8 ms·

Anti-parasitic drug, Ivermectin, eliminates SARS-CoV-2 in cell cultures in lab

50 points by origgm 6y ago

toomanybeersies 6y ago
To paraphrase XKCD [1], a handgun also eliminates SARS-CoV-2 in cells. [1] https://xkcd.com/1217/ https://xkcd.com/1217/
- missedthecue 6y ago
  And in people as well
uxp100 6y ago
This one of those effective outside the human body tests that have a long way to go. We shall see. But I mainly commented to say that it worked well on my scabies years ago. Good for keeping your guinea pigs parasite free too.
- verganileonardo 6y ago
  Yes. Title should better reflect the current stage of the drug (pre-trial).
bulletsvshumans 6y ago
Ivermectin is approved by the FDA, but not (yet?) for treating COVID-19, and not at the doses shown to stop the virus in experimental conditions. The dose shown to be effective against COVID-19 is much much higher than the dosage approved by the FDA for other purposes.
- honksillet 6y ago
  What is the dose needed to treated to COVID. I'm assuming it would have to be continued for at least 5 days and dosed multiple times daily. Normally ivermectin is dosed as a single dose 0.2mg/kg (so 14mg for an average 70kg person) for treating, say scabies.
  - bulletsvshumans 6y ago
    This episode [0] of "This Week In Virology" describes in detail the pharmacokinetics of Ivermectin and the issues with this study. [0] https://www.microbe.tv/twiv/twiv-599/ https://www.microbe.tv/twiv/twiv-599/
- honksillet 6y ago
  I would be surprised if the dose would have to be "much, much" higher. When treating lice or scabies you need to give patient so much that a significant amount is eliminate through the skin. Enough to kill complex multicellular organisms. If I recall, the primary method of elimination of ivermectin is via the liver in the stool (and not via the skin). I wouldn't expect a dose of Ivermectin used to fight COVID to be higher than the dose used to fight, say, scabies. However it would make sense that you would have to take multiple doses over a much longer time to maintain a steady state in the blood stream.
  - deleted 6y ago
    [deleted]
- readhn 6y ago
  from the paper: "..no toxicity was observed with ivermectin at any of the concentrations tested.... Ivermectin has an established safety profile for human use and is FDA approved for a number of parasitic infections1, Importantly, recent reviews and meta analysis indicate that high dose ivermectin has comparable safety as the standard low-dose treatment, although there is not enough evidence to make conclusions about the safety profile in pregnancy. The critical next step in further evaluation for possible benefit in COVID patients will be to examine a multiple addition dosing regimen that mimics the current approved usage of ivermectin in humans. As noted, ivermectin was the focus of a recent phase III clinical trial in dengue patients in Thailand, in which a single daily dose was found to be safe but did not produce any clinical benefit. However, the investigators noted that an improved dosing regimen might be developed, based on pharmacokinetic data. Although DENV is clearly very different to SARS-CoV-2, this trial design should inform future work going forward. Altogether the current report, combined with a known-safety profile, demonstrates that ivermectin is worthy of further consideration as a possible SARS-CoV-2 antiviral. "
  - giardini 6y ago
    Years ago a friend invited me to help him brand his cattle. We rounded 'em up and sent each through a chute where we applied a dose of ivermectin to their back. The procedure was: measure, pour directly on their back and then spread it around with bare hands. We did this for an indeterminate number of cattle. He seemed unconcerned that _we_ were getting quite a dose through our skin too. This friend has lived a remarkably healthy life - he was over 70, never got sick, and could toss hay bales with the best of them. Seeing how Ivermectin is applied, I'm fairly certain there wasn't (and isn't) a single parasite in his body, in his clothes, his pickup truck or his mobile home.
wyxuan 6y ago
In vitro things usually work out pretty well, but as soon as you hit human trials it becomes really difficult. Hydroxochloroquine worked well against covid in vitro (had a lower toxicity than remdesivir) but turned out that it could be fatal with certain diabetes drugs and actually increased ventilator time needed.
- Mountain_Skies 6y ago
  Given the age of hydroxochloroquine, how was it not previously known that it had negative interactions with diabetes drugs?
- honksillet 6y ago
  Source? HCQ has been used for a long time. It is a medication that is usually ordered for chronic conditions. So people might be expected to be on HCQ for YEARS. (Unlike COVID were they could be on the same doses for just days.) It has a well documented side effect profile and drug interact profile known well before COVID came onto the scene.
  - smt88 6y ago
    > It has a well documented side effect profile and drug interact profile known well before COVID came onto the scene. You could have said the same about using aspirin to treat the flu, which we now know can be very dangerous[1]. Drugs also "interact" with diseases, leading to different (side) effects in patients with that disease than without it. 1. https://www.mayoclinic.org/diseases-conditions/reyes-syndrome/symptoms-causes/syc-20377255 https://www.mayoclinic.org/diseases-conditions/reyes-syndrom...
  - wyxuan 6y ago
    Et voila: https://www.biorxiv.org/content/10.1101/2020.03.31.018556v1.full.pdf https://www.biorxiv.org/content/10.1101/2020.03.31.018556v1.... Also here's a source on the ventilator time: https://www.dropbox.com/s/8b2govfsa6n0xbq/NEJM_Clinical%20Outcomes%20of%20Hydroxychlorquine%20in%20Patients%20with%20COVID19.pdf.pdf.pdf.pdf?dl=0 https://www.dropbox.com/s/8b2govfsa6n0xbq/NEJM_Clinical%20Ou...
johnmyleswhite 6y ago
This headline is somewhat misleading; just changing to the wording of "cell cultures" instead of "cells" would make the stage that this work is in more clear.
- cwojno 6y ago
  It's absolutely misleading and dangerous.
  - floatingatoll 6y ago
    Emailing the mods with the footer Contact link will help them realize and correct that.
  - smt88 6y ago
    This is true in the sense that all misleading medical information about over-the-counter drugs is dangerous. It's also true because we already know of at least one person who died self-dosing with an unproven Covid-19 "cure".
  - amluto 6y ago
    Hypochlorous acid (bleach) destroys SARS-CoV-2 in cell culture, too. So do ethanol and soap.
    - yk 6y ago
      A revolver destroys the virus in-vivo. (At least vivo at the beginning of the study.)
      - amluto 6y ago
        That xkcd comic confuses me. Does a revolver really kill pathogens or does it just scatter them? A flamethrower, on the other hand...
        deleted 6y ago
        [deleted]
Someone1234 6y ago
So does bleach. Neither one is a proven treatment for COVID-19 in vivo though. Almost all in vitro (i.e. in a Petri dish) results are of limited value. A lot of things kill viruses in vitro, including air and water, but aren't actually treatments inside people. Until they do at minimum a phase 1 trial (to show basic safety) and have even draft results showing efficacy, I'd hold off on assuming this is relevant to the discussion /at all/.
unsrsly 6y ago
Previously: https://news.ycombinator.com/item?id=22782980 https://news.ycombinator.com/item?id=22782980
mam2 6y ago
I'm pretty sure "heavy fire" can kill cell cultures in lab too.

