Bangladesh begins ivermectin trial in COVID-19 patients

Researchers in Bangladesh have launched clinical trial of ivermectin in COVID-19 patients after a group of doctors said the anti-parasitic drug cut the symptoms by 50 percent in three days.

The drug will be used in combination with antibiotic doxycycline or alone, the International Centre for Diarrhoeal Disease Research, Bangladesh or icddr,b said in a statement on Wednesday.

Ivermectin is a low-cost drug available in Bangladesh. An Australian study found that the drug can kill the coronavirus in 48 hours in a laboratory setting. The study did not include human testing.

Ivermectin is used to treat roundworms, threadworms and other parasites. There is also a formulation used to de-worm animals. Health officials have cautioned that people not take the version intended for animals.

The icddr,b said the study will enrol 72 patients from four hospitals treating COVID-19 patients in Dhaka. Initially, the study has commenced with Kurmitola General Hospital and Mugda Medical College and Hospital while discussions with others underway, according to the statement.

Funded by Beximco Pharmaceuticals Ltd and scheduled to end in two months, the study aims to understand the virological clearance rate and days required for remission of fever and cough by using ivermectin with or without doxycycline, the icddr,b said.

It will also try to understand the changes in oxygen requirement, reasons for patients failing to maintain oxygen saturation above 88 percent despite oxygenation, changes in number of days on oxygen support and hospitalisation, and causes of mortality.

Dr Wasif Ali Khan, senior physician scientist of enteric and respiratory diseases at the icddr,b, said researchers have to explore drugs “that are already on the market, that are well studied, have a low side effect profile and can save lives” because it “may take decades” to develop new ones for COVID-19. Dr Khan is the principal investigator of the study.

A panel of international and local experts are involved with the study that will recruit participants aged between 40 and 65 years, have mild illness and have been suffering for less than seven days.

Patients with allergies to study medicines, suffering from underlying heart, kidney and liver problems, and pregnant or lactating women will be excluded from the study.

One group of the participants will receive a single dose ivermectin along with five doses of doxycycline, while another group will receive ivermectin alone once a day for five days while the third group will receive a placebo for five days.

The test medicine and placebo will be packaged identically and neither the participants nor the study physicians will have the knowledge about who is receiving which particular treatment, the icddr,b said.

Doctors at Bangladesh Medical College, the first private medical institution in the country, said last month that they had applied the medicine on 60 COVID-19 patients.

At least 50 of them experienced reduced symptoms in 48 hours, the BMC doctors said. Also, 25 of them tested negative while others were yet to undergo tests, according to the doctors.  

After four days of using the cocktail of drugs, the COVID-19 test results returned negative for the patients, the BMC doctors said.

US Food and Drug Administration earlier approved ivermectin as a drug for parasitic infections. It has been in use since 1980. It is previously shown to have “broad-spectrum anti-viral activity in vitro”, according to the icddr,b.