Ivermectin is an antiparasitic used since the end of the 80s in the treatment of diseases such as onchocerciasis also called “river blindness”. It is a cutaneous filariasis caused by a nematode, Onchocerca volvulus, transmitted to humans by the bite of a small black fly, a blackfly, which reproduces near waterways. WHO notes that ivermectin is a drug “safe and can be used on a large scale” in the fight against river blindness, and that it “has transformed the lives of millions of people suffering from onchocerciasis since its introduction in 1987. “
This drug is known in our countries to fight against scabies (1)
As early as April 2020, Australian scientists identified ivermectin as a possible treatment for Covid-19 (2)
Today, many international publications draw attention to the effectiveness of ivermectin against Covid-19, at all stages: both as prophylaxis, as well as early or late treatment.
A good way to get an idea of the value of ivermectin is to refer to the report of the hearing of Dr. Pierre Kory in the United States Senate on December 8, 2020 (3)
Ivermectin is effective against COVID-19, based on data from:
– 24 trials, including a total of 7825 patients, using well-matched control groups
– 15 controlled and randomized trials with more than 3,000 patients
– 12 of 24 trials were published in peer-reviewed journals, 3,926 patients, the rest in prepublication
The potential role of ivermectin as a therapeutic and prophylactic agent for Covid-19 is discussed in another review of print and preprinted studies. Positive benefits in terms of mortality, reduced clinical recovery time, reduced incidence of disease progression, and decreased length of hospital stay have been reported in patients at all stages of severity. clinical study in the selected studies. (6)
Adopted in several countries: India, Egypt, Argentina, Mexico, Peru, Uruguay … and most recently Macedonia
Proven in vitro action on viruses, such as the porcine pseudo-rabies PVR virus, an RNA virus, such as Covid-19. By inhibiting UL42 DNA polymerase (7), ivermectin is effective in reducing almost completely, within 48 hours, the viral load of the coronavirus (8).
Prophylactic action demonstrated
Observational, non-randomized, prospective study by Hector Carvallo (9) in Argentina, on hospital staff. After 3 months of taking 12 mg of ivermectin weekly, none of the 788 people developed Covid, compared to 237 out of 407 (58%) in the control group.
Validated therapeutic action
At the start of the disease: prevents its entry into cells, its replication, its multiplication.
In the hospital: anti-inflammatory action, Pierre KORY (10)
The site https://c19ivermectin.com (11) compiled the results of 45 studies. 29 studies in human medicine, 27 of which show positive results with 81% positive results, The 2 negative studies are methodologically inadmissible
In the International Journal of Antimicrobial Agents, Martin Hellwig et coll (12) after a review of the literature, find that “countries where chemoprophylaxis by Ivermectin is administered en masse have a significant impact on contamination by Covid-19. “
First randomized study that of Shouman (13), in the treated group, only 7.4% of contact cases developed symptoms of Covid-19 within 2 weeks after inclusion, compared to 58.4% in the control group. This corresponds to a very significant 87% risk reduction (p <0.001).
Second randomized controlled study ofElgazzar (14), the reduction in the risk of transmission is 80% after 2 doses of ivermectin compared to the control group
Posologie, according to Paul MARIK (15)
150-200 ug / kg ou 12 mg (≤ 80kg) ou 18 mg (≥ 80kg)
Prophylaxis: 200 ug / kg on D1 and D3
High risk subject (200 ug / kg on D1, D3 and every 4 weeks.
Symptomatic at home: Ivermectin 150-200 ug / kg, 2 doses.
Isolated or combined? with AZM, HCQ, vitamin D, vitamin C, Zinc, quercetin, further studies are needed
Between a general vaccination, of which we know neither the effectiveness, nor the consequences in the medium or long term, and an effective, safe, inexpensive treatment, hesitating for a government is equivalent to not assisting a person in danger.
For detractors, the studies are preprints not validated by their peers, but the plausibility is sufficient to launch, without risk, to trust observational studies, without waiting for randomized studies (16). President Macron has repeated over and over again, “we are at war”, and therefore what matters is to face adversity TODAY, failing to have realized it yesterday, time does not is not for scientific study but to help patients.
