TrumpLyftAlles | 3 points | Jul 07 2020 00:48:08

Bulgarian medicine shows good results in treatment of Covid-19 patients (Bulgaria, 2020-07-06)

https://www.bnr.bg/en/post/101305664/bulgarian-medicine-shows-good-results-in-treatment-of-covid-19-patients

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[-] TrumpLyftAlles | 1 points | Jul 07 2020 00:48:29

First ivermectin news from Bulgaria?!

Misleading title: no results are reported.

IVERTODO: Is there a formal trial underway?

The anti-parasitic drug Ivermectin may be effective in the treatment of patients with coronavirus. As early as May, a trial of the drug began in Bulgaria, as the team is entirely Bulgarian and 30 patients have already been recruited in 9 hospitals.

The study in Bulgaria began after information from Australian scientists in April and clinical studies on patients in Spain, Brazil and the United States. The director of the Bulgarian Drug Agency, Bogdan Kirilov, said that the drug has been used for decades against various infections and therefore the drug itself has a known safety profile.

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[-] TrumpLyftAlles | 1 points | Jul 07 2020 00:55:56

Another story featuring the same guy. It's a real trial! Is it registered anywhere?

Preliminary results in July (maybe)!

Bulgarian Team Close to Finding a Treatment for COVID-19 (2020-07-06)

#A Bulgarian team is close to finding a cure for the coronavirus. This was announced at a briefing at the Ministry of Health Bogdan Kirilov, director of the Executive Agency for Medicines.

"In May, a clinical trial with the drug Ivermectin was launched in Bulgaria. The team is Bulgarian, and so is the manufacturing company. So far, 30 patients have been recruited for it. The clinical trial is being conducted in 9 hospitals in Bulgaria," Kirilov said.

"Bulgaria was the first country in the EU to launch such a clinical trial, followed by Spain, Brazil and the United States.

We hope to have primary results by the end of the month."

Kirilov added that the desire of medical specialists is to add more hospitals and patients.

More information about the drug will be presented in late July or early August.

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[-] unhurriedman | 2 points | Jul 07 2020 02:06:31

30 patients? Why these studies have so low "n"

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[-] TrumpLyftAlles | 2 points | Jul 07 2020 02:35:17

Unfortunately (from the trial viewpoint) there aren't enough covid19 patients around some places. There was an article in the last couple weeks about how a trial in Spain is stuck because they can't get enough sick subjects. Bulgaria only had 174 new cases yesterday. Spain had 414.

Houston would be a great place for trial right now!

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[-] unhurriedman | 2 points | Jul 07 2020 03:03:39

Here in Brazil too!

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[-] TrumpLyftAlles | 1 points | Jul 07 2020 03:45:40

Oh man, Brazil: good luck!

Are you taking ivermectin?

Did you see this video by someone in Brazil claiming that ivermectin prevents catching the virus? (I wrote up notes, if you don't want to watch the video.) What do you think? Is his opinion widespread? He says that all the MDs in his town are taking ivermectin to protect against the virus. Does that sound right to you

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[-] unhurriedman | 3 points | Jul 07 2020 06:15:38

Yes, I am taking the 200ugm/kg dose every 15 days, preventively. If I contact someone with a positive covid test I will certainly take it for four consecutive days, as some doctors here advise. It may not protect me, but I believe it won't hurt me. Here in Brazil, Ivermectin has been discussed a lot in the last days. The problem is that it has become a political debate, where defending the use means supporting the president, and not supporting the use means being against the president. This has impoverished discussions.

Yes, many doctors are using it. But there are many different protocols.

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[-] TrumpLyftAlles | 2 points | Jul 07 2020 06:59:34

where defending the use means supporting the president, and not supporting the use means being against the president.

That's really unfortunate. Something similar happened in the US. Made people stupid. Hopefully as the trials come in, people will form their opinions based on the science!

Yes, many doctors are using it. But there are many different protocols.

I've heard different views from a handful of Brazilian MDs on twitter -- including one who said he could lose his medical license if he prescribe ivermectin. Maybe it depends on the locale?

I am taking the 200ugm/kg dose every 15 days, preventively.

