Fact Check in India: ICMR Doesn’t Include Ivermectin in Treatment Guidelines: Contrary to Internet Claims

Sep 11, 2020 | COVID-19, ICMR, Ivermectin, News, Popular Posts, Uttar Pradesh

Fact Check in India ICMR Doesn’t Include Ivermectin in Treatment Guidelines Contrary to Internet Claims

The Indian government hasn’t included ivermectin in its treatment guidelines, although apparently there are claims on social media of the contrary. In fact, ICMR hasn’t recommended the use of the anti-parasite drug for the treatment of COVID-19. As TrialSite reported, in reality, a state government, Uttar Pradesh (UP), authorized the use of the drug off label following the lead of some hospitals in the region, and around the nation already using the drug off label to treat at least mild early onset COVID-19. On August 6, 2020, a UP government circular actually specified the dosage and use of ivermectin for purposes of both prevention and as a treatment of COVID-19.

India’s Factly reported on this important fact check exercise to ensure correct information circulates the internet. The claim associated the recent UP dosage and usage specifications with ICMR, the nation’s research agency, which is outright misleading. TrialSite has reported that ICMR had put forth an initiative to look into the use of ivermectin targeting COVID-19, but little has occurred since then, at least publicly and formally. That investigation was led by Nivedita Gupta, a senior scientist within the agency.

Influences on UP Decision

Undoubtedly, UP has followed the lead of hospitals across the region that have been using ivermectin off label as a treatment against COVID-19. As TrialSite has reported, numerous hospitals in UP and other regions in India have been using ivermectin since the summer. The world was first influenced by Monash University research, evidencing the potential of the anti-parasite drug in a cell culture in vitro experiment. Critics were quick to point out that proper research would require extensive clinical trials to verify that this drug could work safely and effectively in humans for this different indication. As TrialSite discovered in the Peru documentary, due to pandemic conditions physicians often at the community level sprung to action based on these early stage Australian findings. The rationale for “real world” usage came down to the fact that the drug was already approved by regulatory authorities around the world for use against parasites. In fact, the safety profile is well understood and thus doctors in various nations commenced on an effort to treat the disease while carefully observing the results in patients: a somewhat organic “real world” experiment unfolded in various low-to middle-income countries (LMICs) and even in the United States, as was evidenced by the Broward County off label, hospital protocol observational study

Since then, of course, significant information has accumulated, not to mention at least three completed formal studies and another 34 ongoing.

One of the studies cited by Indian media as influencing UP decision makers was one of the completed ivermectin-based studies reported on by TrialSite. The sponsors, including China’s Jiao Tong University; Upazila Health & Family Officer’s Office, Chakoria; and Cox’s Bazar in Bangladesh, were first prompted to investigate ivermectin, like all else around the world, due to the Monash University lab findings. As reported, this Bangladeshi and Chinese-based observational study team concluded that a combination of ivermectin and Doxycycline therapy in the case of mild to moderate degree COVID-19 was superior to Hydroxychloroquine and Azithromycin therapy. In fact, the data produced made it clear the ivermectin treatment was far superior.

COVID-19 & Misleading Information

TrialSite researchers encounter on a regular basis questionable to outright misleading claims. Researchers and those interested in progress toward treatments and vaccines must do their own homework and this involves the use of reputable sources, diligent analysis, and a critical mind. Generally, it’s a good practice to verify any material claims through multiple reputable sources based on the growing body of information associated to COVID-19. 

The information deception campaigns on the internet are, in some cases, so sophisticated that even the most seasoned of researchers can be tricked if but for a while. That deceiving misinformation can even be promulgated by seemingly reputable sources only to confuse an already perplexing situation. TrialSite’ reminds those interested in following biomedical research to use multiple reputable sources with differing points of view, and understand that with particular research initiatives, various “camps” can form with varying interpretations. Be critical.

Source: FACTLY

10 Comments

  1. Jim Rogers

    I am curious to know if you have found any negative results from the ivermectin treatment aside from insufficient testing.

    • MR PETER F BELL

      I too find it curious that all over the world we get “expert” advice that tried and true ivermectin hasn’t been tested enough…
      …. for heavens sake, ivermectin has accidentally save many people in eastern Peru and I think west or central Africa where it was already being used for dengue fever…(which is a VIRUS disease) … not a parasite drug

  2. MR PETER F BELL

    I think it’s very wrong to describe ivermectin as “an anti- parasite drug” when it also treats dengue fever,

    Dengue fever is a viral disease and ivermectin effectively controls the desease… not the mosquito that spreads it.

    In your haste to denounce ivermectin, you have shown your bias by not knowing what you are talkin’ ’bout…

    • TrialSite

      Dear Peter,
      See Medline definition: Anti-parasite
      https://medlineplus.gov/druginfo/meds/a607069.html
      Note even in academic studies below referred to as an antiparasitic agent.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835698/
      Yes it also has been shown to inhibit viruses including SARS-CoV-2.
      We are objective and a U.S. based venture and we are governed by the agencies of the United States–so we report on what the latest status in fact is…. What we describe are the facts. However, check out how many case series, observational studies and actual trials TrialSite has reported on.

