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What the experts say about Tocilizumab, REGEN-COV, Ivermectin & Vitamin D therapy
Several medications as well as Vitamin D have come to the forefront for reported use in the battle against COVID-19.
The Sunday Times asked several experts to give the right message based on scientific evidence on these medications and Vitamin D.
Before dealing with the different medications and therapies, the President of the Sri Lanka Association of Clinical Pharmacology and Therapeutics, Prof. Asita de Silva reiterated that up to now there is no treatment for COVID-19, a viral infection.
“Strong public health measures and vaccination are the way,” he said.
Tocilizumab
Tocilizumab (an immunosuppressive drug used for the treatment of rheumatoid arthritis) has a place in the treatment of COVID-19 patients who are in hospital and are under medical supervision, said Prof. de Silva.
Stressing that there should be a strong emphasis on prevention, other experts said that Tocilizumab is effective but very expensive and the economic cost of treating thousands of patients with this drug would be substantial.
Regeneron (REGEN-COV)
With regard to REGEN-COV, the monoclonal antibody cocktail (casirivimab and imdevimab) developed by America’s Regeneron Pharmaceuticals, Prof. de Silva said that it has a place in the treatment of COVID-19. However, America’s Food and Drug Administration (FDA) has licensed it for use in specific patients.
To be administered together as an intravenous infusion, it has been approved for use by the FDA in the treatment of mild to moderate COVID-19 in adults and paediatric patients (12 years of age or older weighing at least 40 kilograms) with positive results of direct SARS-CoV-2 viral testing and who are at high risk of progressing to severe COVID-19.
Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses.
The World Health Organization (WHO), meanwhile, has said that REGEN-COV2, is an early-stage intervention, anti-viral therapeutic, aimed at stopping the spread of the virus in the lung and respiratory tract by interfering with viral entry, trafficking or replication.
Some experts in Sri Lanka raised the issue of cost with regard to Regeneron like with Tocilizumab.
Ivermectin
With regard to Ivermectin – a medication for the treatment of parasite infestations – Prof. de Silva said that it is a definite “no, no” in the treatment of COVID-19 at present.
While the WHO has been very specific that Ivermectin should not be used unless in a strict clinical trial setting, the Australian Therapeutic Goods Administration has strongly instructed the public that it is not recommended for self-medication in any way.
An expert said that there is no scientific evidence for its use in COVID-19 treatment protocols. “The scientific evidence for the use of Ivermectin is very weak. The WHO has advised against its use unless it is as part of a registered clinical trial,” he said.
A clinician added that there had been a few clinical trials elsewhere in the world using Ivermectin and some of the clinical trials that appear to show the benefit of Ivermectin have subsequently been retracted.
Vitamin D therapy
Prof. de Silva said that there is a body of evidence which seemingly suggests a benefit, while another expert said that it may have some benefit in general because some people do have a Vitamin D deficiency.
“But it should not be relied upon to prevent COVID-19 or treat it.
Once again, the ‘best cure’ for COVID-19 is prevention,” the expert added.