten-geben-wir-ihm-einen-medikamentencocktail-ld.2081020 [Covid-19, instead of eradicating the virus, we give it a “drug cocktail”]
10 The impressive biography of Satoshi Omura can be read here: https://www.nobelprize.org/prizes/medicine/2015/omura/biographical