icddr,b on Monday organised a dissemination seminar to share preliminary findings of a recently concluded study that evaluated the safety and efficacy of ivermectin in combination with antibiotic doxycycline or ivermectin alone for the treatment of confirmed mild cases of Covid-19 in a hospital setting in Dhaka.

The randomised, double-blind, placebo-controlled trial evaluated orally administered ivermectin alone (12mg once daily for 5 days), ivermectin single dose (12mg) in combination with doxycycline (200mg stat doxycycline on day 1 followed by 100mg 12 hourly for next 4 days) compared with placebo among 68 hospitalised patients with Covid-19 in Dhaka.

Patient distribution was 22, 23 and 23 in each group respectively. The participating hospitals were Mugda Medical College and Hospital; Kurmitola General Hospital, Dhaka, Bangladesh, and Dhaka Medical College & Hospital.

The study demonstrated that patients in the five-day ivermectin group were 77% more likely to have early viral clearance on day 14 compared to those who received ivermectin and doxycycline (61%) and placebo (39%).

It also showed that on day 3, eighteen percent (18%) of the patients in the group treated with ivermectin alone began to show viral clearance compared to ivermectin plus doxycycline (3%) and placebo (3%), while on day 7 it stood at 50%, 30% and 13% respectively.

The odds of improvement in clinical status with the 5-day treatment course of ivermectin versus ivermectin and doxycycline, and placebo were also favourable, trending toward reduction of severity of infection indicated by improvement in the blood biomarkers.

The C-reactive protein (CRP), Lactate Dehydrogenase (LDH) and Ferritin levels notably dropped from the baseline to day 7 in the ivermectin alone group compared to other two groups.

The antiparasitic drug is found to be safe and has shown, at best, a modest benefit for mild coronavirus. The study findings have been published in the International Journal of Infectious Diseases (IJID) on 2 December 2020.

Nazmul Hassan MP, Managing Director, Beximco Pharmaceuticals Limited graced the seminar as the chief guest while Professor Dr Syed Modasser Ali, former Advisor to the Prime Minister and Chairman, Bangladesh Medical Research Council (BMRC) as special guest and was connected via online; and Dr Tahmeed Ahmed, acting Executive Director and Senior Director, Nutrition and Clinical Services Division (NCSD) at icddr,b were present among others at the seminar.

Dr Wasif Ali Khan, Senior Physician Scientist of Enteric and Respiratory Diseases at icddr,b and the principal investigator of the study presented the study findings.

He said, “Although the study sample was small to derive at any solid conclusion, the results provide evidence of potential benefit of the early intervention with ivermectin for the treatment of adult patients diagnosed with mild Covid-19. The findings also conform to other global studies on ivermectin as a treatment for Covid-19.”

Nazmul Hassan, “We’re pleased to support the clinical trial of ivermectin, which is an attempt to find an effective and affordable treatment to fight against the Covid-19 pandemic. We’re happy that the treatment regimen shows promise and that will indeed strengthen our fight against Covid-19 and help avoid many untimely deaths.”

Dr Tahmeed Ahmed has expressed his gratitude to Beximco Pharmaceuticals Ltd. DGHS, DGDA, BMRC and participating hospitals for supporting the study.

“It’s extremely important to find an affordable and easy-to-use treatment option to fight against this pandemic in low- and middle-income countries like Bangladesh. We believe a larger clinical trial with ivermectin may help facilitate decision makers to include it in the Covid-19 treatment protocol and we’re exploring for support,” he said.

National public health experts, representatives from the DGHS, DGDA, BMRC, icddr,b, BPL and media were also present at the seminar.

The study, conducted during July-September 2020, was funded by Beximco Pharmaceuticals Ltd, and the company also provided all the drugs used in this trial.

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