Ivermectin is not effective at managing SARS-CoV-2 infection
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 28th, 2022
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The usage of ivermectin to prevent and manage SARS-CoV-2 infection had been controversial since the start of the pandemic. Thus, many studies have been conducted to investigate the efficacy of the antiparasitic agent. Supporting the current literature, an article recently published in the Journal of the American Medical Association had reported on the effectiveness of ivermectin on relieving symptoms of mild to moderate COVID-19 in adults being treated in an outpatient setting.
The randomized control trial was conducted between June 23, 2021 and May 31, 2022 - during which the Delta and Omicron variants are the two most prevalent. The study was conducted at 93 different clinical sites across the United States to ensure geographical variation; however, it lacks racial/ethnic representation due to an under-enrollment of people of color. The trial included 1,591 patients that are older than 30 years old who had been diagnosed with SARS-CoV-2 within 10 days of treatment initiation. The patient was given either placebo or 400 μg/kg of ivermectin for 3 days. The study reported that ivermectin is not effective at improving the recovery time; patients in both groups take approximately 12 days. In addition, ivermectin does not improve the odds of preventing either visits to the emergency room, hospitalizations, or death. In terms of limitation, it can be argued that the low efficacy of ivermectin can be explained by the fact that the initiation of treatment is late during the course of disease; since, treatment was started on day 6 of symptoms manifestation.
The mechanism of action of DARPins molecules such as ensovibep is similar to monoclonal antibodies. However, the small protein can be mass-produced easily and relatively inexpensive using Escherichia coli bacteria. In prior studies, the team had found that ensovibep prevent progression to severe disease in hamster model. Also, in a recent phase 2 clinical trial, ensovibep helps reduce disease severity and lower the risk of hospitalization and death of outpatients with mild-to-moderate COVID-19. This phase 3 study randomly assigned 496 hospitalized patients to receive either an intravenous infusion of ensovibep 600 mg, or placebo. The intervention and placebo was administered as a supplementation to the current standard of care being delivered. During a mid-study analysis, the researchers found that ensovibep does not improve pulmonary function of these hospitalized patients. Thus, the data safety monitoring board halted the study due to futility and concluded that the addition of ensovibep to the current standard of care does not improve clinical outcomes of patients hospitalized due to COVID-19.
The randomized control trial was conducted between June 23, 2021 and May 31, 2022 - during which the Delta and Omicron variants are the two most prevalent. The study was conducted at 93 different clinical sites across the United States to ensure geographical variation; however, it lacks racial/ethnic representation due to an under-enrollment of people of color. The trial included 1,591 patients that are older than 30 years old who had been diagnosed with SARS-CoV-2 within 10 days of treatment initiation. The patient was given either placebo or 400 μg/kg of ivermectin for 3 days. The study reported that ivermectin is not effective at improving the recovery time; patients in both groups take approximately 12 days. In addition, ivermectin does not improve the odds of preventing either visits to the emergency room, hospitalizations, or death. In terms of limitation, it can be argued that the low efficacy of ivermectin can be explained by the fact that the initiation of treatment is late during the course of disease; since, treatment was started on day 6 of symptoms manifestation.
The mechanism of action of DARPins molecules such as ensovibep is similar to monoclonal antibodies. However, the small protein can be mass-produced easily and relatively inexpensive using Escherichia coli bacteria. In prior studies, the team had found that ensovibep prevent progression to severe disease in hamster model. Also, in a recent phase 2 clinical trial, ensovibep helps reduce disease severity and lower the risk of hospitalization and death of outpatients with mild-to-moderate COVID-19. This phase 3 study randomly assigned 496 hospitalized patients to receive either an intravenous infusion of ensovibep 600 mg, or placebo. The intervention and placebo was administered as a supplementation to the current standard of care being delivered. During a mid-study analysis, the researchers found that ensovibep does not improve pulmonary function of these hospitalized patients. Thus, the data safety monitoring board halted the study due to futility and concluded that the addition of ensovibep to the current standard of care does not improve clinical outcomes of patients hospitalized due to COVID-19.