Role of Ivermectin and Hydroxychloroquine in COVID 19

1. COVID 19

2. Agenda
• Role of Ivermectin in COVID 19
• Role of Hydroxycholoroquine in COVID 19
2

3. The trial will compare treatment options – of Remdesivir, Lopinavir Ritonavir, Interferon-beta-1a,
Chloroquine, and Hydroxychloroquine – against standard of care to assess their effectiveness against
Covid-19, theWHO says.
3

4. Ivermectin in COVID 19
4

5. The FDA-approved Drug Ivermectin inhibits the
replication of SARS-1 CoV-2 in vitro.
• Ivermectin has an established safety profile for human use and is FDA approved for
a number of parasitic infections.
• Importantly, recent reviews and meta analysis indicate that high dose Ivermectin
has comparable safety as the standard low-dose treatment, although there is not
enough evidence to make conclusions about the safety profile in pregnancy.
• As noted, Ivermectin was the focus of a recent phase III clinical trial in dengue
patients inThailand, in which a single daily dose was found to be safe but did
not produce any clinical benefit. Although DENV is clearly very different to SARS-
CoV-2
, Leon Caly; et al, The FDA-approved Drug Ivermectin inhibits the replication of SARS-1 CoV-2 in vitro Antiviral Research Available online 3 April 2020, 104787
5

6. 6

7. COVID-19 Drug Research: Ivermectin Might Emerge
As One OfThe Most Suitable Drug Candidates For
COVID-19• In the vitro study, the medical researchers infected cells with SARS-CoV-2, then exposed
them to Ivermectin. "We showed that a single dose of Ivermectin could kill COVID-19 in a
petri dish within 48 hours, indicating potent antiviral activity," says study co-author
Dr David Jans.
• Dr Jans said, "The main way Ivermectin works is to target a key molecule of our cells
that helps the virus to proliferate. By stopping this, the virus replicates more slowly,
and so our immune system has a better chance to mount the antiviral response and kill
the virus. Giving this or any antiviral drug early is thought to give the body the best
chance of beating infection.” and Dr Jans added that the drug is "safe at relatively high
doses”.
• In past studies, the researchers say, the drug has been shown to work against dengue
fever and to limit infections similar to COVID-19, such as the West Nile virus.
7

8. Ivermectin
• Thailand Medical News has come across reports that say the drug can be
neurotoxic at doses above 35mg.
• “This vitro study certainly piqued our interest,” says Dr Jill Weatherhead, MD, an
assistant professor at Baylor College of Medicine in Houston. Her clinic uses the
medicine to treat intestinal parasites found in international travelers or
immigrants.
8

9. Robin E Ferner, Chloroquine and hydroxychloroquine in covid-19,, BMJ 2020;369:m1432 doi: 10.1136/bmj.m1432 (Published 8 April 2020)
9

10. Hydroxychloroquine and azithromycin as a treatment
of COVID-19: results of an open label non-randomized
clinical trial
• Hydroxychloroquine (an analogue of chloroquine) has been demonstrated to have
an anti- SARS-CoV activity in vitro. Hydroxychloroquine clinical safety profile is
better than that of chloroquine (during long-term use) and allows higher daily
dose and has fewer concerns about drug-drug interactions.
• Our team has a very comprehensive experience in successfully treating patients
with chronic diseases due to intracellular bacteria (Q fever due to Coxiella burnetii
andWhipple’s disease due to Tropheryma whipplei) with long-term
hydroxychloroquine treatment (600 mg/day for 12 to 18 months) since more than
20 years.
Philippe Gautret; et al , Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial,, Int J microbial agents, 2020 Mar 20 : 10594910

11. Hydroxychloroquine and azithromycin as a treatment
of COVID-19: results of an open label non-randomized
clinical trial
• Results:-
• Six patients were asymptomatic, 22 had upper respiratory tract infection
symptoms and eight had lower respiratory tract infection symptoms.
• Twenty cases were treated in this study and showed a significant reduction
of the viral carriage at D6-post inclusion compared to controls, and much
lower average carrying duration than reported of untreated patients in the
literature. Azithromycin added to hydroxychloroquine was significantly
more efficient for virus elimination
Philippe Gautret; et al , Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial,, Int J microbial agents, 2020 Mar 20 : 105949
11

12. Hydroxychloroquine and azithromycin as a treatment
of COVID-19: results of an open label non-randomized
clinical trial
• Conclusion:-
• Despite its small sample size our survey shows that hydroxychloroquine
treatment is significantly associated with viral load reduction/disappearance
in COVID-19 patients and its effect is reinforced by azithromycin
Philippe Gautret; et al , Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial,, Int J microbial agents, 2020 Mar 20 : 105949
12

13. 13

14. 14

15. •Thank you