Karnataka government buys 10 lakh tablets of drug most docs say is useless

The Karnataka unit of the National Health Mission last week prescribed Ivermectin, Zinc and Vitamin C for patients awaiting the results of RT-PCR tests and showing symptoms of Covid.

Going a step ahead, the state government has procured ten lakh Ivermectin tablets for distribution to home-isolated patients.

The medical fraternity is divided over the efficacy of the anti-parasitic drug for Covid, which has no definitive treatment. Ivermectin is used for deworming parasites in humans.

The Food and Drug Administration of the US says the drug has no properties to prevent or treat Covid-19. The World Health Organisation (WHO) has also warned against its use.

But doctors who are part of Karnataka's therapeutic committee, which drafts the state Covid-19 treatment protocol, say there isn't sufficient evidence for the efficacy of Ivermectin, but since it is not dangerous either, it can be used by home-isolated patients.

'A useless drug'

Dr Pradeep Rangappa, Senior Consultant, Critical Care, Columbia Asia Referral Hospital, Yeshwantpur, and a member of the State Critical Care Support Unit, said that in his opinion, it's a useless drug given the lack of robust evidence and well-conducted clinical trials. "I'm not sure why it’s being recommended. Guidelines cannot be issued based on a poorly conducted study with very few patients. I wouldn’t recommend it for prophylaxis (prevention) or treatment.”

However, Dr S Sachhidanand, Vice-Chancellor of Rajiv Gandhi University of Health Sciences, who heads the therapeutic committee, said that a study involving 372 participants conducted by the All India Institute of Medical Sciences, Bhubaneswar, had shown the drug was effective in reducing Covid infection in healthcare workers. He also quoted an in vitro study done in Australia that had proven the drug to be effective.

Rangappa differs: "The study was first published in the journal Antiviral Research on April 3 last year. In vitro means the study was done in cell lines. While researchers found significant reduction in coronavirus in the cells in 48 hours, in vitro science need not translate in vivo, in clinical science.”

Studies that are in vivo are those in which the effects of various biological entities are tested on whole, living organisms or cells, usually animals, including humans, and plants, as opposed to a tissue extract or dead organism.

Senior pulmonologist Dr K S Satish, who is also a member of the state Covid expert committee and is the president of the Karnataka Pulmonologists’ Association, said: "No senior pulmonologist would recommend this drug as there is not enough data to support its use. It is not part of the standard care for Covid-19 in the US, the UK or Australia.”

'AIIMS study poorly done'

Pulmonologist Dr Ravindra Mehta, who is a member of the BBMP expert committee on Covid-19, said authorities were recommending Ivermectin just because of the AIIMS study, which had been "very poorly done".

"Our colleagues from the US ask why India is relying on this drug and we have no answer. We can’t just keep giving drugs because patients are desperate. We have had this virus for more than a year now. There is no excuse to use experimental drugs that have no effect anymore," he said.