Yusuff Moshood & Adebayo Folorunsho-Francis
A lung and ICU specialist who has cared for dying COVID-19 patients, Dr. Pierre Kory, says Ivermetcin — a medication used to treat many types of parasitic infestations — could have ‘miraculous’ impact in the treatment of coronavirus.
Kory, who is president of the Frontline COVID-19 Critical Care Alliance, based his claim on almost 30 studies conducted by him and a team of physicians for nine months, indicating that Ivermetcin is very effective in the preventive treatment of the viral condition.
Public health experts in Nigeria, however, called for caution, saying the claim should be properly looked into before being accepted.
At a December 8 presentation before the United States Senate panel, the doctor, who belongs in a group of highly published physicians with about 2,000 peer-reviewed publications to their credit, said Ivermetcin “literally obliterated” COVID-19 during trial tests by his group.
Kory, who works as pulmonary and critical care specialist at Aurora St Luke’s Medical Centre in Milwaukee, recalled that last May, he had recommended to the panel the need to use corticosteroids in managing the pandemic, noting that national and international organisations had said that the steroid hormones could not be used in the management of COVID-19.
“Corticosteroids turned out to be a life-saving recommendation,” Kory told the panel, noting that in the last nine months, his group of researchers had tried to identify a repurposed and available drug to treat coronavirus.
Drug repurposing (also called drug repositioning, reprofiling or re-tasking) is a strategy for identifying new uses for approved or investigational drugs that are outside the scope of the original medical indication.
The American physician lamented that no task force in the United States had reviewed repurposed drugs in an attempt to treat COVID-19, saying, “Novel, expensive pharmaceutically engineered drugs such as Tocilizumab and monoclonal antibodies and vaccines were being deployed, whereas a drug (Ivermectin) is proving to be of miraculous impact.”
He recalled that on August 27, the National Institutes of Health had recommended that Ivermectin be not used outside of control trials, even as he now urged the agency to review its stance.
Kory based his arguments on “almost 30 studies” that showed that “Ivermectin literally obliterates COVID-19 transmission.”
“If you take it, you will not get sick. Ivermectin is effective in prophylaxis prevention of COVID-19,” the lung specialist told the Senate panel.
Continuing, he said the drug’s effectiveness was “confirmed by a trial in Argentina during which 800 health workers were prophylaxed and none of them got sick.”
Kory said the group of scientists working with Ivermectin was led by one Prof. Paul Merrick; and that they had, in the early days of COVID-19 pandemic, come together to review the literature on the viral condition with a view to developing effective treatment protocols.
He said that in the last nine months, his group of researchers had tried to repurpose available drugs to treat COVID-19 and had concluded that a prophylaxis trial of Ivermectin on 800 health workers in Argentina showed that it was effective, as none of the subjects got sick from coronavirus following the treatment.
On the contrary, Kory said, in the 400 health workers that were not prophylaxed with Ivermectin, 237 (58%) got sick; adding, “Ivermectin has immense and potent antiviral activities.”
He said that his group of scientists had done four large randomized controlled trials totaling over 1,500 patients, with each trial showing that as a prophylaxis agent, Ivermectin is effective against the virus
‘It reduces need for hospitalization and death’
“The most profound evidence for its use is among hospitalised patients where four randomised control trials and multiple observation trials all proved Ivermectin’s efficacy against COVID-19,” he added.
Discussing the efficacy of the drug further, Kory said, “Ivermectin won Nobel Prize in Medicine in 2015 for its impacts on global health in the eradication of parasitic diseases.
“It is proving to be an immensely powerful anti-viral and anti-inflammatory agent and is critical for use in COVID-19 treatment,” urging the NIH to review the data submitted to it concerning the drug.
Meanwhile, in June, Australian researchers published the findings of a study that found that Ivermectin inhibited the replication of SARS-CoV-2 in a laboratory setting, but it is not the same as testing the drug on humans or animals.
Following the study, the United States Food and Drug Administration warned members of the public not to self-medicate with Ivermectin products intended for animals.
‘Ivermetcin likely incidental’
PUNCH HealthWise contacted Nigerian researchers and virologists for comment on the scientist’s claims about Ivermetcin.
According to Public Health Physician and Infectious Disease Expert, Prof. Bayo Onajole, Ivermetcin’s effect on COVID-19 is “likely to be just incidental.”
Onajole, an epidemiologist at the Lagos University Teaching Hospital, Idi-Araba, said the claim should be examined critically.
He said every drug has an adverse effect because they have multiple activities, noting that Ivermetcin’s effect on COVID-19 could be an incidental adverse effect from what it was indicated for.
