Ivermectin as a potential drug for treatment of COVID-19: an in-sync review with clinical and computational attributes

Abstract

Introduction COVID-19 cases are on surge; however, there is no efficient treatment or vaccine that can be used for its management. Numerous clinical trials are being reviewed for use of different drugs, biologics, and vaccines in COVID-19. A much empirical approach will be to repurpose existing drugs for which pharmacokinetic and safety data are available, because this will facilitate the process of drug development. The article discusses the evidence available for the use of Ivermectin, an anti-parasitic drug with antiviral properties, in COVID-19. Methods A rational review of the drugs was carried out utilizing their clinically significant attributes. A more thorough understanding was met by virtual embodiment of the drug structure and realizable viral targets using artificial intelligence (AI)-based and molecular dynamics (MD)-simulation-based study. Conclusion Certain studies have highlighted the significance of ivermectin in COVID-19; however, it requires evidences from more Randomised Controlled Trials (RCTs) and dose-response studies to support its use. In silico-based analysis of ivermectin's molecular interaction specificity using AI and classical mechanics simulation-based methods indicates positive interaction of ivermectin with viral protein targets, which is leading for SARS-CoV 2 N-protein NTD (nucleocapsid protein N-terminal domain).

Efficacy and safety of dihydroorotate dehydrogenase (DHODH) inhibitors “leflunomide” and “teriflunomide” in Covid-19: A narrative review

“… Kaur et al, 2021 ; Li et al, ; Sarma et al, ; Wang et al, .…”

COVID-19 recovery measures and use of medications among COVID-19 patients at home: A cross- sectional study in Bangladesh

“…The respondents also utilized antiparasitic drugs, mainly ivermectin. Clinical trials conducted in different countries including Bangladesh showed that ivermectin without and with the combination of other drugs can improve symptoms and reduce mortality, though more evidence is needed on its e cacy [40,41]. One study found that a signi cant number of Bangladeshi populations used ivermectin to relieve COVID-19 symptoms and prophylaxis [42].…”

Repurposing Ivermectin for COVID-19: Molecular Aspects and Therapeutic Possibilities

“…Its low toxicity and safety are attributed to the fact that its human target receptors are 'secluded' in the CNS, and IVM has not been shown to cross the blood-brain barrier. In addition, IVM displays a 100-fold greater affinity for parasitic Clchannels compared to the human homologs (35). Moreover, severe detrimental effects in humans were shown only in those who over-dosed using approximately 15.4 mg/kg body weight IVM, which is 77 times above the prescribed dose.…”

“…There are currently around 50 clinical trials taking place registered on clinicaltrials.gov, which study the effect of IVM as a prophylactic or therapeutic drug (35). Five studies have completed testing at Phase 1, 2 or 3 and three have posted their real-time results, which are included in Table 1.…”