Ivermectin during the COVID-19 pandemic

Ivermectin is an antiparasitic drug that is well established for use in animals and people.^[1] The World Health Organization (WHO),^[2] the European Medicines Agency (EMA),^[3] the United States Food and Drug Administration (FDA),^[4] and the Infectious Diseases Society of America (IDSA)^[5] all advise against using ivermectin in an attempt to treat or prevent COVID-19.

Early in the COVID-19 pandemic, laboratory research suggested ivermectin might have a role in preventing or treating COVID-19.^[6] Online misinformation campaigns and advocacy boosted the drug's profile among the public. While scientists and physicians largely remained skeptical, some nations adopted ivermectin as part of their pandemic-control efforts. Some people, desperate to use ivermectin without a prescription, took veterinary preparations, which led to shortages of supplies of ivermectin for animal treatment. The FDA responded to this situation by saying "You are not a horse" in a Tweet to draw attention to the issue, which they were later sued for.^[7]^[8]

Subsequent research failed to confirm the utility of ivermectin for COVID-19,^[9]^[10] and in 2021 it emerged that many of the studies demonstrating benefit were faulty, misleading, or fraudulent.^[11]^[12] Nevertheless, misinformation about ivermectin continued to be propagated on social media and the drug remained a cause célèbre for anti-vaccinationists and conspiracy theorists.^[13]

^ Tafoya QJ (2021). "Appendix – COVID-19-Directed Medications". In Ramadan AR, Gamaleldin O (eds.). Neurological Care and the COVID-19 Pandemic (1st ed.). Elsevier. pp. 173–174. doi:10.1016/B978-0-323-82691-4.00016-9. ISBN 978-0-323-82691-4. S2CID 239763031. The WHO, the European Medicines Agency, and the IDSA all recommend against the use of ivermectin for treatment of COVID-19, with the NIH stating that there is insufficient data to recommend for or against its use outside the context of a clinical trial. (subscription required)
^ "WHO advises that ivermectin only be used to treat COVID-19 within clinical trials". Newsroom. World Health Organization. Geneva, Switzerland. 31 March 2021. Retrieved 12 May 2023.
^ "EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials". News. European Medicines Agency. Amsterdam. 22 March 2021. Retrieved 12 May 2023.
^ "Why You Should Not Use Ivermectin to Treat or Prevent COVID-19". United States Food and Drug Administration. Consumer Updates. Silver Spring, Maryland: Food and Drug Administration. 10 December 2021. Retrieved 12 May 2023.
^ "IDSA Guidelines on the Treatment and Management of Patients with COVID-19: Recommendations 23-24: Ivermectin". Infectious Diseases Society of America. IDSA Practice Guidelines. Arlington, Virginia. 11 April 2023. Retrieved 12 May 2023.
^ Cite error: The named reference Caly2020 was invoked but never defined (see the help page).
^ Cite error: The named reference shortage was invoked but never defined (see the help page).
^ Cite error: The named reference langford was invoked but never defined (see the help page).
^ Cite error: The named reference coch2022 was invoked but never defined (see the help page).
^ Reis G, Silva EA, Silva DC, Thabane L, Milagres AC, et al. (May 2022). "Effect of Early Treatment with Ivermectin among Patients with Covid-19". N Engl J Med (Randomized controlled trial). 386 (18): 1721–1731. doi:10.1056/NEJMoa2115869. PMC 9006771. PMID 35353979.
^ Lawrence JM, Meyerowitz-Katz G, Heathers JA, Brown NJ, Sheldrick KA (November 2021). "The lesson of ivermectin: meta-analyses based on summary data alone are inherently unreliable". Nature Medicine. 27 (11): 1853–1854. doi:10.1038/s41591-021-01535-y. PMID 34552263. S2CID 237607620.
^ "Ivermectin: How false science created a Covid 'miracle' drug". BBC News. 6 October 2021. Archived from the original on 8 January 2022. Retrieved 26 December 2021.
^ Melissa Davey (15 July 2021). "Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns". The Guardian. Archived from the original on 16 January 2022. Retrieved 12 May 2023.

[Ramadan2021-1] Tafoya QJ (2021). "Appendix – COVID-19-Directed Medications". In Ramadan AR, Gamaleldin O (eds.). Neurological Care and the COVID-19 Pandemic (1st ed.). Elsevier. pp. 173–174. doi:10.1016/B978-0-323-82691-4.00016-9. ISBN 978-0-323-82691-4. S2CID 239763031. The WHO, the European Medicines Agency, and the IDSA all recommend against the use of ivermectin for treatment of COVID-19, with the NIH stating that there is insufficient data to recommend for or against its use outside the context of a clinical trial. (subscription required)

[WHO2021-2] "WHO advises that ivermectin only be used to treat COVID-19 within clinical trials". Newsroom. World Health Organization. Geneva, Switzerland. 31 March 2021. Retrieved 12 May 2023.

[EMA2021-3] "EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials". News. European Medicines Agency. Amsterdam. 22 March 2021. Retrieved 12 May 2023.

[USFDA2021-4] "Why You Should Not Use Ivermectin to Treat or Prevent COVID-19". United States Food and Drug Administration. Consumer Updates. Silver Spring, Maryland: Food and Drug Administration. 10 December 2021. Retrieved 12 May 2023.

[IDSA2023-5] "IDSA Guidelines on the Treatment and Management of Patients with COVID-19: Recommendations 23-24: Ivermectin". Infectious Diseases Society of America. IDSA Practice Guidelines. Arlington, Virginia. 11 April 2023. Retrieved 12 May 2023.

[Caly2020-6] Cite error: The named reference Caly2020 was invoked but never defined (see the help page).

[shortage-7] Cite error: The named reference shortage was invoked but never defined (see the help page).

[langford-8] Cite error: The named reference langford was invoked but never defined (see the help page).

[coch2022-9] Cite error: The named reference coch2022 was invoked but never defined (see the help page).

[10] Reis G, Silva EA, Silva DC, Thabane L, Milagres AC, et al. (May 2022). "Effect of Early Treatment with Ivermectin among Patients with Covid-19". N Engl J Med (Randomized controlled trial). 386 (18): 1721–1731. doi:10.1056/NEJMoa2115869. PMC 9006771. PMID 35353979.

[11] Lawrence JM, Meyerowitz-Katz G, Heathers JA, Brown NJ, Sheldrick KA (November 2021). "The lesson of ivermectin: meta-analyses based on summary data alone are inherently unreliable". Nature Medicine. 27 (11): 1853–1854. doi:10.1038/s41591-021-01535-y. PMID 34552263. S2CID 237607620.

[12] "Ivermectin: How false science created a Covid 'miracle' drug". BBC News. 6 October 2021. Archived from the original on 8 January 2022. Retrieved 26 December 2021.

[Guardian2021-13] Melissa Davey (15 July 2021). "Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns". The Guardian. Archived from the original on 16 January 2022. Retrieved 12 May 2023.

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