Ivermection I am sure doesn’t ring a bell in most people even medical doctors and yet it has been around for almost 50 years. Since 1988, every year about 300 million people take ivermection via a globally coordinated Mass Drug Administration programme. It is used to treat many parasitic diseases which have plagued the world’s poor in tropics for centuries. Ivermectin is the essential mainstay of two global disease elimination campaigns that should soon rid the world of two of its most disfiguring and devastating diseases, Onchocerciasis and Lymphatic filariasis, which blight the lives of billions of the poor and disadvantaged.
In the early 70s Ōmura, then head of the Antibiotics Research Group at Tokyo’s Kitasato Institute, formed a collaboration with the US-based Merck, Sharp and Dohme (MSD) pharmaceutical company to isolate organisms from soil samples and carried out preliminary in vitro evaluation of their bioactivity. Despite decades of searching around the world, the Japanese microorganism remains the only source of avermectin ever found. It started off as a veterinary drug. Since its discovery ivermection which is derived from avermectin has been used to treat billions of livestocks and pets around the world.
It is truly a wonder drug, it is versatile, it is safe and it has been well tested in both animals and human beings over many decades. Ivermectin has continually proved to be astonishingly safe for human use. It is such a safe drug, with minimal side effects, that it can be administered by non-medical staff and even illiterate individuals in remote rural communities, provided that they have had some very basic, appropriate training. Having said that it has always been targeting both internal and external parasitic infestation, until now. Ivermectin though known for its antiparasitic effects, it is also known to have antiviral effects against a broad range of viruses. Ivermectin is known to have partial efficacy against several single-strain RNA viruses. In vitro it inhibits SARS-CoV-2 replication using micromolar concentrations of ivermectin. As of December 2020, there are about 120 trials evaluating the efficacy of ivermectin to treat or prevent Covid19 infection. In Spain, the SAINT clinical trial is currently underway and aims to determine the efficacy of a single dose of ivermectin, administered to low risk, non-severe COVID19 patients. Despite the fact that ivermectin has been shown to be effective in vitro against Sars-Cov-2, this can only be achieved with high doses. At the present moment there is a lack of formulation for drug delivery for high doses of ivermectin. Researchers are looking into inhalation therapy methods for Covid19 patients.
Before we get too excited about the availability of a cure or a prevention of Covid19 infection that is cheaper, safer and more convenient than vaccinations, there are still many challenges. We live with the hope that this Wonder Drug will not let us down as it has saved many lives before us, men and animals. Until then stay safe and stay home.
*The 2015 Nobel Prize in Physiology and Medicine was awarded to William C. Campbell and Satoshi Ömura for their discoveries leading to ivermectin.
Happy Chinese New Year to all celebrating.
Dr Betty Teh
Editor in Chief
Beating Hearts