      Not sure where you are coming from here when you claim we are denouncing ivermectin–frankly just the opposite. But TrialSite is a place for objectivity and facts..

      Regards,
      Publisher

    • Hoyt Nelson

      Hi, Mr. Bell,

      Ivermectin has shown activity against dengue in the test tube but a trial failed to show efficacy. To the best of my knowledge, ivermectin has never been demonstrated as an effective therapy against ANY virus — until covid-19, where it’s very effective IMO.

      You shouldn’t accuse TrialSiteNews of anti-ivermectin bias. TSN has done an *excellent* job of covering ivermectin, better than any other organization. Search the site for “ivermectin” and you’ll see *many* articles, IMO well-balanced and accurate.

      – Hoyt

  3. Hoyt Nelson

    > As reported, this Bangladeshi and Chinese-based observational study team concluded that a combination of ivermectin and Azithromycin therapy in the case of mild to moderate degree COVID-19 was superior to Hydroxychloroquine and Azithromycin therapy.

    You meant to write:

    > a combination of ivermectin and Doxycycline therapy

    This document from AIIMS on the MoHFW site:

    https://www.mohfw.gov.in/pdf/AIIMSeICUsFAQs01SEP.pdf

    says:

    > Can Ivermectin be used for COVID patients?

    > Ivermectin has been found to be a potent inhibitor of SARS CoV2 replication in vitro, but the doses required to achieve this effect in vivo far exceeds the usual dose. It is currently not recommended in the national guidelines but can be used in patients in whom HCQ is contraindicated.

    The PDF is on mohfs.in.gov. Going to that site, I read that it is the site of the Ministry of Health and Family Welfare, Government of India.

    This article:

    https://www.who.int/india/news/feature-stories/detail/how-india-scaled-up-its-laboratory-testing-capacity-for-covid19

    states:

    > Technology landscaping, leveraging resources and optimizing the processes to increase efficiency were the key approaches that the Indian Council of Medical Research (ICMR), Ministry of Health & Family Welfare (MoHFW), Government of India undertook to expand the scale of testing.

    That language seems to imply that ICMR is an agency within MoHFW.

    You state that ICMR doesn’t include ivermectin in its treatment guidelines. Is that more or less significant than the fact that MoHFW *does* include ivermectin in *its* guidelines — as appropriate for patients in whom HCQ is contraindicated.

    Confusing!

    The FDA does not approve the use of ivermectin for scabies, but the CDC recommends ivermectin for scabies treatment, while noting that the FDA doesn’t approve the drug for that purpose.

    Sometimes government agencies are not all of one mind.

    As I wrote the above, I had the vague theory that ICMR is the equivalent of the FDA, but apparently it’s more like the CDC?

    Wikipedia:

    https://en.wikipedia.org/wiki/Central_Drugs_Standard_Control_Organisation#:~:text=Within%20the%20CDSCO%2C%20the%20Drug,of%20Health%20and%20Family%20Welfare.

    says:

    > Within the CDSCO, the Drug Controller General of India (DCGI) regulates pharmaceutical and medical devices, under the gamut of Ministry of Health and Family Welfare.

    So MoHFW is the over-arching agency.

    Perhaps it is more significant that MoHFW permits use of ivermectin (under limited circumstances) that the fact that ICMR does not. This assumes that All India Institute of Medical Sciences speaks with MoHFW’s authority, since it’s on MoHFW’s site. That could be wrong.

    Confusing.

    Does any of this matter? Ivermectin is being used, e.g. in Uttar Pradesh as you mention.

    Let the bureaucrats argue over guidelines, and the doctors save lives with ivermectin.

    • TrialSite

      Thanks for the edit Hoyt.
      Also very much appreciate your detailed deep dive into this. We verify and you are correct. MoHFW is a parent agency over ICMR. ICMR however much like the NIH will establish its national guidelines.
      A great document you found. It is published by the medical school All India Institute of Medical Sciences (AIIMS). This is a separate entity however interestingly it declares this is the “National e-ICU on COVID-19 Management.”
      Further delving into this and apparently the e-ICUs are the result of a collaboration between AIIMS and the Ministry of Health. See link. https://www.business-standard.com/article/news-cm/india-covid-19-recovery-rate-crosses-75-120082400978_1.html

      So for now we stand by the statement that ICMR doesn’t have ivermectin on its guidelines (although we know they were looking into it) but per your findings there it would appear Ministry of Health and the leading public medical school have ivermectin as an alternative where HCQ contraindicated.

      What we have to do is call into AIIMS and find out how this all works from a governance perspective in India. But we certainly appreciate this fantastic research.

      We do know Ivermectin is prescribed in many hospitals in India–we have reported on numerous ones and that the drug was associated with acceleration of improvement to patients. Of course this is all anecdotal and we can’t claim this is evidence…

      We’ll call into the AIIMS and MOH this week and try to get to the bottom of this.

      Thanks Hoyt!

      Publisher

      • Hoyt Nelson

        Thanks for your typically-thorough response!

        – Hoyt

  4. Michael Green

    It’s the money nobody is going to get rich selling Ivermectin

  5. Ronak

    Ivermectin market has shown 50% growth over previous year as per August 2020 (MAt basis) over previous year in India

    this shows that people are taking any publication be it China or Bangladesh based study

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