Can the antidepressant fluvoxamine (Luvox) be used to treat COVID-19?
Does Fluvoxamine Treat COVID-19?
- A number of clinical trials have been completed using fluvoxamine to treat COVID-19 patients. The results of clinical trials so far have not been clear, or have limitations making it difficult to draw definite conclusions.
- Some trials show fluvoxamine to be effective in treating COVID-19, as it reduces the time spent in hospital and decreases the risk of death, while other trials showing no significant difference in health outcomes.
- The current National Institutes of Health (NIH) COVID-19 treatment guidelines report that there is insufficient evidence either for or against the use of fluvoxamine for the treatment of COVID-19.
- More trials using fluvoxamine to treat COVID-19 need to be done so that there is more specific, evidence based information that can be used to decide whether it can be recommended for COVID-19 treatment. These need to be randomized controlled studies that have large sample sizes and are well designed.
Is fluvoxamine an FDA approved Medicine?
- Fluvoxamine (original brand name: Luvox) is an FDA approved medicine used to treat obsessive compulsive disorder.
- Fluvoxamine is not FDA approved to treat COVID-19.
TOGETHER Clinical Trial
In the TOGETHER trial (NCT04727424) fluvoxamine showed positive results and was effective treating COVID-19 by reducing the risk of hospitalization for patients at risk of progressing to severe disease. This was a randomised, blinded, placebo-controlled trial with 741 patients taking fluvoxamine and 756 taking placebo.
The study showed that patients who were treated with fluvoxamine were more stable and their COVID-19 did not deteriorate as much when compared to placebo patients. This was measured by the number of patients being admitted to a higher level of care, either a COVID-19 emergency setting or transferred to a tertiary hospital.
Fluvoxamine results showed risk of being admitted to a higher level care was lower:
- absolute risk reduction of 5·0%
- relative risk reduction of 32%.
Fluvoxamine patients who had early treatment were less likely to get severe COVID-19 symptoms when compared to the placebo patients, so less likely to be hospitalized.
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How does fluvoxamine work for COVID-19?
- Fluvoxamine is being used to treat COVID-19 as it has been shown to have an anti-inflammatory effect and also has an effect on immune cells.
- It does this by binding to sigma-1 receptors in immune cells which lowers production of inflammatory cytokines. The overproduction of cytokines is one of the causes of symptoms of COVID-19.
BOTTOM LINE
- Fluvoxamine is currently being studied for treatment of COVID-19
- Current NIH guidelines report that there is insufficient evidence either for or against the use of fluvoxamine for the treatment of COVID-19.
- More clinical trials are needed to gain certainty on fluvoxamine effect on COVID-19
- Fluvoxamine is an FDA approved medicine for treatment of OCD, it is not an approved medicine for treatment of COVID-19.
References
- NIH COVID-19 Treatments Guidelines - Fluvoxamine [Accessed October 30, 202]
- https://www.covid19treatmentguidelines.nih.gov/therapies/immunomodulators/fluvoxamine/
- Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. [Accessed October 30, 2021] https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00448-4/fulltext
- Profession Medication Information Luvox CR. [Accessed October 30, 2021] https://www.drugs.com/pro/luvox-cr.html
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