Why is Ivermectin CONTROVERSIAL?

Ivermectin Controversy

The anti-parasite drug has become the latest topic of debate as a potential cure for COVID-19. However, after discovering some flaws in the preprint study report, scientists refuted Ivermectin’s possible claims for curing COVID-19. Eduardo Lopez-Media, a pediatrician at the Centre for the study of Pediatric Infections in Cali, Columbia, has investigated the efficacy of Ivermectin against covid-19 symptoms said that the first papers that make everyone believe the drug actually works.

The Story

On 13th November 2020, Lead Researcher Dr Ahmed Elgazzar, a professor emeritus including five more researchers from two Egyptian Universities, uploaded a paper titled “Efficacy and Safety of Ivermectin for treatment and prophylaxis of Covid-19 Pandemic” at the Research Square preprint server. The report claims to evaluate the effect of Ivermectin on six hundred Covid-19 patients and how the drug can help prevent and treat the virus. The authors argue that Ivermectin can reduce the number of deaths and the length of hospital stay of patients. Moreover, the author also claims the drug prevents the onset of Covid-19.

Dr Elgazzar is an editorial board member of the Journal’s website and a former chief-editor of the Benha Medical Journal. He has authored several papers related to Pulmonology in the past. The report by Elgazzar about the effect of Ivermectin on covid-19 was greatly welcomed by the scientific community worldwide since it consists of the largest Ivermectin trial ever conducted.

The paper was yet to get the green light from peer review or published in any scientific journeys; the study was already cited in around 30 other studies. Some studies were already peer-reviewed in popular journals. Meanwhile, More than 150,000 users accessed the paper.

The Problem with the Study

The flaws in the study surfaced when Jack Lawrence, a master’s student at the University of London, was reading the Elgazzar paper during a class assignment. He noted some phrases in the report that draws similarities with other published works. After contacting other researchers, the group discovered several matters of concern such as duplication of patient records, some patients were already dead before the study data, and inconsistencies in numbers, raw data and information in the paper.

While some researchers praised the papers, some remains sceptic. In January 2021, the South African national health department found some reporting issues in the report marking the study containing a high risk of biasness.

The paper summarizes that the clinical trial of Ivermectin showed a 90 per cent reduction in covid-19 death rates. However, on 14th July 2021, several organizations and research teams found a string of plagiarism and data manipulation in the Elgazzar paper, leading preprint server research square to withdraw the report over ethical concerns.

In response, Dr Ahmed Elgazzar said he was not given a chance to defend before the platform pulled out the paper. During the early pandemic, scientists have conducted laboratory studies about Ivermectin and found it to have the potential to inhibit coronavirus cells. However, scare data, and conflicting conclusions led to the withdrawal of trials.

Following the growing worldwide attention on Ivermectin as a Covid-19 treatment, a guideline development group was assembled comprising an independent and international panel of experts. The group pooled data from 16 randomized controlled trials with 2407 enrolled covid-19 in-patients and out-patients. They conclude that there is insufficient evidence of Ivermectin reducing risk of mortality, need for mechanical ventilation, clinical improvement or need for hospitalization. This is because all studies had less number of participants, limited trial data and a small number of events.

Conspiracy Theorists and Support

Several conspiracy theories have surfaced that blames big pharma companies for holding Ivermectin and depriving people of a cheap cure for covid-19. Besides conspiracy theorists, Ivermectin has received widespread support from several influential political figures.

In December 2020, Dr Pierre Kay, a leading personality in the Frontline Covid-19 critical care organization, heavily promoted the drug. As a result, he was asked to prove his claim in front of the United States Homeland Security and Governmental Affairs Committee. Besides, Ivermectin has also received support at least three times by MP Craig Kelly in the Australian House of Representatives and several times in both Houses of Parliament in the UK.

Some pro-Ivermectin advocacy groups, including FLCCC and the BIRD group, have also appeared supporting the drug. While some boast their founders’ medical credentials, others cite the Elgazzar Paper as proof.

Challenges for Ivermectin Researchers

Meanwhile, Carlos Chaccour, Global-Health Researcher at the Barcelona Institute for Global Health, says that conducting rigorous studies on Ivermectin is challenging as they don’t get enough financial support from funders and academics from wealthy countries. Besides, some trials are often dismissed as most of them have been conducted from lower-income countries. Finding participants for the trial is tricky, as most people worldwide are already taking Ivermectin as a Covid-19 prevention measure.