To date, the accumulated evidence demonstrating the efficacy and safety of ivermectin in COVID-19 supports its immediate use on the basis of a risk / benefit calculation in the context of a pandemic. They justify the request for a Temporary Recommendation for Use for Ivermectin. This is made by lawyer Jean Charles Teissèdre
The Temporary Recommendation for Use (RTU) was created by Law n ° 2014-892 of August 8, 2014 – art 10, creating an Article L. 5121-12-1 in the Public Health Code (https://www.legifrance.gouv.fr/codes/id/LEGIARTI000042685759/2021-07-01/ ), in order to allow and secure the prescription of a drug benefiting from a Marketing Authorization (MA), if necessary, in an indication that does not correspond to that of its Marketing Authorization.
The National Medicines Safety Agency (ANSM), responsible for issuing this authorization, specifies the two conditions required to prepare this RTU:
“- that there is a therapeutic need
– and that the benefit / risk ratio of the medicinal product is presumed favorable, in particular on the basis of published scientific data on efficacy and safety ”.
Ivermectin therefore responds favorably to these two requirements.
BIBLIOGRAPHIE 1 - C.Bernigaud et col : Bénéfice de l’ivermectine : de la gale à la covid19 un exemple de sérenpidité. Annales de Dermatologie et de Vénérologie ; Dec 2020 ; Vo 147 ,issue 12 ; p A194 2 - Kylie Wagstaff : Lab experiments show anti-parasitic drug, Ivermectin, eliminates SARS-CoV-2 in cells in 48 hours. Monash Biomedicine Discovery Institute. A avril 2020 3- Testimony of Pierre Kory, MD Homeland Security Committee Meeting: Focus on Early Treatment of COVID-19 December 8, 2020 4 - https://ivermectine-covid.ch Revue des données sur l’efficacité de l’ivermectine pour la COVID-19 5 - https://ivmmeta.com : Ivermectin is effective for COVID-19: meta analysis of 28 studies Covid Analysis, November 26, 2020 (Version 11, January 4, 2021) 6 - Stefanie Kalfas et col : The therapeutic potential of ivermectin for Covid-19 : a systematic review of mecanism and evidence . Med RXiv 4 decembre 2020 7 – Changjie Lv et col : L’Imervectine inhibe l’ADN polymérase UL42 du virus de la pseudorage dans le noyau et la prolifération du virus in vitro et in vivo. Recherche antivirale novembre 2018 ; vol 159, 55-62 8 - Leon Caly et col : The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral Research. Juin 2020 ; Vol 178, 104787 9 - Hector Carvallo et col : Protocolo: https://www.cadenanueve.com/wp-content/uploads/2020/08/Protocolo-IVERCAR-Sinopsis-y-Resultados.pdf 10 – Pierre Kory, Debriefing France Soir 10.12.2020 11 - https://c19ivermectin.com : résultats de 45 études, dont 29 humaines et 27 positives 12 - Martin D.Hellwig, Anabela Maia : A COVID-19 prophylaxis? Lower incidence associated with prophylactic administration of ivermectin. International Journal of Antimicrobial Agents, 28 novembre 2020, 106248 13 - Waheed Shouman : Use of Ivermectin as a Prophylactic Option in Asymptomatic Family Close Contacts with Patients of COVID-19 https://clinicaltrials.gov/ProvidedDocs/61/NCT04422561/Prot_SAP_000.pdf 14 - Ahmed Elgazzar : Efficacity and Ssafety of Ivermectin for treatment and prophylaxis of Covid-19 pandemic. https://www.researchsquare.com/article/rs-100956/v2 15 - Paul MARIK : EVMS Covid 19 Management protocol, an overview of the MATH+ and I-MASK Protocols. 17 décembre 2020 . : https://www.evms.edu/covid-19/medical_information_resources/ 16 -Mike Bray et col : Ivermectin and COVID-19: A report in Antiviral Research, widespread interest, an FDA warning, two letters to the editor and the authors' responses. Antiviral Res. 2020 Jun; 178: 104805