According to the findings of a big clinical investigation, a popular and affordable antidepressant may reduce the likelihood that high-risk Covid-19 patients would be admitted to the hospital. The findings, which were published on Wednesday, might pave the way for new recommendations for the use of the medicine both in the United States and throughout the world.
Fluvoxamine, a medication used to treat obsessive-compulsive disorder, has been approved by the Food and Drug Administration for over 30 years. However, as the coronavirus began to spread, researchers were interested in the medicine because of its capacity to lower inflammation, which may enable it to suppress the body’s excessive reaction to a coronavirus infection.
The drug fluvoxamine had shown promise in a number of smaller trials conducted earlier in the epidemic, but none had shown findings as substantial or convincing as the one released on Wednesday by a collaboration of researchers from Canada, the United States, and Brazil, according to independent specialists. According to the findings of the trial, fluvoxamine decreased the requirement for hospitalisation or extended medical monitoring by one-third among approximately 1,500 Covid patients in Brazil who were either administered fluvoxamine or a placebo. It was published in The Lancet Global Health, a peer-reviewed journal.
Some patients had difficulty tolerating the medication and quit taking it, according to the research, prompting some outside experts to wonder if they had yet discovered the optimal dosage of the medication. However, the advantages were considerably more noticeable among individuals who had mostly adhered to their physicians’ directions. When administered to such patients, fluvoxamine decreased the requirement for hospitalisation by two-thirds and the chance of death by half: just one Covid patient who received fluvoxamine died, compared to 12 who received a placebo.
Doctor David Boulware, an infectious disease investigator at the University of Minnesota who collaborated on a smaller, real-world trial of the medicine in Covid patients in California, said, “That’s pretty terrific.” Furthermore, he said, “it is not a brand-new, pricey medicine.” The good thing about this is that it has a well-established safety profile.”
Other concerns remained unanswered by the trial, according to the researchers, apart from correct dosage. The study’s lead author, Penny Ward, a visiting professor in pharmaceutical medicine at King’s College London, pointed out that part of the drug’s impact seemed to be a reduction in the requirement for lengthy medical observation, which was monitored alongside hospital admissions. Furthermore, Professor Ward noted that the majority of the patients in the research were not vaccinated, making it difficult to predict how well the medicine would perform in those who were.
Despite the fact that the latest study was conducted about a year after smaller trials of the medicine, it served as a reminder of the difficulties that many researchers have encountered when conducting large-scale studies of Covid therapies. Scientists say that the Biden administration has increased financing for such research, but that enrolling enough patients has only become more difficult. After all, the majority of high-risk Americans have been vaccinated, and vaccine-averse individuals may be less reluctant to participate in trials.
Because fluvoxamine is already licenced for the treatment of obsessive-compulsive disorder, physicians may prescribe it for Covid “off label.” In contrast to other repurposed medications with significantly less scientific evidence, like as hydroxychloroquine and ivermectin, Dr. Boulware claims that prescriptions for the drug have grown just marginally throughout the epidemic.
“It hasn’t really developed any kind of cult following,” he said.
Federal treatment guidelines state that bigger studies are needed to examine the use of fluvoxamine for Covid, and experts said they anticipated those recommendations to alter as a result of the current research, which was published in the journal Cancer.
Furthermore, the new results are predicted to increase the appeal of the medicine in less developed countries: ” A 10-day course of the medication costs around $4.