Ivermectin: a multifaceted drug of Nobel prize-honoured distinction with indicated efficacy against a new global scourge, COVID-19
A D Santin, David E Scheim, P A Mccullough, M Yagisawa, T J Borody
New Microbes and New Infections, doi:10.1016/j.nmni.2021.100924
In 2015, the Nobel Committee for Physiology or Medicine, in its only award for treatments of infectious diseases since six decades prior, honoured the discovery of ivermectin (IVM), a multifaceted drug deployed against some of the world's most devastating tropical diseases. Since March 2020, when IVM was first used against a new global scourge, COVID-19, more than 20 randomized clinical trials (RCTs) have tracked such inpatient and outpatient treatments. Six of seven meta-analyses of IVM treatment RCTs reporting in 2021 found notable reductions in COVID-19 fatalities, with a mean 31% relative risk of mortality vs. controls. During mass IVM treatments in Peru, excess deaths fell by a mean of 74% over 30 days in its ten states with the most extensive treatments. Reductions in deaths correlated with the extent of IVM distributions in all 25 states with p < 0.002. Sharp reductions in morbidity using IVM were also observed in two animal models, of SARS-CoV-2 and a related betacoronavirus. The indicated biological mechanism of IVM, competitive binding with SARS-CoV-2 spike protein, is likely non-epitope specific, possibly yielding full efficacy against emerging viral mutant strains.
Ethical approval and consent to participate This is a review and ethical approval was not required.
Transparency declaration TJB is a principal in Topelia Therapeutics (Ventura, California), which seeks to commercialize cost-effective treatments for COVID-19, including IVM. All other authors report no conflicts of interest.
Appendix A. Supplementary data Supplementary data to this article can be found online at https:// doi.org/10.1016/j.nmni.2021.100924.
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