That seems light to me. Is the expense significant?

I'm dosing at 200mcg/kg twice a week, because ivermectin has a half-life of about 18 hours.

Given that half-life, you're down to about 1.25 mcg/kg after a week.

If I contact someone with a positive covid test I will certainly take it for four consecutive days, as some doctors here advise.

Interesting that that's their advice!

The problem of course is knowing when you've been in contact with someone. Do you take your temperature daily, or use an oxymeter?

I'm high risk about 7 ways so I'm super-isolating and almost never see anyone aside from my pharmacist and the grocery store clerk -- and I keep those contacts down to once a month.

Thanks for the update from Brazil! Good luck with the craziness there. Stay healthy! Stay in touch.

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[-] jpdowlin | 2 points | Jul 07 2020 18:12:40

I am not a doctor, but twice a week seems a bit often. I have looked at the Pharmacokinetics of IVER and it accumulates in fat and some other tissues. With that dosing, you could end up with toxic doses accumulating in tissue after a period of time - because the 18hr half life is only for plasma. How come once month dosing or 6-month dosing for worms/parasites works? I assume it is because of a longer half life in tissue/adipose.

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[-] TrumpLyftAlles | 2 points | Jul 07 2020 18:25:21

You may be right. It's a recent TIL for me that IVER accumulates in fat -- and Dog knows I have plenty of that.

because the 18hr half life is only for plasma

Good point.

How come once month dosing or 6-month dosing for worms/parasites works?

A study found scabies infestation was 90% lower two years after IVER treatment!

you could end up with toxic doses accumulating in tissue

This is hard for me to accept because I'm so convinced that ivermectin is safe, safe, safe. How would a toxic dose manifest? What part of the body is at risk? Are there any studies showing toxic effects? I'm aware of a study and a report about central nervous system disorders. The study didn't speak to overdose. The report was about someone with fairly mild CNS symptoms who recovered after two days off the drug.

I've seen a couple but haven't ever closely read IVER pharmacokinetics articles because the language and science is so hard for me to understand. Is there an article that you'd recommend?

Punchline, though: If I want ivermectin to prevent my catching the virus, do I need it in my blood plasma or is the store in my fat sufficient? That's unknown. I want to err on the side of not catching COVID-19; AFAIK IVER toxicity is a comparatively minuscule threat. Of course, I don't know much. This is all guesswork.

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[-] jpdowlin | 2 points | Jul 07 2020 21:18:54

I read the cow and goat papers :) They cover PK of ivermectin for those 2: https://www.researchgate.net/publication/7992778_Influence_of_the_route_of_administration_on_efficacy_and_tissue_distribution_of_ivermectin_in_goat

and

https://parasitology.cvm.ncsu.edu/vmp930/supplement/ivermectin_pharmocology_rev2009.pdf

I know IVER has a high therapeutic index. But every medicine has a toxic dose - i can't say how high it is in IVER. I read one testimony on Facebook of somebody who hallunicated after taking 60 or 90mg more than 1 month after infection (#covidlong). Maybe that was the 2nd dose, can't remember the details. But the precautionary principle should win out here - you're almost certainly ok with dosing less frequently, but there is the marginal risk of your frequent dosing is probably too high, IMO. We don't want to lose you - you're the best source of IVER-Covid19 info on the Interweb!

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[-] TrumpLyftAlles | 1 points | Jul 07 2020 21:55:25

you're the best source of IVER-Covid19 info on the Interweb!

That's an awfully nice thing to say! :)

There's a lot in the "The pharmacokinetics and metabolism of ivermectin in domestic animal species" article. I'll try to read it the next time I'm fully awake.

Thanks for the link!

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[-] unhurriedman | 1 points | Jul 07 2020 18:15:43

I've heard different views from a handful of Brazilian MDs on twitter -- including one who said he could lose his medical license if he prescribe ivermectin. Maybe it depends on the locale?

It does not depend on the location. The medical council is federal. But there is much speculation on the subject.

That seems light to me. Is the expense significant?

No, I'm afraid of neurotoxicity.

The problem of course is knowing when you've been in contact with someone. Do you take your temperature daily, or use an oxymeter?

