Ivermectin is a wonderful drug. So effective that its discovery deserved the 2015 Nobel Prize in Medicine and Physiology awarded to Japanese chemist Satoshi Omura and American parasitologist William Campbell. Omura isolated a number of potentially physiologically active compounds from a species of Streptomyces bacteria that were then investigated by Campbell who discovered that one of these, avermectin, was remarkably efficient against parasites. A slight chemical modification led to “Ivermectin” that proved to be very effective at treating human parasitic diseases such as river blindness, a tropical disease caused by a worm spread by the bites of a type of black fly. The drug is also widely used in veterinary medicine as a deworming agent.
As is often the case, the effectiveness of a medication for one condition arouses interest in other potential applications. The usual first step is to explore possibilities “in vitro,” meaning research on cell cultures in a petri dish. Antiviral activity is often explored and indeed Ivermectin has shown such activity, albeit at very high doses.
These experiments stimulated human clinical trials and also triggered the “off label” use of Ivermectin for COVID infections. Unfortunately, when the published trials were examined by the Cochrane organization, a highly respected group of experts, the conclusion was that there is insufficient evidence for the use of the drug in the treatment of COVID-19. It is also noteworthy that the major paper by Egyptian researchers that has been cited by Ivermectin proponents has been retracted for mismanagement of the data.
The lack of evidence has not deterred enthusiasm for the use of the drug by contrarian physicians and scientists who claim that evidence is being suppressed by the CDC. This is not the case. All regulatory agencies would be delighted if there were such a simple solution to the problem of COVID. In the meantime, spurred on by irresponsible internet bloggers, people are self-medicating with Ivermectin, sometimes with doses that have proved to be toxic.
This is what has led the CDC to release a rather unusual statement telling people that “You are not a horse. You are not a cow. Seriously, y”all. Stop it.” Based on the evidence available, that is sound advice. Should further studies, and a number are underway, show that Ivermectin is indeed effective at curbing the symptoms of COVID-19, that advice will change. That is the way of science.
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