LETTERS: Recently there have been viral news as regard the Ivermectin use as prophylaxis and treatment for Covid-19, supported by anti-vaccine groups.
And a police report has been made against the Health Ministry regarding this. Apart from the mitigation measures and vaccination programme, we should be focusing on treatment finding.
So, we follow the narrative and conduct the clinical trial on this locally while there are actually a few researches that have already been done abroad and published like Roman 2021, Bryant 2021 and Hill 2021.
However, one research (Elgazzar) in the group of researches analysed (meta analysis) in the Hill 2021 and the Bryant 2021, was withdrawn from the previous publication due to plagiarism and false data collection.
In the Hill 2021 review, before the fraud data was discovered, it noted initially that Ivermectin is concluded as 56 per cent successful to reduce the rate of mortality with favourable clinical recovery and reduced hospitalisation, the withdrawal of Elgazzar study affected the outcome massively.
The question is why should we put too much effort on this when we already know the defects and the non-favourable outcome of Ivermectin in another meta analysis like Roman 2021?
Roman 2021 has concluded that Ivermectin did not reduce all-cause of mortality, length of hospital stay and viral clearance in ten randomised control trials involving 1,173 patients.
Meanwhile, we have a few promising studies on treatment of Covid-19 that I would like to share and personally urge the Health Ministry and the local university hospitals to gather a team and join the studies.
The first one is the AT 527 trial which is now in the global phase three clinical trials (Morningsky trial) which will be announced soon.
In the global phase two interim analysis (Moonsong), the study on AT 527 in hospitalised patients with mild to moderate Covid-19, it is indicated that the AT 527 rapidly reduced the viral load levels, in which at Day 2, patients receiving AT 527 experienced 80 per cent greater mean reduction from the baseline viral load as compared to placebo and a sustained viral load reduction maintained through day 8.
Such a potent antiviral activity may lead to faster recovery time for patients with Covid-19 while minimising the transmission of infection and it is an oral medication which may offer a convenient treatment. It is worth trying and granted for local clinical research than the Ivermectin.
There are also studies on antiviral and antibody cocktail in treatment of Covid-19 infection like the REGEN-COV (casirivimab and imdevimab) which resulted in reduced hospitalisation or death by 70 per cent in non-hospitalised Covid-19 patients.
The National Institute of Health, United Kingdom in June 2021 announced a combination of antiviral monoclonal antibody cocktail can help save lives in hospitalised patients with severe Covid-19 who were unable to generate an antibody response (seronegative) of their own before beginning of treatment. It involved 9,785 hospitalised patients with Covid-19 where one third was found as the seronegative patients.
The antibody combination significantly reduced the primary outcome of 28-day mortality by one-fifth compared with usual care alone (24 per cent of patients in the antibody combination group died vs 30 per cent of patients in the usual care group). These results mean that for every 100 such patients treated with this treatment, six lives would be saved. And there are many more clinical trials ongoing which are promising.
I believe that we should be objective and clear with the direction in the type of clinical trial chosen in the treatment part and with what medication. The Health Ministry and the Higher Education Ministry should engage more and direct the researchers to a clear vision with the correct timing, enough funding and other appropriate measures.
Dr Mohd Syihabuddin Mohd
Kuala Lumpur
The views expressed in this article are the author's own and do not necessarily reflect those of the New Straits Times