However, out of the three approaches in the randomized clinical trials, the solo use of ivermectin shows more promise than the rest
A limited scale clinical trial in Dhaka’s Covid-19 dedicated hospitals gave an encouraging scenario for the effectiveness of specific doses of the antiparasitic drug, ivermectin, for mild Covid-19 cases.
But researchers and health experts said the drug had not been cleared for therapeutic use or was safe for mass use.
They said the medicine only could be used at the clinical stage and only after being prescribed by physicians.
The remarks came up at a dissemination seminar organized by International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) in Dhaka to share the preliminary findings of the study conducted from July to September.
The randomized, double-blind, placebo-controlled trial evaluated orally administered ivermectin alone (12mg once daily for 5 days), and ivermectin single dose (12mg) in combination with doxycycline (200mg stat doxycycline on day 1 followed by 100mg 12 hourly for next 4 days) compared with placebo, among 68 hospitalized patients with Covid-19 in Dhaka.
Patient distribution was 22, 23 and 23 in each group respectively. The participating hospitals were Mugda Medical College and Hospital, Kurmitola General Hospital, and Dhaka Medical College and Hospital.
No pregnant women and children under age 5 were selected as participants, while those who took ivermectin in the last seven days before the study were not selected.
While presenting the study, Dr Wasif Ali Khan, senior physician scientist of Enteric and Respiratory Diseases at icddr,b and principal investigator of the study, said the study demonstrated that patients in the 5-day ivermectin group were 77% more likely to have early viral clearance on day 14 compared to those who received ivermectin and doxycycline combo (61%), and placebo (39%).
It also showed that on day 3, 18% of the patients in the group treated with ivermectin alone began to show viral clearance compared to ivermectin plus doxycycline (3%) and placebo (3%), while on day 7 it stood at 50%, 30%, and 13% respectively.
“Although the study sample was too small to derive any solid conclusion, the results provide evidence of potential benefits of early intervention with ivermectin for the treatment of adult patients diagnosed with mild Covid-19,” Dr Wasif said.
Prof Tarek Alam, advisor to the study, said: “From our observation, we have already witnessed its efficiency. But without trial, recommendations or a therapeutic approach could not be made. A randomized clinical trial gave the findings.
“It’s a limited scale research, so it could not be conclusive. We [Bangladesh Medical] are doing another research with 200 patients, although it became tough to select participants as patients are taking ivermectin without consulting physicians.
Till the end of this trial, and conclusive research, no one should buy and take ivermectin without a physician’s prescription,” he added.
Bangladesh Society of Medicine Secretary General, Dr Ahmed Kabir, said the randomized control trial has made an attempt to confirm the required dose for the patients, adding: “If you can start ivermectin early when viral load is less, it is helpful.”
“However, you have to understand that it will not cure a Covid-19 patient completely but would stop the spread of infection,” said the member of Clinical Guideline Formulation Committee for Covid-19 Management.
“This is for clinical use only, not for the therapeutic till now,” the professor said, adding that this is why the medicine is not included in the seventh version of the National Covid Clinical Management Guideline yet.
He urged all not to take the medicine if they were not confirmed as Covid-19 patients, and to take them only as prescribed by a physician.
Managing Director of Beximco Pharmaceuticals Limited, Nazmul Hassan, MP, and icddr,b acting executive director Dr Tahmeed Ahmed were present at the program, among others.