TrialSite recently introduced Nigeria’s ‘Making Moves to Fund Ivermectin Research Targeting COVID-19 Ivermectin Program’ led by the group known as “IVERCOVID.” A team of researchers led by Lagos University Teaching Hospital investigated this potentially game changing low cost, generic drug targeting COVID-19. Nigeria has good reason to be interested—especially in places such as Lagos. One of the world’s most populous nations at 213 million, Lagos, at about 20 million in the wider metropolitan area, is the largest urban area in Africa. A highly compact mass of humanity, a contagion virus isn’t welcome here, a densely populated place where many don’t have the luxury of suburban space helpful for social distancing. As Bloomberg also reminds the world, Lagos represents the commercial hub of this largest economy in Africa. Why Ivermectin? Well, according to at least unpublished preliminary results from the IVERCOVID study, 50% of those taking Ivermectin were negative by day 5. Although these results are not peer-reviewed nor published, they cannot be considered medical evidence but they most certainly can be considered at least material data point of interest, given all of the other data points now accumulating in the Ivermectin story. Of paramount importance now are peer-review journal entries and rigorous patient registries capturing real world evidence.
Well as TrialSite has chronicled since the University of Monash findings in early April the FDA-approved broad spectrum antiparasitic agent actually evidences anti-viral impact targeting a broad range of viruses including SARS-CoV-2, the virus behind COVID-19. Meta-analyses of about three dozen studies now from groups on both sides of the Atlantic (United States and the UK) reveal that the drug can reduce mortality rates associated by COVID-19 by as much as 75%. Writing for Bloomberg, Ruth Olurounbi shares the recent aggregate analysis of Dr. Andrew Hill, affiliated with University of Liverpool and Unitaid. However he was inspired by the U.S.-based Front Line COVID-19 Critical Care Alliance (FLCCC) who started tracking TrialSite stories by the late summer. This group of doctors were intrigued by growing signals, originating from studies around the world that this drug actually may inhibit the SARS-CoV-2 virus.
Pragmatic African Making Moves
With some exceptions, this continent isn’t wealthy like North America, Europe or East Asia. There aren’t huge amounts of money lying around to waste on anything and the pharmaceutical sectors here aren’t quite as lucrative. The saying, ‘Necessity is the Mother of Innovation,’ may just ring true here.
Although a tumultuous start (brief moment where South African agents were raiding private Islamic hospital to find the drug subject of a Nobel Prize), in embracing the anti-parasitic drug used in many nations in the continent to fight parasites such as river blindness, countries such as South Africa and Zimbabwe have made a turnaround, now embracing the potential of the drug. Partly out of pragmatism as authorities witnessed growing problematic black markets that would lead to dangerous practices such as rampant self medication using the veterinary variety of the drug, now proactive research programs that may embrace research as care options will offer the drug to those ill in a more controlled and prescribed manner as part of what appears to be a sort of patient registry. A solid idea if this is in fact the direction they take.
For whatever reason, much of Nigeria (and the rest of Africa) avoided the great wrath of this pandemic during the first waves of the pathogen from Spring to Summer 2020. But something has changed. By late November cases started to spike everywhere. While nowhere near as bad as places like America, nonetheless the rise in cases scared many as the same luxury of practices like “social distancing” just isn’t possible in the slums of Lagos for example. As cases hit a 1,597 seven day average by Jan. 24, 2021, the tension became palpable here. The COVID-19 caseload was now more than double when the pandemic commenced. Now the cases appear to be declining again but authorities here aren’t sitting idle.
Now the city of Lagos reports a positivity rate of 24% with 9,586 active cases of the illness and Bloomberg’s Ms. Olurounbi reports the demand for oxygen intensifies from 70 cylinders per day to up to 400 per day as more and more Lagos residents become ill. Again, the overall death rates here in this young country are low (almost 2,000 deaths) but no one here wants to test their luck. Risk mitigation measures are top of mind now as Lagos can’t afford a contagion of the type that impacted New York, Los Angeles or London.
Now part of that action of not sitting idle is buying a product. And apparently as much of it as they can. Recently state Governor Babajide Sanwo-Olu tweeted, “While this medication has not yet been approved for the broad treatment of the coronavirus disease, the state government has however taken the bold step of ensuring we have adequate stocks.”
The IVERCOVID Study
Led by the Lagos University Teaching Hospital, this study (ISRCTN40302986) deals with the drug that has been in use in Africa for over three decades for the treatment of river blindness. Inspired by the University of Monash findings that the drug could reduce COVID-19 viral loads by a factor of 5000 in 48 hours, like many other developing nations to low to middle-income countries (LMICs), Nigeria sought out to test this hypothesis with tolerable human dosages. They sought to answer questions such as whether the drug can reduce death rates and illness duration and what were optimal doses. Could the drug be used as pre-Exposure prophylaxis (PrEP) for example? If this could be so, it could truly be a “game-changer in how sick people are treated, essentially with two to six tablets, or even in how populations are prevented from getting the disease.”
Led by Professor Olufemi Babalola, according to their posting, they are working on developing results that can be included in a peer-review journal such as the Nigerian Medical Journal, National Postgraduate medical journal or The Lancet.
In a recent MarketWatch press release entry, Nigerian Vice-President Yemi Osinbajo pledged federal backing for ongoing research for the team of Nigerian-based professors and scientists researching the drug. Apparently, the results thus far from Ivercovid have shown promise.
The Results Shared Thus Far Sound Promising
In this press release the group shared that “In its results so far, the study noted that the randomization was effective based on distribution of age, sex and some clinical presentation at baseline such as cough and fever.” The author of the press release shared that “Days-To-Negative” (DTN) was reduced by 3.8 days overall which could be considered comparable to the Remdesivir findings that that drug could reduce hospitalization by 4 days. Of note, at least some patients are actually negative by Day 2 and 50% by Day 5 reported the press release. These are compelling results assuming the study was designed appropriately—and TrialSite has no reason to believe anything to the contrary.
Call to Action: Industry watchers—track the IVERCOVID group in Nigeria.