Provincia alerta fatales “efectos colaterales” con el uso de ivermectina en pacientes con Covid

La Sociedad Argentina de Infectología (SADI) y la Sociedad Argentina de Terapia Intensiva (SATI) emitieron recientemente un comunicado sentando posición respecto al uso de la Ivermectina en tratamientos de pacientes infectados por COVID-19. En forma coincidente el Ministerio de Salud de La Pampa, alertó respecto a los “efectos colaterales indeseables” y algunos probablemente “mortales” de tal consumo.

“La ivermectina es una droga antiparasitaria de amplio uso en medicina humana y veterinaria, con dosis definidas para conservar un patrón de tolerancia y seguridad para indicaciones conocidas” señala el documento de la SADI y la SATI. “Además de su acción antiparasitaria” sostiene, “la ivermectina es un potencial inhibidor de la replicación viral del SARS-CoV-2. Sin embargo, la evidencia disponible in vitro sugiere que para alcanzar niveles efectivos de ivermectina se necesitarían importantes aumentos y potencialmente tóxicos de la dosis”.

Días atrás, y ante la publicación de varios medios de prensa provinciales respecto a pacientes contagiados de coronavirus que hicieron uso del medicamento, el ministro de Salud de La Pampa, Mario Rubén Kohan, conferencia de prensa mediante, sentó la posición del Ministerio en el caso.
“Siempre me interesó, y me sigue interesando, saber la existencia de alguna droga que genere un efecto paliativo en esta enfermedad, pero (respecto a la Ivermectina) no hay trabajos científicos publicados, o al menos nosotros no los conocemos. Recientemente la SATI (Sociedad Argentina de Terapia Intensiva) como la SADI (Sociedad Argentina de Infectología) no recomiendan su uso, y es lo que se puede decir hasta ahora” señaló el ministro a la Agencia Provincial de Noticias.

Kohan consideró necesario, atento a la continua difusión de tratamientos contra el coronavirus utlizando la mencionada droga, “dar una respuesta contundente desde la mirada que tenemos en el ámbito de Salud. Todos tenemos grandes expectativas por medicamentos que atenúen el impacto de esta enfermedad, muchos han sido testeados, como es el caso de la hidroxicloroquina que fue y es muy publicitada por el presidente de un país vecino, y que no solamente demostró que no era eficaz, sino que además mataba gente”, señaló.

En relación al uso de la ivermectina en particular, agregó que es una droga “que despierta mucho interés, yo lo sigo muy de cerca. Hay una publicación de hace unos meses en Australia, que indica que esta inhibe la replicación viral, pero se necesitan diez veces la dosis habitual que consumimos. Es una droga antigua que data de más de 30 años, y que no se utiliza solamente en veterinaria sino también en el ser humano, pero con dosis mínimas”.
“Hay dos trabajos hechos en la Argentina, uno de prevención y otro en pacientes, pero estos trabajos han sido bastante desprolijos, no tienen la rigurosidad que se exige.

No hay estudios clínicos randomizados de calidad para la toma de decisiones terapéuticas. La sociedad científica nacional desaconseja el uso por la particular razón de que hay que multiplicar la dosis diaria y los efectos colaterales son indeseables y algunos probablemente mortales, no han sido testeados. Por lo tanto, no podemos recomendar su uso”, concluyó.

Documento de posición
Tanto la SADI como la SATI, el 20 de octubre pasado, firmaron un documento titulado “Ivermectina para el tratamiento y/o profilaxis de CVID-19” dando cuenta entre otras cuestiones que “hasta el momento la evidencia científica en curso que evalúa el uso de ivermectina sola o combinada con otras drogas para la prevención y/o tratamiento de la infección por SARS-Cov2, es de muy baja calidad y no han reportado datos claros de eficacia clínica”.

“Los recientes resultados preliminares (sin publicación ni revisión de pares) de un estudio realizado en Argentina evidenció que la administración de ivermectina al triple de dosis habitual en 45 pacientes habría producido mayor eliminación del virus en secreciones respiratorias, pero sin correlación con mejoría clínica. Sin embargo, se necesitan más estudios con mayor número de individuos para determinar este parámetro y otros asociados a eficacia clínica y seguridad” señalan.

Y agregan, “la ivermectina no es una droga inocua y aún a dosis terapéuticas puede provocar un número frecuente (>10%) y considerable de efectos secundarios adversos, desde leves a graves. Sguiendo los lineamientos de la ANMAT, la utilización de una medicación en carácter de uso compasivo, solo se encuentra autorizada para pacientes debidamente identificados, lo que excluiría la utilización de la ivermectina en forma masiva como actualmente se pretende”.

El documento concluye afirmando que “por todo lo anteriormente expresado, y mientras no existan evidencias de mayor calidad, SADI recomienda que no se utilice la ivermectina para el tratamiento y/o profilaxis del SARS-CoV2 al margen de estudios bien diseñados, debidamente registrados, y que sean éticamente aceptables”.

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