50 points by origgm 6y ago

To paraphrase XKCD [1], a handgun also eliminates SARS-CoV-2 in cells. [1] https://xkcd.com/1217/ https://xkcd.com/1217/

missedthecue 6y ago
And in people as well

uxp100 6y ago

This one of those effective outside the human body tests that have a long way to go. We shall see. But I mainly commented to say that it worked well on my scabies years ago. Good for keeping your guinea pigs parasite free too.

verganileonardo 6y ago
Yes. Title should better reflect the current stage of the drug (pre-trial).

bulletsvshumans 6y ago

Ivermectin is approved by the FDA, but not (yet?) for treating COVID-19, and not at the doses shown to stop the virus in experimental conditions. The dose shown to be effective against COVID-19 is much much higher than the dosage approved by the FDA for other purposes.

honksillet 6y ago
What is the dose needed to treated to COVID. I'm assuming it would have to be continued for at least 5 days and dosed multiple times daily. Normally ivermectin is dosed as a single dose 0.2mg/kg (so 14mg for an average 70kg person) for treating, say scabies.
- bulletsvshumans 6y ago
  This episode [0] of "This Week In Virology" describes in detail the pharmacokinetics of Ivermectin and the issues with this study. [0] https://www.microbe.tv/twiv/twiv-599/ https://www.microbe.tv/twiv/twiv-599/
honksillet 6y ago
I would be surprised if the dose would have to be "much, much" higher. When treating lice or scabies you need to give patient so much that a significant amount is eliminate through the skin. Enough to kill complex multicellular organisms. If I recall, the primary method of elimination of ivermectin is via the liver in the stool (and not via the skin). I wouldn't expect a dose of Ivermectin used to fight COVID to be higher than the dose used to fight, say, scabies. However it would make sense that you would have to take multiple doses over a much longer time to maintain a steady state in the blood stream.
- deleted 6y ago
  [deleted]
readhn 6y ago
from the paper: "..no toxicity was observed with ivermectin at any of the concentrations tested.... Ivermectin has an established safety profile for human use and is FDA approved for a number of parasitic infections1, Importantly, recent reviews and meta analysis indicate that high dose ivermectin has comparable safety as the standard low-dose treatment, although there is not enough evidence to make conclusions about the safety profile in pregnancy. The critical next step in further evaluation for possible benefit in COVID patients will be to examine a multiple addition dosing regimen that mimics the current approved usage of ivermectin in humans. As noted, ivermectin was the focus of a recent phase III clinical trial in dengue patients in Thailand, in which a single daily dose was found to be safe but did not produce any clinical benefit. However, the investigators noted that an improved dosing regimen might be developed, based on pharmacokinetic data. Although DENV is clearly very different to SARS-CoV-2, this trial design should inform future work going forward. Altogether the current report, combined with a known-safety profile, demonstrates that ivermectin is worthy of further consideration as a possible SARS-CoV-2 antiviral. "
- giardini 6y ago
  Years ago a friend invited me to help him brand his cattle. We rounded 'em up and sent each through a chute where we applied a dose of ivermectin to their back. The procedure was: measure, pour directly on their back and then spread it around with bare hands. We did this for an indeterminate number of cattle. He seemed unconcerned that _we_ were getting quite a dose through our skin too. This friend has lived a remarkably healthy life - he was over 70, never got sick, and could toss hay bales with the best of them. Seeing how Ivermectin is applied, I'm fairly certain there wasn't (and isn't) a single parasite in his body, in his clothes, his pickup truck or his mobile home.

