Source: Dagens Medicin

We believe that the Medical Products Agency should follow the example of the Czech Republic, Slovakia and several other countries and approve ivermectin as treatment for covid-19, write three doctors. 

Not having any working early treatment or prophylaxis to use against covid-19, we have experienced to be a great frustration. The fear of this disease has created a desperation and anxiety that we have not seen before. The toolbox to alleviate this concern has been left blank. We believe that the drug ivermectin could fill this void.

Early in the covid-19 pandemic, an emergency working group was formed in the United States under the name The Front Line COVID-19 Critical Care Alliance (FLCCC Alliance). It was a group of reputable intensive care physicians with expertise, especially regarding severe infections. In collaboration with colleagues around the world, experiences were exchanged, and treatment protocols were developed, several of which are used by healthcare worldwide and so also in Sweden, (1,2). Early in the pandemic, ivermectin was discussed and most studies have shown its positive effect both as a treatment but also as a prevention against covid-19 (1). In December last year, the FLCCC published a summary article on ivermectin recommending the drug (3).

Ivermectin is a well-known drug that is approved against parasites by the WHO, EMA and FDA (the American equivalent of the Medical Products Agency). The drug was discovered in the 1970s and in 2015 its authors received the Nobel Prize in Medicine (4). Ivermectin is widely used in low- and middle-income countries to treat machine infections (5,6). 

The medicine is cheap (SEK 100 to 200 per treatment) and the medicine is on the WHO’s list of essential medicines (7). In total, about 3 billion doses of ivermectin have been distributed (8) and in its usual dose (0.2-0.4 mg / kg) the substance is considered extremely safe to use in humans (9,10).

It has also been shown to have antiviral and anti-inflammatory properties which have further extended its use (11). 

To date, there are 102 studies regarding the effect of Ivermectin on covid-19. 64 of these studies compare Ivermectin treatment to a control group and 62 are peer-reviewed. A total of 585 researchers and 22,425 patients were included in the studies. All studies are gathered in a database that is constantly updated. (12)

In summary, when comparing ivermectin with the control group, the studies show the following (12):
• 85 percent improvement in 14 prophylaxis studies
• 74 percent improvement in 26 early treatment studies
• 46 percent improvement in 22 studies of late treatment
• 69 percent improvement in 24 study mortality results
• 62 percent improvement in 32 randomized controlled trials 

When we turned to the Medical Products Agency with a request for ivermectin against covid-19, they referred to their European counterpart, EMA, which advised against treatment with ivermectin. (14)

This has not prevented both the Czech and Slovak National Medicines Agency from approving ivermectin for treatment with covid-19. (14,15)

Ivermectin has been approved for treatment in several countries and regions around the world. (16)

The EMA’s reasons for advising against ivermectin have been met by the FLCCC, which convincingly shows that the decision is not based on an overall picture without selecting a few studies with little or no positive effect without looking at the whole. (13)

We have also turned to the Swedish Society of Infectious Diseases, which after four months still has not answered our questions about ivermectin as a possible treatment.

We believe that the Medical Products Agency should follow the example of the Czech Republic, Slovakia and several other countries and approve ivermectin as treatment for covid-19 (16).

In our eyes, ivermectin could be what ends the pandemic.

Magnus Burling , specialist in general medicine

Hans Zingmark , specialist in internal and pulmonary medicine

Sture Blomberg , specialist in anesthesia and intensive care, associate professor

References:

1. https://covid19criticalcare.com

2. https://infektion.net/wp-content/uploads/2021/03/nationella-covid-mar-2021-revision-210307.pdf 

3. Kory., P. Meduri, GU, Varon, J. et al (2020). Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. (www.flccc.net)

4. https://www.nobelprize.org/uploads/2018/07/advanced-medicineprize2015.pdf 

5. Barrows NJ, Campos RK, Powell ST, et al. A screen of FDA-approved drugs for inhibitors of zika virus infection. Cell Host Microbe. 2016; 20: 259–270.

6. Conterno LO, Turchi MD, Corrêa I, et al. Anthelmintic drugs for treating ascariasis. Cochrane Database Syst Rev. 2020; 1. doi: 10.1002 / 14651858.CD010599.pub2.

7. World Health Organization. 21st Model List of Essential Medicines. Geneva, Switzerland; 2019. Available at: https://www.who.int/publications/i/item/ WHOMVPEMPIAU2019.06. Accessed January 26, 2021.

8. Nicolas P, Maia MF, Bassat Q, et al. Safety of oral iver- mectin during pregnancy: a systematic review and meta-analysis. Lancet Glob Health. 2020; 8: e92 – e100.

9. Banerjee K, Nandy M, Dalai CK, et al. The battle against covid 19 pandemic: what we need to know before we “test fire” ivermectin. Drug Res (Stuttg). 2020; 70: 337–340.

10. NavarroM, CamprubíD, Requena-MendezA, etal. Safety of high-dose ivermectin: a systematic review and meta-analysis. J Antimicrob Chemother. 2020; 75: 827–834.

11. Kircik LH, Del Rosso JQ, Layton AM, et al. Over 25 Years of clinical experience with ivermectin: an over-view of safety for an increasing number of indications. J Drugs Dermatol. 2016; 15: 325–332.

12. https://c19ivermectin.com 

13. https://covid19criticalcare.com/ivermectin-in-covid-19/faq-on-ivermectin/ 

14. https://www.ema.europa.eu/en/news/ema-advises-against-use-ivermectin-prevention-treatment-covid-19-outside-randomised-clinical-trials 

15. https://trialsitenews.com/slovakia-becomes-the-first-eu-nation-to-formally-approve-ivermectin-for-both-prophylaxis-and-treatment-for-covid-19-patients/ 

16. https://ivmstatus.com 








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