Fluvoxamine may prevent respiratory deterioration in COVID-19, reports JAMA
First publication of a placebo-controlled trial demonstrates that early treatment with antidepressant Fluvoxamine can prevent respiratory deterioration in COVID-19.
SAN FRANCISCO - Researchers at Washington University School of Medicine in St. Louis have found in a double-blind, randomized controlled clinical trial that investigated whether the antidepressant medication fluvoxamine, if taken within seven days of first symptoms of COVID-19 was effective and can reduce the risk for respiratory deterioration. None of the 80 patients who took the drug met the respiratory deterioration criteria compared to an 8.3% rate in the 72 patients who took a placebo.
The findings of the study have been published in JAMA, The Journal of the American Medical Association.
Dr. Carolyn Machamer, a professor of cell biology at the Johns Hopkins School of Medicine and a member of CETF's scientific advisory board (SAB), who has studied the basic biology of coronaviruses for years noted, "The results of the fluvoxamine trial are encouraging and warrant a further evaluation in a larger study. A treatment that can prevent lung problems in people with mild symptoms of COVID-19 is desperately needed."
Under the leadership of Dr. Eric Lenze, director of the Healthy Mind Lab at Washington University School of Medicine in St. Louis, study researchers tested fluvoxamine, which is typically used to treat patients with obsessive-compulsive disorder, in coronavirus patients because it has strong anti-inflammatory properties. The researchers believed this capability could prevent cytokine storms - the body's massive, sometimes deadly, inflammatory reaction to coronavirus and other infections.
"This placebo-controlled study indicates that fluvoxamine may prevent serious breathing problems in people with mild COVID-19 illness, and is the first in this patient population to be published in a peer-reviewed journal," said Lenze. "These are promising findings, and we look forward to conducting a much larger study in the coming weeks to further evaluate the effectiveness of fluvoxamine."
The 152 trial participants, all of whom were 18 years or older, were diagnosed with mild forms of COVID-19, and lived in either Missouri or Illinois. Participants were randomly assigned (1:1) to take either fluvoxamine or a placebo. In this outpatient clinical trial, there was no face-to-face contact between participants and clinicians; study materials, including the study drug, were delivered to the participants' homes. In this trial, of the 80 participants who received the drug, zero hit the endpoint of clinical deterioration (oxygen saturation of 92% or lower along with difficulty breathing or hospitalization for pneumonia), as opposed to the six of 72 people who got the placebo and experienced deterioration. The results show that fluvoxamine has the potential to reduce the risk of hospitalization in COVID-19 patients.
"We now have evidence that an inexpensive, safe, and readily available pill can reduce deterioration and hospitalization from COVID-19," said Steve Kirsch, CETF founder. "This trial validates what we have already learned from multiple scientific studies, the greater the sigma-1 activation, the greater the protection."
The study result affirmed a large, multi-center observational study done in France that showed that SSRI drugs significantly reduced the risk of requiring a ventilator or death from COVID-19. The French study showed that the SSRIs with the highest sigma-1 receptor activation had the greatest benefit.
Unaffiliated to this study, David Seftel, M,D., Harvard-educated internist and CEO of Stanford partner lab Enable Biosciences who serves as a Principal Investigator for several NIH projects, opined: "Fluvoxamine might be considered by doctors for off-label use to treat COVID-19 patients early in their disease. Even if vaccines or other therapeutics are used as a first line of defense, fluvoxamine may dramatically decrease the odds that someone will need to be hospitalized."