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Disclosures: Kory and Marik report no relevant financial disclosures.
December 08, 2020
3 min read
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'This was a gift to us': Ivermectin effective for COVID-19 prophylaxis, treatment

Disclosures: Kory and Marik report no relevant financial disclosures.
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Editor’s note: One of the studies cited in this story, conducted in Egypt, has since been retracted. The FDA has not approved ivermectin for use in treating or preventing COVID-19. Moreover, the Infectious Diseases Society of America recommends against ivermectin for the treatment of outpatients with COVID-19, unless in the context of a clinical trial.

Numerous studies have provided evidence supporting the use of ivermectin to prevent and treat COVID-19, according to the Frontline COVID-19 Critical Care Alliance.

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Numerous studies have provided evidence supporting the use of ivermectin to prevent and treat COVID-19, according to the Frontline COVID-19 Critical Care Alliance. Source: Adobe Stock.

Paul Marik, MD, FCCM, FCCP, founder of the alliance and a professor and chief of the division of pulmonary and critical care medicine at Eastern Virginia Medical School, said that ivermectin “is a safe drug that is exceedingly cheap.”

He added that “what is truly remarkable — this was a gift to us — ivermectin has high activity against COVID-19.”

In a press conference, researchers said that ivermectin is an FDA-approved anti-parasitic drug that has been available for approximately 40 years and previously earned researchers a Nobel Prize.

Ivermectin is a key factor in the alliance’s I-MASK+ protocol for prophylaxis and early treatment of outpatients with COVID-19. In the protocol, those at high risk for COVID-19 infection receive ivermectin at 0.2 mg/kg on day 1 and day 3, and weekly for 4 weeks; those who were exposed to COVID-19 receive the same dose at day 1 and day 3; and both groups receive daily doses of vitamin D3, vitamin C, quercetin, zinc and melatonin. For early outpatients with COVID-19, the protocol calls for one dose of ivermectin at 0.2 mg/kg at day 1 and day 3, along with the same daily vitamins and 325 mg per day of aspirin.

During the press conference, Marik said that much of the data available on ivermectin in the treatment and prevention of COVID-19 has been published since August, which was the last time the NIH updated its recommendations for the novel coronavirus.

Thus far, Marik said, studies have indicated that ivermectin has demonstrated efficacy in preventing COVID-19 infection prior to and after exposure to COVID-19. He also said that it has been shown to effectively treat the virus in the early symptomatic stages and among patients hospitalized with COVID-19.

In a review of the literature, Marik and colleagues detailed all available clinical trial results on ivermectin in COVID-19 and concluded that the drug has benefits in preventing and treating COVID-19 infection.

For instance, Marik and colleagues noted that a randomized controlled trial in Egypt found that among health care and household contacts of COVID-19 patients, just 2% of those who received ivermectin and wore PPE tested positive for the novel coronavirus, compared with 10% of contacts who were only given PPE.

Marik and colleagues also described a randomized controlled trial of hospitalized patients that was done concurrently with the prophylaxis study. The trial included 400 patients split into four groups — two consisting of patients with mild to moderate illness and two consisting of severely ill patients. Patients with mild to moderate illness received one dose of ivermectin per day in addition to standard care or hydroxychloroquine twice a day in addition to standard care. The researchers determined that the rate of illness progression was significantly lower among those who received ivermectin (1% vs. 22%). Severely ill patients were assigned to receive standard care plus ivermectin or hydroxychloroquine. The researchers determined that in addition to lower rates of COVID-19 illness progression in the ivermectin group (4% vs. 30%), the ivermectin group also had a lower mortality rate (2% vs. 20%).

Pierre Kory, MD, MPA, an associate professor of medicine and a critical care physician at St. Luke's Medical Center in Milwaukee, Wisconsin, said that in the days since their review was written, even more studies have been published supporting the use of ivermectin in patients with COVID-19.

“All studies showed positive benefits — the majority showed a decrease in mortality, decreases in hospitalization,” Kory said.

In light of the positive data on ivermectin in COVID-19, the researchers called on national and global health authorities — including the NIH, WHO and the CDC — to examine the data.

“We are appealing to these national and global health authorities,” Marik said. “Please, review the data, and provide guidance to health care workers across the world so that they can prescribe this medication.”

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