50 patients in Pakistan were prescribed Ivermectin. This Phase 4 clinical trial recorded the response of the patients after the ivermectin as well as those who were given a placebo.
Ivermectin has different effects to treat a variety of diseases and it has proven antimicrobial, antiviral, and anti-cancer properties and is considered a wonder drug.
It is highly effective against many microorganisms including some viruses. Many studies revealed its antiviral effects on RNA viruses such as Zika, dengue, yellow fever, West Nile, Hendra, Newcastle, Venezuelan equine encephalitis, chikungunya, Semliki Forest, Sindbis, Avian influenza A, Porcine Reproductive and Respiratory Syndrome, Human immunodeficiency virus(HIV) type 1, and severe acute respiratory syndrome coronavirus SARS-CoV-2.
There are few studies showing antiviral effects of ivermectin against DNA viruses such as Equine herpes type 1, BK polyomavirus, pseudorabies, porcine circovirus 2, and bovine herpesvirus.
Ivermectin plays a vital role in several biological mechanisms, therefore it could emerge as a potential candidate in the treatment of a wide range of viruses including COVID-19 as well as other types of positive-sense single-stranded RNA viruses. In vivo studies of animal models revealed a broad range of antiviral effects of ivermectin, however, more clinical trials are necessary as it's the need of the hour to do so, as we can validate the potential efficacy of ivermectin in clinical settings.
The recent report by Caly et al.6 describing the antiviral potential of ivermectin against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro arrives to the agenda of potential candidates for COVID-19 treatment.
Currently, there is not any Food and Drug Administration (FDA) approved specific effective antiviral treatment available for COVID-19. Although most of the COVID-19 patients have mild or moderate courses, up to 5%-10% can have severe, potentially life-threatening courses, there is an urgent need for the development of effective & safe drugs to deal with this novel virus. Optimized supportive care remains the mainstay of therapy. There are more than 300 clinical trials going on, various antiviral and immunomodulating agents are in different stages of evaluation for COVID-19 in those trials and results/ primary endpoints of a few trials will be published in the next couple of months. Despite the urgent need to find an effective and safe antiviral treatment for COVID-19 through randomized controlled studies, certain agents are being used all over the world based on either in-vitro or conclusive evidence or observational studies.
The clinical efficacy and utility of ivermectin in SARS-CoV-2-infected patients is unpredictable at this stage, as we are dealing with a completely novel virus.
There is an urgent need for investigation of the mortality causes and development of novel therapeutic options for severe COVID-19.