July-August . 2021 | @ Halal
Halal Health
17
BY FATIHAH MANAF
A
QUESTION on the halal status of Ivermectin was asked to the president of the Malaysian Muslim Consumers Association ( PPIM ), Dato ’ Nadzim Johan .
PPIM was one of the NGOs that signed a letter calling to approve Ivermectin use in Covid-19 treatment .
Using AstraZeneca vaccine as an example , the president said the use of Ivermectin should be deemed permissible .
He said : “ The Indonesian Ulema Council ( MUI ) decided that AstraZeneca vaccine is haram , but our Ulema has deemed it permissible . If we ’ re looking at the ingredients , there are no questionable elements like fetal tissue in Ivermectin . Its benefits also outweigh the risks .
“ If Ivermectin can help to cure many diseases , then it is okay for us . However , if its usage was later approved by the Ministry of Health ( MoH ), we can ask JAKIM to properly verify its halal status .”
The president also expressed his hope regarding the approval of Ivermectin use for Covid-19 treatment . He said people were not supposed to make this an issue . PPIM is an active NGO that strives to change the landscape of consumerism among Muslims in Malaysia .
In February , an open letter signed by five NGOs was addressed to the MoH . The letter sought immediate approval to use Ivermectin for Covid-19 treatment in the country . In Malaysia , the anti-parasitic drug was only approved to be used on animals .
The letter received mixed responses from the public . Some of them were optimistic about having Ivermectin as an affordable treatment against Covid-19 . However , many were sceptical since Malaysia had yet
Push for Ivermectin
Muslim consumer groups urge government to consider its use to treat Covid-19
Dr Noor Hisham
to approve its use on humans .
Response from MoH
“ Science would remain the best weapon against the SARS-Cov-2 virus , not circumstantial hype ,” said the Director-General of Health Malaysia , Tan Sri Dr Noor Hisham Abdullah , in his blog on May 16 .
In his post , Dr Noor Hisham seemed to express his doubt concerning Ivermectin in Covid-19 treatment . He stated MoH could not endorse Ivermectin to prevent or treat Covid-19 illness without the benefit of evidence from well-designed clinical trials .
He also highlighted that many existing Ivermectin studies had limitations such as small sample size , non-controlled study designs or that the drug was only used as an add-on treatment .
A randomised-controlled trial published in the Journal of American Medical Association ( JAMA ) in March this year had shown that there was no significant improvement in Covid-19 symptoms when 476 adults with mild Covid-19 disease were given a five-day course of Ivermectin .
Nadzim Johan
Dr Noor Hisham said : “ Whilst Ivermectin may have some anti-viral and anti-inflammatory effects , the evidence remains inconclusive .”
However , MoH took the initiative to conduct a randomised clinical trial to repurpose Ivermectin and evaluate its efficacy and safety in high-risk Covid-19 patients ( NMRR-21-155-58433 ). The trial was set to enrol 500 Covid-19 patients who were admitted to 12 MoH hospitals .
Dr Noor Hisham emphasised it was important for MoH to figure out what worked and hoped this study would correct MoH ’ s perspective on the clinical effectiveness of Ivermectin .
MoH starts Ivermectin trial for high-risk Covid-19 patients
Dr Noor Hisham stated in his blog that effective pharmacological treatments for Covid-19 remained a challenge for MoH . He shared the Randomised Evaluation of Covid-19 Therapy ( RECOVERY ) trial showed that a steroid called dexamethasone helped improve mortality outcomes for Covid-19 patients in the severe stage of infection .
However , there was still a lack of treatment in the management of mild and moderate cases .
In terms of mortality outcomes , the World Health Organisation ( WHO ) Covid- 19 Solidarity Trial for Covid-19 Treatments ( SOLIDARITY ), which included Malaysia , had found insufficient evidence for the use of remdesivir , hydroxychloroquine , interferon and lopinavir .
Currently , the Malaysian Consensus Management Guidelines for Covid-19 maintains favipiravir as the only anti-viral therapy for the management of Covid-19 cases . This recommendation , however , may change as more evidence becomes available .
On June 5 , Dr Noor Hisham informed that MoH had started their Ivermectin trial for high-risk Covid-19 patients ( I-TECH Study ). The trial was approved by the Medical Research and Ethics Committee ( MREC ), MoH , on May 25 , 2021 .
He stated that the study compares Ivermectin treatment ( specific dose with specific duration ) with the standard of care alone . 500 subjects from high-risk groups aged 50 years and above admitted to MoH hospitals with mild / moderate Covid-19 symptoms ( Stage 2-3 ) will be enrolled in the study .
The study aims to determine the efficacy of Ivermectin in preventing the progression of Covid-19 to severe disease ( Stage 4-5 ) and in terms of mortality outcomes .
The First-Patient-In ( FPI ) for the Ivermectin trial was on May 31 2021 . Eight patients have been enrolled in the study so far . The study is also expected to be completed by September 2021 .
It is hoped that this Ivermectin clinical trial will bring good news to Malaysians , and the results will help MoH fight Covid-19 .