“Today, you can do the sequencing of drug and through that, you can see its effectiveness in other ways
“So many drugs are being touted for the management of COVID-19. However, many of them are just incidental.
“It is likely to be incidental, rather than being curative, just like chloroquine was touted for the management of the pandemic.
“If a drug is to be used for COVID-19, more research needs to be carried out to enable everyone know if they will have a good effect.”
Zeroing in on Ivermetcin, Onajole said, “I, however, think that an antiviral will be more effective for COVID-19 than an antihelmintic.
“I must note, however, that we are in a global village. If the research shows that this drug can help us solve our problem, it doesn’t matter where it was carried out, we can look into it and use it.”
Also speaking with PUNCH HealthWise, a medical virologist at Adeleke University, Ede, Osun State, Dr. Elijah Kolawole, said a clinical trial should be carried out with Ivermetcin in Nigeria before considering it for COVID-19 treatment.
It may be recalled that a team of scientists led by Kolawole had, in June, announced the discovery of a preventive vaccine against the novel coronavirus.
Kolawole, however, said it would take a minimum of 18 months before the vaccine could be released for widespread use due to a large amount of research, analysis and approvals required by medical authorities.
Concerning the American scientist’s claim about Ivermetcin, Kolawole said, “You cannot conclude based on those findings.
“There is a need to test the drug here before its recommendation, as I don’t know much about a clinical trial on the drug in Nigeria of today.”
While noting that he has not worked with Ivermetcin before, Kolawole said he did not believe there is a conspiracy by pharmaceutical companies not to look into generic drugs for COVID-19 treatment.
“Every drug or vaccine for COVID-19 must follow the laid down principles and laws governing clinical trials before any conclusion can be made. And only big pharmaceutical companies with huge financial strength can carry out such trials,” he said.
‘Ivermetcin may be deleterious to human subjects’
Also speaking on the issue, a pharmaceutical researcher and National Chairman of the Nigerian Association of Pharmacists in Academia, Prof. Emmanuel Chinedum Ibezim, said he was aware that Ivermetcin was being studied as a possible target drug for SARS CoV-2 and presently under serious clinical study.
“This claim has not received much-needed attention because of the high in-vitro dose of the drug employed in the study, which would, expectedly, be deleterious to human subjects, thus yielding a negative risk-benefit ratio.
“The drug has been studied earlier and shown to be active against several RNA viruses such as Zika virus, Influenza A virus, Newcastle disease virus, Chikungunya virus, yellow fever virus, Dengue virus, Japanese encephalitis virus and DNA viruses such as BK polyomavirus and Eqquine herpes virus type,” Ibezim said.
He said Ivermetcin is an orally used antiparasitic drug produced during the 1970s in the treatment of oncocerciasis (river blindness)
“It targets the glutamate-gated chlorine channels that are only present in invertebrates. It is a very safe drug and, to date, more than three billion treatments have been distributed in the context of the Mectizan Donation Programme alone, with an excellent safety profile. Most adverse reactions are mild,” he said.
Ibezim, however, said that the clinical efficacy and utility of Ivermectin in SARS CoV-2 infected patients are unpredictable at this stage, adding, “We should wait for results of well-designed large-scale randomised clinical trials on its efficacy for COVID-19.”
‘Ivermectin prescription works well’
Also speaking with PUNCH HealthWise, hospital pharmacist, Dr. Kingsley Amibor, said,
“I share the same view with Dr Pierre Kory that Ivermectin works well. I think that the medicine should be given a chance along with other potent ones like hydroxychloroquine and azithromycin.
“There shouldn’t be any hard and fast rule about it. Those doing well on hydroxychloroquine and azithromycin should be allowed to continue with them and be discharged to go home once they get well. But those not responding well to the two drugs could be put on Ivermectin and discharged once they are okay.”
Amibor also said the issue of taking vaccine for the pandemic does not sit well with many people.
“The masses are getting suspicious about the motive, especially now that there are so many theories about the vaccine.
“People are getting skeptical now that we are hearing about allergic reactions from some of those who have been inoculated with the Pfizer vaccine.
“Secondly, I don’t think it should be made compulsory for Nigerians. Elsewhere in the world where they have a high risk of COVID-19 like in the United States, Britain and Spain, compulsion may be considered. But people have survived this long in Nigeria without the vaccine. I think they should let them be,” he said.
A molecular virologist at the Nigerian Institute of Medical Research, Dr. Joseph Shaibu, however, expressed concerns about how the US pulmonologist came about his theory, saying, the drug should be subjected to a trial to prove Kory’s claim.
“From studies, the drug is on trials against some range of viruses and there is no definite statement on its potency against SARS-CoV-2 yet,” he said.
