Ivermectin: what is it?
Developed in collaboration with Merck & Co. and the Kitasato Institute in Japan, ivermectin is an anti-parasitic medication. On each side, Satoshi Omura and William Campbell oversaw the project. Ivermectin swiftly rose to prominence in the veterinary industry as a result of its broad spectrum of action against both internal and exterior parasites, which enhanced animal health and increased output.
In the 1970s, the globe was fighting river blindness, or onchocerciasis, a disease that devastated entire communities in rural areas and was brought on by the parasite Onchocerca volvulus. Who had already found some success as a result of the World Bank’s involvement? Upon the release of ivermectin, however, it was seen that the agent responsible for onchocerciasis in horses, Onchocerca cervicalis, essentially vanished in regions where the novel medication was administered.
Due to this, ivermectin testing in humans was expedited and approved by French regulatory bodies in the early 1980s. This was followed by Merck & Co.’s historic decision to give as much ivermectin as needed for the duration required to eliminate river blindness. As a result, the Mectizan donation program was established. Over the course of the previous 30 years, this program has distributed over 3 billion treatments and has saved many lives. Later, lymphatic filariasis—another crippling illness brought on by filarial worms—was added to the program.
For their finding, Omura and Campbell were granted the 2015 Nobel Prize in physiology or medicine, a distinction they shared with Tu Youyou, the Chinese researcher who discovered.
What is the purpose of ivermectin in humans?
Here, we list a few of the global uses that have been authorized.
- Ivermectin is marketed in the United States for the following indications at doses of up to 200 mcg/kg once a year:
- The intestinal parasite Strongyloides stercoralis, which can lead to serious systemic illness.
- Blindness by river or onchocerciasis
- Ivermectin is also sold as a single dose of up to 400 mcg/kg in Europe to treat scabies and lymphatic filariasis.
- In Australia, treating severe crusted scabies with three or more 200 mcg/kg doses over the course of a month is advised.
Exist any more viable or established uses?
Ivermectin 6 mg exhibits partial efficacy against several common intestinal parasites in humans, including Ascaris lumbricoides and Trichuris trichura, despite not being approved for these reasons.
In addition to numerous other internal or external parasites, it is occasionally used off-label against ectoparasites such as head lice and Tunga penetrans.
One exciting area of research in which ISGlobal scientists are actively engaged is the population-level application of ivermectin to eradicate malaria-transmitting mosquitoes that feed on treated humans or animals.
Ivermectin safety: is it safe?
Ivermectin is a very safe medication at the currently allowed levels when used for the existing indications. With a stellar safety record, almost three billion treatments have been given out in the framework of the Mectizan Donation Program alone to far. The majority of side effects are modest, transient, and more often related to parasite death than to the medication itself.
Glutamate-gated chloride channels, which are unique to invertebrates, are the target of ivermectin. Only the GABA-gated chlorine channels, which have the potential to cross-react with ivermectin, are expressed by mammals. Nevertheless, the blood-brain barrier, a network of pumps that keeps potentially harmful substances outside of our neurological system, protects these, which are solely expressed in the central nervous system. That being said, Rebecca Chandler reported on 28 individuals outside of onchocerciasis endemic areas that experienced significant neurological adverse responses following ivermectin treatment.
If a patient has a high load (>30.000 mg/ml) of the Loa loa parasite, ivermectin treatment may cause fatal side effects, including severe encephalopathy. This has stopped ivermectin from being administered in a number of nations in central Africa where drug use may be permitted by the existing test-and-treat approach.
Ivermectin use in children under the weight of 15 kg is not well-supported by research. Ivermectin use during pregnancy is not supported by any evidence.
People using ivermectin at doses of 800 mcg/kg or more in earlier studies have occasionally reported momentary vision problems, though Guzzo did not mention this.