Ivermectin
| 證據等級: L5 | 預測適應症: 9 個 |
目錄
Ivermectin: From Parasitic Infections to Vulvovaginal Candidiasis
One-Sentence Summary
Ivermectin is a long-established antiparasitic agent that paralyzes invertebrate parasites by binding glutamate-gated chloride channels; no formal original-indication record was provided in this evidence pack. The TxGNN model predicts potential efficacy for Vulvovaginal Candidiasis, but this direction is currently supported by 0 clinical trials and 0 publications, and no antifungal mechanism has been established for ivermectin.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Parasitic infections (inferred from known pharmacology; no structured original-indication data was provided) |
| Predicted New Indication | Vulvovaginal Candidiasis |
| TxGNN Prediction Score | 99.95% |
| Evidence Level | L5 |
| Taiwan Market Status | Not marketed |
| Number of Authorizations | 0 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism-of-action data is not available in this evidence pack (original_moa: [Data Gap]). Based on the drug's known pharmacology, ivermectin binds invertebrate glutamate-gated chloride channels, causing parasite paralysis and death — this is the basis of its established antiparasitic use. No established antifungal (anti-Candida) mechanism has been demonstrated for ivermectin; only scattered in vitro reports suggest weak, non-specific antifungal activity, which is insufficient to constitute a mechanistic link to vulvovaginal candidiasis.
The 99.95% TxGNN score is therefore more plausibly explained by graph-embedding proximity — ivermectin and vulvovaginal candidiasis likely sit near shared "genitourinary/reproductive-tract infection" neighborhoods in the knowledge graph — rather than a genuine pharmacological relationship. Notably, 8 additional predicted indications for ivermectin in this evidence pack (esophageal candidiasis, HPV infection, vulvovaginitis, C. glabrata, congenital/neonatal candidiasis, postmenopausal atrophic vaginitis, invasive candidiasis) show the same pattern: high scores clustered around candida/genitourinary conditions, each with little or no supporting mechanism, trials, or literature. This systematic clustering further supports a graph-topology artifact rather than a true repurposing signal.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Taiwan Market Information
Ivermectin is currently not marketed in Taiwan, with 0 approved licenses on record — no product authorization data is available.
Safety Considerations
Please refer to the package insert for safety information.
Note: TFDA package insert warnings/contraindications data is currently a blocking data gap (DG001) — a preliminary safety assessment (S1) cannot proceed until this is resolved.
Conclusion and Next Steps
Decision: Hold
Rationale: There is no established antifungal mechanism for ivermectin, and no clinical trials or literature specifically support its use in vulvovaginal candidiasis — the high TxGNN score is best explained by graph proximity bias rather than genuine pharmacological relevance. This is compounded by a blocking gap in TFDA safety data, which prevents even a preliminary safety evaluation.
To proceed, the following is needed:
- TFDA package insert (warnings, contraindications) — currently blocking
- Confirmed mechanism-of-action data from DrugBank
- In vitro/preclinical evidence of genuine antifungal activity against Candida spp.
- At least early-phase clinical or observational data specific to vulvovaginal candidiasis
- A systematic review of the other 8 candida/genitourinary-clustered predictions before treating any of them as independent signals
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.