What’s the future of Ivermectin’s Study?

Even though the effect of Ivermectin has not been proven effective, the OTC drug has become widely popular in several parts of the world. What worries scientists is that people might use it as an alternative to vaccines even though the effectiveness of vaccines are clinically proven. The world health organization advises people not to consider Ivermectin as a Covid-19 treatment and limit its use for clinical trials only.

Chasseur and other studying Ivermectin say no substantial evidence to prove the drug’s effectiveness against the Covid-19 virus. Their hope lies in the ongoing studies in Brazil involving 3500 participants.

What is Ivermectin?

Ivermectin is an FDA approved medication used for treating parasitic diseases. It is available in two forms- one for treating certain health conditions in people. The other is strictly prescribed by veterinarians for treating animals.

Ivermectin is used from treating two infections caused by parasitic worms

Strongyloidiasis: It is a condition that causes bloating, heartburn, diarrhea, stomach pain, and rashes. However, some people with this disease do not show any symptoms.

Onchocerciasis: Also known as River Blindness, this disease can lead to eye diseases, abnormal growth under the skin and itchy rash.

Ivermectin can also be used topically to treat rosacea, scabies and head lice.

Ivermectin is used on animals for treating parasites and preventing heartworm diseases.

Never take Ivermectin meant for animals as it could be hazardous for humans. Animals such as horses or cows can weigh around 2000 pounds. As a result, they are given heavy doses of the drug, which is toxic for humans. Plus, Ivermectin for animals contains inactive ingredients, which, again, are not safe for human applications.

What are the Side Effects of Ivermectin?

Side-effects of Ivermectin includes:

Treatment for onchocerciasis (river blindness)

Less common:

  • Eyes/eyelid irritation, pain, redness or swelling
  • Headache
  • Swelling on face, hands, feet, legs or arms

More common:

  • Fever, skin rash or itching
  • Rapid heartbeat
  • Joint or muscle pain
  • Rapid heartbeat

Rare:

  • Lightheadedness

Treatment for Strongyloidiasis

Less common:

  • Diarrhea
  • Skin rash or itching
  • Dizziness

Rare:

  • Sleepiness
  • Shaking or trembling
  • Loss of appetite

Some side effects not mentioned in the list may also occur in some patients. Contact your doctor if you notice any other effects while taking medicine.

How Do You Take Ivermectin?

If your doctor prescribed Ivermectin for treating your medical conditions, make sure to tell them about any of your other health conditions, such as:

  • Asthma
  • Liver disease
  • Allergies against foods, medicines or ingredients
  • Pregnancy, breastfeeding or planning to conceive
  • Any medications or supplements you are taking currently

Note: Ivermectin can react badly with medicines like blood-thinning drugs.

Always take Ivermectin as advised by your doctor. Swallow (not chew or lick) the medicine with a glass of water. Make sure you take it on an empty stomach thirty minutes before your meals or 2 hours afterwards. Taking the medication with food is not recommended.

Complete the entire course of the medicine as prescribed by your doctor. After a couple of doses, you may feel better, but that doesn’t mean the disease is completely gone. If discontinued without completing the recommended dose, the disease may come back. Your doctor may have to prescribe you a higher strength/dose the second time since your body may have developed drug resistance.

If you miss a dose, then take it as soon as possible. If it’s time for your next dose, then take the dose alone. Don’t take a double dose.

Is Ivermectin Approved to Treat COVID-19?

The FDA disapproves Ivermectin to treat or prevent any illness associated with Coronavirus.

Although scientists are studying and running clinical trials about the drug for its efficacy against Covid-19, the information is inconclusive and may need more time for the final result. Several major groups such as the FDA, the World Health Organization, and the Infectious Diseases Society of America do not recommend using the drug for covid-19 treatment unless they are enrolled for a clinical trial for a professional medical study.

The best way to prevent the Coronavirus is to get yourself and your loved ones vaccinated. The vaccines are approved for people above 12 years and are generally considered safe and effective. Meanwhile, the same cannot be said for Ivermectin for covid-19. Unless you are under a doctor’s care, there is a chance of overdosing, leading to seizures, coma and even death.

Reference links

What Is Ivermectin? (webmd.com)

Why Was a Major Study on Ivermectin for COVID-19 Just Retracted? – Grftr News

High-profile coronavirus retractions raise concerns about data oversight

How a Torrent of COVID science changed research publishing — in seven charts

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