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.