NHS doctors should not give ivermectin to Covid-infected Britons because it makes ‘no difference’ to their condition and it may cause serious side effects, the health service’s medicines watchdog has ruled.
In new guidance issued today, the National Institute for Health and Care Excellence (NICE) said the divisive treatment should not be used in hospitalised or mildly ill patients, unless they are participating in a clinical trial.
A review of 18 trials by NICE showed the dewormer drug — which can cost as little as £1.50 per treatment — had no significant effect on Covid hospitalisation or deaths.
But ivermectin was found to cause serious side effects in some cases that resulted in patients having to be taken off their medication. NICE lists chest discomfort, weakness, and difficulty breathing as common side effects.
Ivermectin is already used in around 20 countries — including Greece, Bulgaria and Slovakia — to treat Covid after yielding promising antiviral results in lab studies.
It became the poster-child drug of choice among anti-vax conspiracy theorists over the summer, particularly in the US, who claimed it offered a way out of the pandemic without the need for jabs.
But it is only licensed in the UK as a treatment for parasitic worms, head lice, scabies and rosacea. Covid patients can still obtain it through private healthcare in ’emergency’ circumstances.
The EU and US’ drugs watchdogs have also advised against using it for Covid, but private doctors are still prescribing it.
NICE admits most of the studies on ivermectin so far have been flawed and inconclusive.
Oxford University scientists are currently giving the drug to a group of volunteers as part of the PRINCIPLE trial, a randomised control study which aims to finally answer questions about the benefit of the drug.
Ivermectin can cost as little as £1.50 per treatment and is licensed in the UK to treat parasitic worms, head lice, scabies and rosacea
The National Institute for Health and Care Excellence (NICE) examined evidence from seven trials involving Covid-infected people who started taking the treatment while at home. The trials reported that people taking ivermectin were less likely to be hospitalised compared to those who did not take the drug (centre graphic). However, among both groups, nine people per 1,000 per died within 28 days of testing positive for the virus (left graphic). Additionally, three times as many people had to stop having ivermectin compared to those who needed a change to their standard care due to a side effect (right graphic). NICE said it had ‘very low’ confidence in all of the data from the trials
NICE looked at 11 trials that gave ivermectin to hospitalised Covid patients. The trials found people who took the drug were less likely to die within 28 days compared to those who received standard care (left graphic). People taking the drug were also slightly less likely to be admitted to ICU (centre graphic) or require ventilation (right graphic). However, NICE said its confidence in the data across the trials is ‘low’ or ‘very low’, because they were inconsistent, imprecise, or had a high risk of bias
NICE examined evidence from seven trials, none of which took place in the UK, involving Covid-infected people who started taking ivermectin while at home.
The number of participants in each study ranged from 24 to 501, with one group in each taking the drug, while the other took a placebo drug or received standard care.
What is ivermectin and can it REALLY treat Covid?
What is Ivermectin?
Ivermectin is an anti-parasitic drug developed during the 1970s.
What is it used for?
Today the medication is prescribed for treating scabies, head lice and rosacea.
The National Institute for Health and Care Excellence (NICE), the UK health watchdog, recommends it should also be given for round worm infections.
Can it REALLY treat Covid-19?
The jury is out on whether it can provide a ‘miracle cure’ for Covid.
Analysis of 18 trials by NICE found none of the evidence so far provides sufficient evidence that the drug can help in the fight against Covid.
It said ivermectin should only be offered to patients in the UK if they are involved in a clinical trial.
The ongoing PRINCIPLE trial is offering the drug to thousands of Britons in an attempt to identify at-home Covid treatments.
The trials reported that people taking ivermectin were less likely to be hospitalised — between 51 and 55 per 1,000, depending on the dose they received — compared to those who did not take the drug (78 per 1,000).
But NICE said the data is not strong enough to show any statistically significant benefit from taking the drug.
The trials also show that among both groups, nine people per 1,000 per died within 28 days of testing positive for the virus.
And slightly more people who took ivermectin required mechanical ventilation (16 per 1,000) compared to those who did not (12 per 1,000).
Again, these were not found to be statistically significant.
Additionally, three times as many people had to stop having ivermectin (33 per 1,000) compared to those who needed a change to their standard care due to a side effect (11 per 1,000).
NICE said the number of patients having to stop taking ivermectin due to adverse reaction ‘was significantly higher’ compared to patients receiving normal care or a placebo drug.
The watchdog also said the drug could potentially cause ‘rare serious adverse events’, but studies have so far been too small to pick up on these.
NICE lists chest discomfort, weakness, and difficulty breathing as side effects from the drug, as well as seizures and brain damage in very rare and extreme cases.
The medicines regulator also looked at 11 trials that gave ivermectin to hospitalised Covid patients in countries outside the UK. Each study included between 31 and 180 volunteers.
These trials found people who took the drug were less likely to die within 28 days (36 per 1,000) compared to those who received standard care (87 per 1,000).
People taking the drug were also slightly less likely to be admitted to ICU or require ventilation and cleared the virus quicker, according to the studies.
But NICE said it has ‘concerns with the results’, because the ‘certainty of the evidence is very low’.
And the Covid patients hospitalised in countries where the trials took place had less severe Covid than required to be admitted to hospital in the UK, so the data cannot be applied to the UK patients.
The watchdog concluded that trials so far show ivermectin provides no statistically significant benefits, so it cannot be recommended for any age group to take at home or in hospitals.
But it noted that ongoing trials, such as PRINCIPLE, could improve available evidence on the drug.
NICE said its confidence in the data across all the studies is ‘low’ or ‘very low’, because the trials were inconsistent, imprecise, or had a high risk of bias. So there is a ‘high degree of uncertainty’ about whether the drug has any effect in managing Covid, the watchdog said.