wyxuan 6y ago

In vitro things usually work out pretty well, but as soon as you hit human trials it becomes really difficult. Hydroxochloroquine worked well against covid in vitro (had a lower toxicity than remdesivir) but turned out that it could be fatal with certain diabetes drugs and actually increased ventilator time needed.

Mountain_Skies 6y ago
Given the age of hydroxochloroquine, how was it not previously known that it had negative interactions with diabetes drugs?
honksillet 6y ago
Source? HCQ has been used for a long time. It is a medication that is usually ordered for chronic conditions. So people might be expected to be on HCQ for YEARS. (Unlike COVID were they could be on the same doses for just days.) It has a well documented side effect profile and drug interact profile known well before COVID came onto the scene.
- smt88 6y ago
  > It has a well documented side effect profile and drug interact profile known well before COVID came onto the scene. You could have said the same about using aspirin to treat the flu, which we now know can be very dangerous[1]. Drugs also "interact" with diseases, leading to different (side) effects in patients with that disease than without it. 1. https://www.mayoclinic.org/diseases-conditions/reyes-syndrome/symptoms-causes/syc-20377255 https://www.mayoclinic.org/diseases-conditions/reyes-syndrom...
- wyxuan 6y ago
  Et voila: https://www.biorxiv.org/content/10.1101/2020.03.31.018556v1.full.pdf https://www.biorxiv.org/content/10.1101/2020.03.31.018556v1.... Also here's a source on the ventilator time: https://www.dropbox.com/s/8b2govfsa6n0xbq/NEJM_Clinical%20Outcomes%20of%20Hydroxychlorquine%20in%20Patients%20with%20COVID19.pdf.pdf.pdf.pdf?dl=0 https://www.dropbox.com/s/8b2govfsa6n0xbq/NEJM_Clinical%20Ou...

johnmyleswhite 6y ago

This headline is somewhat misleading; just changing to the wording of "cell cultures" instead of "cells" would make the stage that this work is in more clear.

cwojno 6y ago
It's absolutely misleading and dangerous.
- floatingatoll 6y ago
  Emailing the mods with the footer Contact link will help them realize and correct that.
- smt88 6y ago
  This is true in the sense that all misleading medical information about over-the-counter drugs is dangerous. It's also true because we already know of at least one person who died self-dosing with an unproven Covid-19 "cure".
- amluto 6y ago
  Hypochlorous acid (bleach) destroys SARS-CoV-2 in cell culture, too. So do ethanol and soap.
  - yk 6y ago
    A revolver destroys the virus in-vivo. (At least vivo at the beginning of the study.)
    - amluto 6y ago
      That xkcd comic confuses me. Does a revolver really kill pathogens or does it just scatter them? A flamethrower, on the other hand...
      - deleted 6y ago
        [deleted]

Someone1234 6y ago

So does bleach. Neither one is a proven treatment for COVID-19 in vivo though. Almost all in vitro (i.e. in a Petri dish) results are of limited value. A lot of things kill viruses in vitro, including air and water, but aren't actually treatments inside people. Until they do at minimum a phase 1 trial (to show basic safety) and have even draft results showing efficacy, I'd hold off on assuming this is relevant to the discussion /at all/.

unsrsly 6y ago

Previously: https://news.ycombinator.com/item?id=22782980 https://news.ycombinator.com/item?id=22782980

mam2 6y ago

I'm pretty sure "heavy fire" can kill cell cultures in lab too.