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Covid-19: Ivermectin’s politicisation is a warning sign for doctors

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n747 (Published 01 April 2021) Cite this as: BMJ 2021;373:n747

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Re: Covid-19: Ivermectin’s politicisation is a warning sign for doctors turning to orphan treatments

Dear Editor,

Ivermectin is not the first, and won’t be the last medication that we prescribe off-label, when we believe, right or wrong, it will be beneficial to our patients. What is unusual, instead, is the worldwide opposition by health agencies to its use in COVID-19, in spite of 35 years of favorable pharmacovigilance records, and the many signals of efficacy (and dare say effectiveness) although not from formally perfect trials – see Bryant et al. preprint https://doi.org/10.31219/osf.io/k37ft .

While science cannot take shortcuts, medical practice has to bet its odds against time, risk of death or lasting disability, and unaffordable or unavailable cures. Today we are fighting a virus that in a mere year has killed almost 3 million humans, and chances are we will have to fight its lifelong sequelae in a much larger population for years to come; and in addition it is rapidly mutating. Given the low risk of adverse events and the yet to ascertain, but generally favorable outcomes of ivermectin prophylaxis and treatment in COVID-19, the most humane and ethical conduct, in my opinion, is to issue a temporary authorization to general practitioners for its use, collecting the relative data, and urgently fund and perform those missing well-designed clinical trials that WHO, EMA and FDA, among others, advocated for.

Competing interests: No competing interests

06 April 2021
Ernesto de Bernardis
Medical doctor
ASP Siracusa, Italy
Addiction medicine dept. “SerT Lentini”, via Macello 4, 96016 Lentini IT