"I think it has become another hydroxychloroquine."
The words are from Carlos Chaccour, researcher at the Institute for Global Health in Barcelona.
In the summer of 2021, will ivermectin be what the molecule advocated by Didier Raoult was a year ago?
If the comparison is limited, this drug is in turn in the spotlight as a fourth wave of Covid-19 threatens to overwhelm France.
Two camps are opposed.
On the one hand, those who praise its supposed effectiveness in combating SARS-CoV-2.
On the other hand, researchers and scientists are almost unanimous in saying that there is a lack of data and that it is impossible to establish whether ivermectin has an effect.
A debate revived by the publication on Tuesday of a study by the Institut Pasteur carried out on hamsters.
We take stock.
What is ivermectin?
It is, at the base, a drug of the range of anthelmintics and which is useful, in particular, to treat certain gastrointestinal infections and the scabies, indicates Vidal.
The American laboratory Merck has been marketing it since the 1970s under the name Stromectol.
Like hydroxychloroquine, “it's a cheap molecule that we know well,” says immuno-oncology researcher Eric Billy.
Why do some defend its use in the face of Covid-19?
They believe that this drug would limit the risk of symptoms, especially severe symptoms in the event of infection with SARS-CoV-2.
A hypothesis, moreover, shared by many scientists at the very beginning of the pandemic, in particular because "some of the properties of ivermectin make it possible to slow down the replication of several viruses, including that of the flu", underlines Carlos Chaccour.
Today, the “pro” ivermectin are based on several studies.
In April 2020, a team of Australian researchers from Royal Melbourne Hospital and Morash University concluded that the molecule would destroy SARS-CoV-2 in cell cultures.
Except that the quantities needed were such that they would be potentially toxic to humans.
On Tuesday, several personalities also shared the results of a study by the Institut Pasteur suggesting that "ivermectin alleviates the symptoms of Covid-19 in an animal model".
"We have known it for months, it is enough to document oneself, but forbidden to speak about it", exclaimed the sovereignist Florian Philippot.
The leader of Debout France, Nicolas Dupont-Aignan, for his part denounced a "vaccine obsession [which] diverts our leaders from common sense".
Gosh: the Pasteur Institute publishes a study showing a positive effect of #ivermectin against covid!
We have known for months, it is enough to document oneself, but forbidden to speak about it!
Are we finally interested or we continue with the #PassDeLaHonte ?! https: //t.co/Sm28yEFuGO
- Florian Philippot (@f_philippot) July 13, 2021
Except that this work was carried out on hamsters.
However, "we see that there is an effect on the symptoms and this makes it possible to generate hypotheses for clinical research on humans, but we never extrapolate a study of a drug on animals", emphasizes epidemiologist Thibault Fiolet.
The first author of this study, Guilherme Dias de Melo, does not say anything else.
“Our study provides preclinical data that scientifically demonstrates a protective action of ivermectin during SARS-CoV-2 infection in an animal model.
These data are essential to support clinical trials in humans, ”says the researcher on the Institut Pasteur website.
Read alsoIvermectin, an effective drug against Covid?
Like an air of déjà vu ...
Another very often cited study, pre-published in November, concluded that the risk of severe form was reduced when taking ivermectin.
Except that it was withdrawn from the site, this Wednesday, July 14, because of "ethical concerns".
The raw data did not correspond to the scientific protocol described, summarizes the Guardian.
More anecdotal, "we had someone in the study who died on June 31," describes Thibault Fiolet.
So much so that some are talking about a new scandal "Surgisphere 2.0", named after the company that participated in the study full of errors on hydroxychloroquine.
What do we really know about its effectiveness in humans?
Let's say it straight away: there is nothing to certify that ivermectin produces effects against Covid-19 in humans. Which does not mean that it is ineffective. Several clinical studies have been carried out, but they are all marred by "methodological limits" writes the Director General of the National Agency for the Safety of Medicines (ANSM) in a letter of March 31, 2021 sent to lawyer Fabrice Di Vizio. He had filed, on behalf of health professionals, a request for a temporary recommendation for the use (RTU) of ivermectin to fight Covid-19.
"Many studies were carried out on very small numbers, in others the severity of the symptoms was not sufficiently well described, etc.", describes Thibault Fiolet.
"On its site, the French Society of Pharmacology and Therapeutics also indicates that at present," no data allows to recommend the use of ivermectin to prevent or treat an infection with SARS-CoV-2 " .
“There is not enough evidence to say that it is effective, nor that it is not.
We are still in a no man's land ”, sums up Carlos Chaccour.
What do clinical trials say about #ivermectin?
Nothing very conclusive in humans (including for mild cases)
This is why its use is not recommended https://t.co/aluOe9a3NR pic.twitter.com/iM68pLR7Z2
- Thibault Fiolet 🇪🇺 (@T_Fiolet) July 15, 2021
Last March, the ANSM promoted the establishment of “clinical trials with a robust methodology”.
Several studies have been launched, in particular by the University of Minnesota (United States) and that of Mcmaster (Canada).
But the final results are not expected for several weeks at best.
Without delay, several countries, especially in South America, nevertheless authorized its use at certain times, ignoring the recommendations of the World Health Organization (WHO),