Ivermectin: 22M down the drain

An antiparasitic drug spikes in demand in the pharmaceutical market today as news regarding its efficacy for treating CoVid-19 has circulated in social media. With the relentless increase in the CoVid-19 cases and scarcity in vaccines’ supply, this news has further pushed the Philippines’ government to approve the drug and order a clinical trial for the efficacy of Ivermectin as a cure for the virus infection. The Department of Science and Technology (DOST) allocated a Php 22 million budget to initiate the study which will be spearheaded by Dr. Aileen Wang of the University of the Philippines-Philippine General Hospital (UP-PGH). Despite the health and economic crises brought by the prolonged lockdown and unfaltering CoVid-19 cases, conducting a clinical trial for this “cure” can be inessential and a misspending.

A pharmacist holds the anti-parasite drug ivermectin. Photo taken from REUTERS

WHAT IS IVERMECTIN?

Ivermectin is originally proposed for treating gastrointestinal parasite infestation, head lice, and skin conditions such as rosacea (redness in face). It was developed in 1975 and popularized again this year due to the reported study by Australian researchers at Monash University.

Despite its positive popularity, the US Food and Drug Administration (FDA) still recognizes the drug as an anti-parasitic medicine and not a viral medicine. The US FDA and World Health Organization (WHO) strongly discourage the use of drugs for treating CoVid-19 patients due to lack of substantial evidence to prove its effectiveness.

Ivermectin was initially intended for treating animals, however, more recent studies have suggested its safety as human medication and was even known as the first drug to treat Onchocerciasis in humans. The drug is commonly combined with other deworming medications and is available in tablets, topical liquid, and injectable.

CAN IVERMECTIN KILL COVID 19 VIRUS?

Australia researchers from Biomedicine Discovery Institute (BDI) published a study with promising results showing the inactivation of SARS-CoV-2 within 48 hours of exposure to Ivermectin. The drug was claimed to be an inhibitor of SARS-CoV-2 replication which disable its viral processes and ultimately inactivating the virus. The experiment was done in vitro which means that the virus was observed in a laboratory setting using a virus culture with no involvement of a live patient.

Even with the positive feedback of the study, it is insufficient to claim that Ivermectin can be used as a cure provided that the study was only effective in a laboratory setting. Its effects on actual patients is yet to be known. This is one of the reasons why WHO has also detested the treatment with Ivermectin for CoVid-19 patients. In the rise of new variants of the virus, a factor which was not considered in the experiment, it is also uncertain whether Ivermectin will be an effective defense for the virus or could lead to more harm.

The controversial claims on the study have caused researchers and experts from all over the world to join the quest on testing the effectiveness of Ivermectin. In Bangladesh, a short clinical trial was conducted showing affirmative and significant results on the treatment of early-onset mild CoVid-19 patients with Ivermectin. The study reported remission of CoVid-19 symptoms and no adverse effects. In contrast, a study in Colombia which conducted a larger and longer clinical trial obtained negative feedback. The study also observed patients with mild virus infection but reported that no significant difference between the results of the patients who are put in placebo and patients treated with ivermectin. The study concluded that ivermectin did not improve the time it takes for the patients to resolve the virus symptoms and even cause headache among the patients who received the drug. Thus, further investigation should be performed before approving the use of Ivermectin for CoVid-19 cases.

BENEFITS AND RISKS OF IVERMECTIN

The major controversy on the use of Ivermectin for CoVid-19 is its price. For Php 35, you can purchase a capsule of ivermectin which is a lot cheaper than the price of vaccines ranging from Php 600- Php 4,500 per dosage. The dosage of ivermectin to effectively kill the virus is still undetermined. Overdose with ivermectin can lead to skin rash, nausea, vomiting, digestion problem, facial or limb swelling, liver injury, and seizures.

Currently, 5,000,000 Sinnovac, 2,556,000 AstraZeneca , and 15, 000 Sputnik V vaccines have already arrived in the country. About 2 million doses of CoVid vaccine have been administered as reported by the Department of Health as of May 4. Clearly, this is not enough to accommodate the 109 million population of the Philippines. Hence, the pursuit of cheaper medicine becomes more ideal. However, given the uncertainty of its effectiveness and the right dosage, distribution of this drug for CoVid-19 patients and unauthorized self-medication should highly be discouraged.

EXIGENCY FOR CLINICAL TRIAL

As mentioned, the veracity of Ivermectin as a medication for CoVid-19 patients is still unknown and therefore, clinical trials are imperative to affirm its effectiveness. However, clinical trials usually take years before generating an accurate result of the study. Additionally, several batches of vaccines have already been pre ordered and about to be delivered in much less time than the duration of a clinical trial. The success of the clinical trial is also unguaranteed.

The Philippines has already extensively allotted and borrowed billions of pesos to address the health concerns brought by the pandemic. This consequently has put the country in economic strain and acquired larger debt. Although the initiative to hold clinical trials is compelling, especially that research studies are rarely funded by the government, it would be more sensible and strategic to let other countries conduct the clinical trials for Ivermectin. Other countries have more advanced resources to pursue this study and a lot of their researchers have already begun the trials. Spending millions of pesos for an investigation that several countries are already performing would be an excessive waste of money. Instead, we could just wait for the result of their studies and if the drug is proven to be effective, then we can decide to shift from ordering vaccines to ordering or producing Ivermectin.

In lieu of the supposed clinical trial, the Php 22 million budget can alternatively be given to the underpaid health workers or allotted for other research and studies. We should remember that the solution to this pandemic does not really lie with finding the cure but the proper management and control of virus infection and its outspread.

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References

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