All around social media, ivermectin is talked about as a possible cure for COVID-19 symptoms – but, is it? When celebrities like Joe Rogan advocate for treating COVID with ivermectin on their massive platforms, they may be doing more harm than good. Even some healthcare providers will prescribe ivermectin to their patients. The information (or misinformation) about the effectiveness of ivermectin for treating the coronavirus has spread across the internet, making patients wonder, “Who can I trust?”

What is Ivermectin?

Ivermectin is a medication that is currently FDA-approved and indicated for the treatment of intestinal strongyloidiasis and onchocerciasis -conditions caused by parasitic worms. Some topical forms of ivermectin are approved for the treatment of external parasites such as head lice.

What Are the Guidelines for Treating COVID-19 in the United States?

The current United States guidelines for the treatment of COVID-19 in hospitalized patients include the use of the antiviral Remdesivir or immunomodulatory drugs such as tocilizumab or baricitinib because of clinical trials that were performed.

What Clinical Trials Have Been Done On the Effectiveness of Ivermectin in Treating COVID-19?

There are more than 25 completed clinical trials evaluating the efficacy of ivermectin in the treatment of COVID-19 and there are many still recruiting. While many of these clinical trials are randomized trials, due to ethical circumstances, clinical researchers cannot make these studies placebo-controlled. Many of these studies compare ivermectin to the standard of care which is not yet standardized for this novel viral infection. In fact:

• One study completed in Iraq compared oral ivermectin to a standard of care of acetaminophen, vitamin C, zinc, vitamin D3, Azithromycin, Dexamethasone, and Oxygen therapy.
• Another study completed in Bangladesh compared ivermectin to acetaminophen, vitamin D, oxygen, LMWH, and dexamethasone without any antiviral or antibiotic therapy.
• There currently are no completed clinical trials evaluating the efficacy of ivermectin in COVID-19 patients in the United States.

Many of these trials were conducted overseas, a majority in Egypt. However, within some of these studies that have been completed, not many relevant results can be found. This means there is no evidence proving ivermectin as an effective treatment for COVID-19.

What Contributed to the Popularity of Ivermectin?

The widespread misinformation about the efficacy of ivermectin has flooded the United States. The origin comes from a clinical trial from December 2020 done in Egypt that showed the drug had more than 90 percent efficacy against COVID-19 infection. This trial, however, was not peer-reviewed. Looking closely into the data from the trial, patients who had died before the trial had been included in the data to favor the use of ivermectin. These discoveries led to the removal of the study and its results from its original publishing resource.

Why Do Some Healthcare Professionals Prescribe Ivermectin to Treat COVID-19?

Since the release of trials similar to that done in Egypt, some physicians have been prescribing antiparasitic medication for patients with COVID-19 infection. The medication does have an FDA-approved indication that does not require any REMS program to prescribe. Even against the advice of the National Institutes of Health, the Infectious Diseases Society of America, and the FDA, some prescribers still continue to give patients this medication. In fact, some physicians claim they have seen positive results in patients who have taken ivermectin for their COVID-19 infection, or have heard anecdotal information from other physicians about its benefits. With no strong clinical trial data to support its use, there is a concern that physicians are straying from evidence-based medicine due to the strains of the pandemic.

What Can Medical Affairs Professionals and Medical Science Liaisons Do to Stop Misinformation From Spreading?

There is a significant role to play as resources who can provide accurate information. Medical affairs professionals and MSLs should be the most trusted to clearly communicate to healthcare providers because of their significant scientific background, industry experience, and access to the latest data. An important role of medical affairs professionals is taking the scientific data from clinical trials, and evaluating and disseminating this information to healthcare professionals so they can stay updated with new information. In the setting of a novel viral infection like the COVID-19 pandemic, staying up to date is crucial to the wellbeing of these patients as new treatment guidelines will be made and changed very frequently as more is learned about the infection.

Healthcare providers may already feel bombarded with all the new information that comes out as the hospitals were overwhelmed with new patients. It’s important for medical affairs professionals to be able to educate them on accurate and relevant information. To combat the misinformation, medical affairs professionals must show healthcare providers the clinical data that’s lacking in the use of ivermectin in COVID-19 infection. It’s also important to educate these providers about the dangers they are potentially exposing their patients. As providers, they represent the medical community and by spreading this misinformation, their word is trusted by those who do not understand clinical data or do not have access to that information. 

References: Office of the Commissioner. “Why You Should Not Use Ivermectin to Treat or Prevent COVID-19.” U.S. Food and Drug Administration, FDA, https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19. Bhimraj, Adarsh, et al. “Covid-19 Guideline, Part 1: Treatment and Management.” Infectious Disease Society of America, 14 Mar. 2022, https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/#toc-17. “Information on Covid-19 Treatment, Prevention and Research.” National Institutes of Health, U.S. Department of Health and Human Services, https://www.covid19treatmentguidelines.nih.gov/. ClinicalTrials.gov, https://clinicaltrials.gov/ct2/search/index. Lexicomp Online, http://online.lexi.com.