Should Ivermectin be used to treat COVID?
by John B. Abell MD, ABIM, IFMCP,FAARFM, ABAARM
There has been much ado from the CDC and FDA with negative press on using a “parasite” drug in both prophylaxis and treatment of COVID 19. No, we are not treating a parasite, I concur with that. I have not heard of anything in the press regarding doctors using trazodone to help with insomnia. Turns out, this is the number one reason this drug is prescribed today. Trazodone is FDA approved for treatment of major depressive disorder, never for insomnia. And this list can go on and on.
We many times forget about the “mechanism of action” of drugs. Physicians should look at the science of medicine if they truly want to help their patients to achieve their best possible outcome. I personally think physicians should look more closely at the physiologic basis of an individual’s disease as well to improve outcomes.
Ivermectin as one studies it has multiple actions:
- Inhibits and disrupts binding of SARS-CoV-2 S protein at the ACE-2 receptors (all primary car, cardiology doctors know and treat ACE-2 daily)
- Binds to SARS-CoV-2 spike protein and interrupts several mechanisms to help prevent “clumping” of cells.
- Directly inhibits the NF-kb pathway, STAT-3, and indirectly inhibits PAK-1 by increasing its ubiquitin-mediated degradation. (NF-kb is the ultimate mediator or all inflammation, and is something I have studied for going on 8-10 years)
- inhibits both importin a-b as well as the KPNA-1 receptors causing natural antiviral IFN release
- inhibits viral RdrP, responsible for viral replication.
- And this is JUST a partial list of the mechanisms of action of Ivermectin. See reference below for a more detailed list.
Drug repurposing, drug redirecting is defined as the identification of novel uses for existing drugs. This is nothing new in medicine. Most drugs work in more than one way and can be used for more than one purpose. And I think that that’s something that apparently the FDA has forgotten for the physicians being able to use ivermectin on off label uses.
Although several drugs received Emergency Use Authorization for COVID-19 infection with unsatisfactory supportive data, Ivermectin, on the other hand, has been sidelined irrespective of sufficient convincing data supporting its use. Nevertheless, many countries adopted ivermectin as one of the first-line treatment options for COVID-19. (The Journal of Antibiotics June 15,2021)
Ivermectin has been studied rather extensively actually in both prophylaxis and treatment of COVID-19.
Real-time data is also available with a meta-analysis of 55 studies to date. As per data available on 16 May 2021, 100% of 36 early treatment and prophylaxis studies report positive effects (96% of all 55 studies). Of these, 26 studies show statistically significant improvements in isolation. Random effects meta-analysis with pooled effects using the most serious outcome reported 79% and 85% improvement for early treatment and prophylaxis respectively.
The probability that an ineffective treatment generated results as positive for the 55 studies to date is estimated to be 1 in 23 trillion (p = 0.000000000000043). The consistency of positive results across a wide variety of cases has been remarkable. It is extremely unlikely that the observed results could have occurred by chance. (Ivermecta.com)
- There is evidence of a negative publication bias, and the probability that an ineffective treatment generated results as positive as the 63 studies is estimated to be 1 in 1 trillion.
- While many treatments have some level of efficacy, they do not replace vaccines and other measures to avoid infection. Only 27% of ivermectin studies show zero events in the treatment arm.
- Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. All practical, effective, and safe means should be used. Those denying the efficacy of treatments share responsibility for the increased risk of COVID-19 becoming endemic; and the increased mortality, morbidity, and collateral damage.
- The evidence base is much larger and has much lower conflict of interest than typically used to approve drugs.
I urge you to take a look at some of the trials attached, posted on the FLCCC Alliance website. Especially the graphs within showing impressive data using mass distribution of ivermectin and reduction of the incidence of COVID-19 infections.
And the moral of the story? Guess all those primary care doctors out there have to withdraw all their prescriptions for trazadone for insomnia?