‘Ivermectin advocates should provide clinical evidence’
A consultant virologist at the University of Ibadan, Prof. Olufemi Olaleye, said, presently, there is no clinical trial reports to support Kory’s claim.
“Advocates of Ivermectin for treatment of COVID-19 needs to convince the world with scientific clinical evidence instead of the media campaign. Although there is no one drug that can give a form of cure, people infected are well managed now and they are managed accordingly,” he said.
He, however, expressed reservations about the proposed vaccination of people in developing countries, including Nigeria.
“I must say there is still a lot of questions to be answered concerning the issue of vaccines.
“How long can this vaccine protect? Is it going to be an annual inoculation for protection?
“Even in the United States and the UK where the vaccines are given currently, they approved them for what is called ‘Emergency Use Authorisation.’ That means it is not a full approval. It was only approved temporarily because of the emergency.
“I am also worried about where we hope to keep the Pfizer vaccine because the issue of storage is certainly beyond us now.
“We don’t have that capacity to store and transport at minus 80-degree temperature. Even the AstraZeneca vaccine that can be stored at a refrigeration temperature of 2.8 degree centigrade is still a challenge because of the power supply.
“As I said, there is a lot of questions to answer if we are going in the direction of vaccine,” he said.
‘American physician not talking science’
Also reacting, a pulmonologist at the Federal Medical Centre, Abeokuta, Ogun State, Dr. Olusola Adeyelu, said that Dr. Pierre Kory was not talking science.
“In his video, he kept talking about using it for prevention. Do you take a drug to prevent disease?
“What we know can prevent anything is a vaccine. You should also know by now that what the world’s leading researchers and scientist presently are running after is the vaccine.
“For instance, what will they request if you are travelling out of or to a country? It is the yellow form to determine if you are vaccinated.
“Some embassies even go further to run an X-ray on travellers. Why? They want to find out whether there is any lesion in you.
“Have you seen anybody taking drugs to prevent tuberculosis? You can only take it for treatment, not prevention,” he said.
He explained that medicine has branches, which are: the clinical aspect and basic medical science.
He further stated that basic science harps more on pharmacology which is all about drugs propounding.
“There are antibiotics, anthelmintics, antimalarial and antifungal. Today, some people go about prescribing the antifungal drug for staphylococcus. It will never work. What we know that can prevent COVID-19 for now is the use of face mask, social distancing and vaccine.
‘Ivermectin is for guinea worm’
“Ivermectin is to eradicate guinea worm, not coronavirus. It is just like saying you want to use Acyclovir, an antiviral medication, to treat malaria because you think it will immu modulate your system and make it stronger to prevent malaria,” he said.
Cautioning that COVID-19 should not be treated as a new virus, Adeyelu said, “It is part of the family of viruses that cause catarrh and one thing is peculiar to them — they have a shelf life. This means if you have catarrh now, it will go within seven days.
“Science has a role and observation that start from known to the unknown. As long as science is concerned, Kory does not know what he is talking about. If he says Ivermectin, which is used in the treatment of worm, can cure a virus, I tend to disagree scientifically.
“Let him further tell us where he did his randomised controlled trial. A randomised trial simply means separating a group of people who have the disease from those who don’t have and are not likely to have,” he said.
Demand for ivermectin in local pharmacies not frequent
Ivermectin is available in several community pharmacies across Nigeria as a prescription-based medication. It comes in generic and branded packs.
A generic drug is a pharmaceutical medication that contains the same chemical substance but have no brand name or registered trademark.
At Tonyson Pharmacy in Yaba, an attendant, Michael Nagbe, told our correspondent that a Mectizan branded pack of 50 Ivermectin tablets costs N1,200; while a single tablet costs N50.
“It is a controlled medication. We don’t sell to people without prescription,” he said.
Nagbe also disclosed that unlike regular essential drugs, the demand for Ivermectin is not frequent.
At Alpha Pharmacy and Stores in Ikeja, Lagos, a young pharmacist who didn’t disclose his name confirmed that the price was the same.
“But what we retail is the single tablet. We don’t have packs of Mectizan at the moment,” he said.
Business Head of Ibadan, Oyo State-based Vanguard Pharmacy, Mrs. Osho Adedoyin, told our correspondent on phone that the product was also available at the cost of N1,100 per pack and N150 per tablet.
When PUNCH HealthWise contacted the Nigeria Centre for Disease Control to know its position on Ivermectin, Director-General of the agency, Dr. Chikwe Ihekweazu, was not available.
As of the time of filing the story, he had yet to respond to the SMS and WhatsApp messages forwarded to him.
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