Why HCQ and Ivermectin were removed from India’s Covid-19 treatment protocol

The Indian Council of Medical Research (ICMR) and the National Task Force on Covid-19 have dropped the use of Ivermectin and Hydroxychloroquine (HCQ) drugs from their revised guidelines for the treatment of the infection.

The decision was taken after experts found that these drugs have little to no effect on Covid-related mortality or clinical recovery of the patient.

“HCQ may be considered for removal from guideline, with recommendation to use with caution only in clinical trial setting (since there is some genuine uncertainty regarding the possible benefit for severe cases and in low dose),” said the document titled ‘considerations for exclusion of Ivermectin and Hydroxychloroquine from the clinical guidance for management of adult Covid-19 patients’.

Several clinical studies have shown the low mortality benefit for HCQ, said the document. In fact, when HCQ is administered with azithromycin, it increases the risk of adverse drug effect (ADE) in patients, experts said.

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Studies also found there was no clarity on mortality benefit, no effect on length of hospital stay and recovery in case of Ivermectin.

Recommending that Ivermectin be dropped from the clinical guidance, experts cited 13 systematic reviews of which “7/13 showed mortality benefit, 4/13 no mortality benefit, 2/13 inconclusive/unclear.”

Additionally, there was a high risk of bias in many of the studies, particularly with the ones showing mortality benefit, as the level of certainty is low in them.

The recommendations were made at a meeting of the All India Institute of Medical Sciences (AIIMS) and the ICMR national task force for Covid-19 and the Joint Monitoring Group on August 20.

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Meanwhile, cautioning that the upcoming festival season is a critical period, AIIMS-Delhi Director Dr Randeep Guleria said the next 6-8 weeks are going to be critical and the community has to come together to ensure people follow all Covid norms and aggressively encourage vaccination.

While the number of new Covid-19 cases are steadily declining across the country, the Union Health Ministry has advised states and UTs to keep a strict vigil as the country is still in the midst of the second surge of the pandemic.

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