I'm high risk about 7 ways so I'm super-isolating and almost never see anyone aside from my pharmacist and the grocery store clerk -- and I keep those contacts down to once a month.

I am also isolated. Leaving only for the essentials. I live at my in-laws' house. They are elderly and have diabetes. My wife has asthma. So we have to take care of ourselves. I have an oxymeter too.

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[-] TrumpLyftAlles | 2 points | Jul 07 2020 18:49:56

I'm afraid of neurotoxicity.

Have you seen this? A patient took 12mg of ivermectin every day for two weeks, at which point her husband brought her to the hospital because of central nervous system symptoms. She recovered 2 days after stopping the ivermectin.

A couple ivermectin safety studies, one specifically about neurological adverse events, are discussed here. IMO neurotoxicity isn't a threat -- but needless to say, you decide about that for you.

I am also isolated. Leaving only for the essentials. I live at my in-laws' house. They are elderly and have diabetes.

Yikes! Watch out for those elders!

My wife has asthma

There's evidence that asthmas is protective againstt the virus. Don't depend on that.

Good luck!

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[-] unhurriedman | 2 points | Jul 07 2020 18:55:04

Have you seen this? A patient took 12mg of ivermectin every day for two weeks, at which point her husband brought her to the hospital because of central nervous system symptoms. She recovered 2 days after stopping the ivermectin.

Interesting!

There's evidence that asthmas is protective againstt the virus. Don't depend on that.

Really? I am surprised.

A couple ivermectin safety studies, one specifically about neurological adverse events, are discussed here. IMO neurotoxicity isn't a threat -- but needless to say, you decide about that for you.

I will study more about this. Thanks!

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[-] TrumpLyftAlles | 2 points | Jul 07 2020 19:08:03

There's evidence that asthmas is protective

https://www.jacionline.org/article/S0091-6749(20)30745-4/abstract

Surprisingly, the authors report a low prevalence of asthma (0.9% [5 of 548]) in patients with COVID-19, markedly lower than in the adult population of Wuhan (6.4%) and hence speculate that there may be a T H2-mediated reduced susceptibility to COVID-19 in patients with asthma. 1 A recent literature review including an additional 12 predominantly Chinese COVID-19 cohorts/cases (874 patients) showed that asthma was “surprisingly underreported,”

Smokers are also underrepresented among COVID-19 patients.

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[-] unhurriedman | 2 points | Jul 07 2020 20:19:36

https://www.trialsitenews.com/oxford-queensland-university-of-technology-team-on-stoic-trial-can-inhalers-stop-covid-19-from-progressing/

Maybe?

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[-] TrumpLyftAlles | 1 points | Jul 07 2020 20:40:15

Sorry, not following. Maybe what? Explain please.

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[-] unhurriedman | 2 points | Jul 07 2020 21:55:50

Perhaps asthmatics have fewer complications because of the use of inhalable corticosteroids. This is the hypothesis of this research.

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[-] TrumpLyftAlles | 2 points | Jul 07 2020 22:38:26

Ah, thanks. I'm dim.

Corticosteroids are useful in severe stages because they help calm the cytokine storm -- right?

The observation, though, is that fewer asthmatics come down with the virus; hospital admissions are lower than would be expected. So not cytokine-related.

The study is about possibly slowing the advancement of covid19 -- not about the seeming prophylactic effect of asthma.

Maybe corticosteroids are protective.

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[-] TrumpLyftAlles | 1 points | Jul 07 2020 00:58:52

And yet another Bulgaria article, with just a brief mention of the same study.

Covid-19: Bulgaria extends epidemic declaration to end of July (2020-07-06)

This one said there will be results after July ends.

Bogdan Kirilov, executive director of the Medicines Agency, told the briefing that a Bulgarian team was “very close” to concluding tests regarding a medicine to use against Covid-19. He expected to be able to give further details after the end of July.

Bulgaria began clinical trials of the medicine, Ivermectin, in May, the first country in the EU to begun such trials, Kirilov said. At nine hospitals in Bulgaria, 30 volunteers are participating in the clinical trials.

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