In clinical use since 1981 as an oral and topical medicine for a range of parasitic infection, ivermectin is on WHO’s List of Essential Medications. Anecdotally, the standard dose of 9mg used once has been correlated with some instances of “rapid clinical resolution in severe hospitalized COVID-19 [cases].” Clinical studies are underway; while ivermectin is shown to inhibit SARS-CoV-2 in vitro, but this seems to require a far higher dose than the “standard.” And this casts “doubt on the utility of this agent as an antiviral drug in COVID-19 unless very markedly higher doses are used.” This latest ivermectin update is based on an editorial/literature review in Open Heart, an open-access journal, which is “an official journal of the British Cardiovascular Society.” The piece notes that viral-replication blocking would be less useful in late-COVID-19 with cytokine storms. Yet anecdotes point to success at this later stage. So, research should consider the idea that “ivermectin is acting as an anti-inflammatory in these cases.” This motivated the editorial search for “literature on ivermectin for anti-inflammatory actions.”
Prior Research Suggests Effectiveness
Zhang et al looked at ivermectin in mice in 2008. They began by challenging mice with fatal doses of the pro-inflammatory intraperitoneal lipopolysaccharide (LPS). Then they showed that ivermectin administered two hours before the LPS. The scientists showed a 50% reduction in mortality with a 4mg/kg dose. In vitro studies have also shown the medicine to block cytokine production. Extrapolation from mice to humans calculates an effective dose of 36 mg. One year later another study ivermectin was found to suppress, “activation both of NF-kappaB and the stress-activated MAP kinases JNK and p38.6” Two other reports show the drug, “exerts anti-inflammatory effects in murine models of allergic inflammation.” While conceivable that the anti-inflammatory properties of ivermectin are limited “to LPS or toll-like receptor 4 (TLR4) signaling,” it may also work downstream on, “other proinflammatory signaling pathways.”
The authors argue that it is reasonable to think that, at doses near or slightly above standard dosing, ivermectin, “may have important clinical potential for managing disorders associated with life-threatening respiratory distress and cytokine storm—such as advanced COVID-19. Ivermectin may have been ‘flying under the radar’ in this regard during four decades of clinical use.” Rajter et al reported showed a significantly lower death rate for 173 patients given ivermectin versus the 107 who were not. Gorial et al looked at mean hospital stay time in patients who did and did not get ivermectin. The first group had average hospital stays of 7.62 days versus 13.22 days for the second group. Two persons died in the control group; none died in the ivermectin group. Notably, “these apparent therapeutic benefits were seen in hospitalized patients, in whom antiviral measures are suspected to be less effective than anti-inflammatory measures targeting cytokine storm.”
Call to Action: Follow the link to the literature review in Open Heart.