Varying perspectives arose as Ivermectin has been frequently discussed by many in various platforms on its preventive and treatment roles in COVID-19. In addition, many scientific publications, including randomized controlled trials, systematic reviews and meta-analyses on Ivermectin, are easily accessible across the internet. Despite the systematic reviews and meta-analyses having a higher level of evidence, a critical appraisal is crucial for better evidence-based practice.

The Center of Epidemiology and Evidence-based Practice (CEEBP), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, had organized a webinar on “Evidence-based Practice of Ivermectin Use and COVID-19: Critical Appraisal on the Systematic Reviews and Meta-analyses” on 16^th July 2021 via Zoom webinar, live-streamed in Facebook as well as Youtube.

We are honoured to have our invited panellist, Dato’ Dr Zainal Ariffin bin Omar, President of Malaysian Public Health Physicians Association (PPPKAM), sharing his expert opinions. We are also pleased to have Professor Dr Moy Foong Ming and Professor Dr Sanjay Rampal A/L Lekhraj Rampal being the panellists for the forum discussion sharing their viewpoints on the Ivermectin use and COVID-19. The critical appraisal session was presented by our speakers from Dr Malar Velli A/P Segarmurthy, Dr Ang Swee Hung, who are Doctor of Public Health (DrPH) candidates, as well as Mr Ng Yit Han, who is PhD candidate from the Department of Social and Preventive Medicine, University of Malaya. Both forum discussion and critical appraisal sessions were moderated by Dr Lye Chuan Way who is a DrPH candidate as well.

The total participation of the webinar was around 1830 participants with an estimation of 230 participants on Zoom, 1100 on Facebook LIVE, and 500 from the Youtube LIVE.

Here are the summary key messages from the webinar: –

The current evidence, potentially beneficial for mild to moderate disease. However, there is a high risk of bias in the RCTs conducted.
Ivermectin is not registered for human use under National Pharmaceutical Regulatory Agency (NPRA). The safety profile for Ivermectin and the dosage of human use are still remained unclear.
Ivermectin is safe for its conventional use as antiparasite for animals, yet it is not tested for regular or higher dosing when repurposed.
Critical appraisal and regular updates on the latest publications are crucial to ensure the evidence-based decisions are made for the better benefits.
Many asked about the use of Ivermectin if close one contracted COVID-19 in the question and answer session. As there is still lacking of evidence for the use of Ivermectin, it could be detrimental than beneficial.

In conclusion, the evidences from the systematic reviews and meta-analyses were still inconclusive. Hence, it is crucial to keep updated and critically appraise on the evidences for the Ivermectin use. Public health measures and vaccinations still the best as for now,and they are proven to effective in the prophylaxis of COVID-19.

Always do good and do no harm.