WHO recommends against using lvermectin for treating COVID-19
Delhi: Amidst swirl of claims surrounding the cheap anti-parasite drug Ivermectin, WHO has issued a guideline on its utility for COVID-19 treatment.
According to WHO, Ivermectin should only be used for the treatment of COVID-19 within clinical trials until more data is available on its use, WHO has advised. Currently, evidence on ivermectin for treatment of COVID-19 patients is inconclusive.
The recommendation, which is now part of WHO's guidelines on COVID-19 treatments, applies to COVID-19 patients of any disease severity.
In response to the increased international attention on ivermectin as a potential treatment for COVID-19, a guideline development group was convened. This group is an independent, international panel of experts, which includes clinical care experts in multiple specialties and also include an ethicist and patient-partners.
The recommendation is based on the review of pooled data from 16 randomized controlled trials that enrolled a total of 2407 participants which consisted of both inpatients and outpatients with COVID-19.
They determined that the evidence on whether ivermectin reduces mortality, need for mechanical ventilation, need for hospital admission and time to clinical improvement in COVID-19 patients is of "very low certainty," due to the small sizes and methodological limitations of available trial data, including small number of events.
The panel did not look at the use of ivermectin to prevent COVID-19, which is outside of scope of the current guidelines.
Previous recommendations on the use of therapeutics for COVID-19:
- Strong recommendation for the use systemic corticosteroids for severe or critically ill COVID-19 patients; with a conditional recommendation against their use in patients with mild/moderate COVID-19.
- Conditional recommendation against administering remdesivir in addition to usual care.
- Strong recommendation against the use of hydroxychloroquine or chloroquine for treatment of COVID-19 of any severity.
- Strong recommendation against administering lopinavir/ritonavir for treatment of COVID-19 of any severity.
- Conditional recommendation for the use of low dose anticoagulants in hospitalized patients (this recommendation is part of the clinical management guidelines). We suggest the use of low dose anticoagulants rather than higher doses, unless otherwise indicated.
Ivermectin is a broad spectrum anti-parasitic agent which is included in WHO essential medicines list for several parasitic diseases. It is used in the treatment of strongyloidiasis, onchocerciasis (river blindness), and other diseases caused by soil transmitted helminthiasis. It is also used to treat scabies.