Conducted mainly in the Hospital for Tropical Diseases in Bangkok, the study published today in eLife, part of the ongoing PLATCOV trial – a Wellcome Trust-funded phase 2 multi-centre platform that requires a comparatively small sample size to assess the antiviral pharmacodynamics and effectiveness of medicines in treating early symptomatic COVID-19 infections.
The findings support claims that the drug has little antiviral activity against SARS-CoV-2 - and help resolve the controversy about the effectiveness of ivermectin in treating COVID-19.
“Our study shows there is no support for the continued use of ivermectin in treating COVID-19,” says senior author and PLATCOV co-PI Prof Sir Nicholas White, Professor of Tropical Medicine at the Mahidol Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand, and the Centre for Tropical Medicine and Global Health (CTMGH), Nuffield Department of Medicine, University of Oxford, UK.
Several different drugs have been suggested for the early treatment of COVID-19. Monoclonal antibodies, a type of targeted drug therapy, have been shown to be effective in preventing and treating COVID-19. However, they are expensive and they require an intravenous injection to be administered. Similarly, the new drugs molnupiravir and nirmatrelvir have shown promise in clinical settings, but they are largely unavailable outside of high-income settings. Repurposed drugs, such as ivermectin, have therefore been explored in treating COVID-19, as they are more affordable and generally available. However, trials of these drugs have often been flawed and/or underpowered. This has led to uncertainty and confusion over the effectiveness of these drugs, especially in the case of ivermectin.
“Even now, three years after the start of the pandemic, it remains uncertain whether any of the proposed repurposed antiviral treatments are effective at fighting COVID-19, highlighting the limitations of the tools currently used to assess these drugs,” explains co-lead author Dr William Schilling, Research Physician at MORU and CTMGH. Schilling contributed equally alongside fellow co-lead author Podjanee Jittamala, a lecturer in the Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University.