Ex-health minister backs results of Ivermectin study

(FMT) – Former health minister Dzulkefly Ahmad has welcomed the results of a health ministry study on Ivermectin, which found that the controversial drug sold in the black market does not reduce the risk of severe illness among Category 4 and 5 Covid-19 patients.

Stating that the I-tech study was conducted under the principle of “evidence-based medicine” and based on data collected through randomised clinical trials conducted by the ministry, Dzulkefly added that it “corroborated well and is in sync with other (international) findings”.

“Definitive hypothesis testing trials like TOGETHER (an Ivermectin trial in three countries) and the I-tech study are crucial in deciding whether a treatment modality will be included in national or international treatment guidelines,” he told FMT.

“Not poorly conducted, underpowered hypothesis-generating trials which have created confusion to some practitioners and the public alike.”

Dzulkefly, the health minister under the previous Pakatan Harapan administration, also dismissed claims by a doctor, whose clinic was raided by authorities for supplying Ivermectin to his patients, that the ministry’s study could not make any conclusions on its efficacy for prevention and early treatment.

In a statement to FMT last night, Dr Amir Farid Isahak said the study only focused on hospitalised patients and that it cannot make any conclusions on the efficacy of Ivermectin as prevention and early treatment for Category 1 and mild Category 2 Covid-19 cases.

He also said the study did not change “our perspective” about Ivermectin for prophylaxis and early treatment.

Commenting on Amir’s stance, Dzulkefly said studies were designed and undertaken for a specific research question with a specific primary hypothesis, calling it the “basics of a clinical trial”.

“The I-tech study is designed for a specific research question,” he said.

“If, at all, you find a positive finding in a secondary objective or hypothesis, you must undertake another trial with a specific primary objective and hypothesis.”

Health director-general Dr Noor Hisham Abdullah said yesterday that based on the results of the study, the ministry did not recommend that Ivermectin be included in existing Covid-19 treatment guidelines as it did not reduce the risk of severe illness from Covid-19.

He also reminded medical practitioners not to recommend or sell Ivermectin for treatment of Covid-19 “until there is more solid scientific evidence”.

The study involved 500 Covid-19 patients above the age of 50 who have at least one comorbidity and had been admitted to hospital after either being diagnosed as Category 2 (symptomatic without pneumonia) or Category 3 (symptomatic with pneumonia).

It was designed to find out whether administering Ivermectin on such patients within the first week of Covid-19 symptoms would prevent them from deteriorating to Category 4 (with pneumonia requiring oxygen therapy) and Category 5 (critical and requiring assisted ventilation).

A total of 17.3% of the group who received standard care progressed to Category 4 and 5 while the figure was 21.2% for the group which received Ivermectin.

Those in the standard care group progressed to Category 4 and 5 in 2.9 days while those in the group which received Ivermectin progressed to Category 4 and 5 after three days.

Meanwhile, three times more adverse events – mostly diarrhoea – were reported in the Ivermectin group versus the standard care group.

Weighing in on the results of the test, Malaysian Pharmacists Society president Amrahi Buang said the findings “finally show” that Ivermectin was not recommended for treatment of Covid-19.

He said the findings were consistent with that of similar trials in Brazil and Argentina and called on the “pro Ivermectin group” to accept them.

“If they want to do a different study, they are most welcome and must follow proper protocol,” he said.

“We hope the public stops using Ivermectin immediately.”

Mostly used in veterinary medicine in Malaysia, there have been numerous debates about Ivermectin’s use to treat Covid-19 in humans. In July, a number of opposition MPs pushed the government to look into the matter.

Ivermectin was one of the hottest topics on Twitter last night, with former health deputy director-general Dr Christopher Lee among those congratulating physicians and others involved in the trials, which were held across government hospitals and the low-risk quarantine and treatment centre at the Malaysia Agro Exposition Park Serdang.

“Well-designed and robust clinical research must always drive our clinical practice,” he said.

Among the more vocal critics of Ivermectin’s use included Hospital Putrajaya’s consultant physician and nephrologist Dr Rafidah Abdullah, who in August painted a clear picture of the dangers of using the drug to prevent or treat Covid-19.

“I’m always seeing complications from Ivermectin. I’ve given up,” she said in a tweet.

“A patient who recovered from Covid-19 also wanted to take Ivermectin, and now (the patient’s) liver functions have become problematic. Yellow – jaundice.”

She was more succinct when retweeting a health ministry infographic detailing the results of the I-tech study yesterday.

“RIP Ivermectin.”