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Vaccinating the public against COVID-19 has been a priority since the first shots came online last December. But at the same time, scientists have continued their quest to identify potential treatments for people who get infected.
One of them, the generic drug fluvoxamine, has shown significant potential. Developed 40 years ago as an antidepressant, fluvoxamine—sometimes known as Luvox—has been used mainly to treat obsessive-compulsive disorder (OCD), per the National Alliance on Mental Illness (NAMI). Recently, researchers have been taking a closer look at how the medication could be an important treatment to prevent patients who test positive for COVID-19 from getting seriously ill with the infection.
And now, in the largest randomized trial to date, researchers suggest it might have a role to play for people with early-diagnosed, symptomatic COVID-19.
What the new research tells us about treating early COVID-19 with fluvoxamine
Researchers from Canada, the US, and Brazil conducted the latest study, reported in the Lancet Global Health on October 27. It's part of a larger trial designed to investigate the potential of repurposing existing drugs against COVID-19.
Nearly 1,500 largely unvaccinated Brazilian adults with symptomatic COVID-19 and underlying health issues, such as diabetes and heart disease, were enrolled in the study and treated in one of 11 outpatient clinics. Because of their health status, they were all considered at high risk of developing severe COVID. Half of the study participants were treated with fluvoxamine, while the other half received a placebo, and patients were observed for 28 days after treatment.
Of the people who took 100 milligrams of fluvoxamine twice daily for 10 days, roughly 11% needed an "extended" stay (meaning more than six hours) in an emergency care setting or required hospitalization. That compares with nearly 16% of those taking the sham treatment.
The bottom line: the treatment was associated with a 5% reduction in the "absolute" risk of hospitalization or prolonged emergency care. There was a 30% reduction in the "relative" risk of hospitalization among those receiving fluvoxamine compared to people taking the placebo. In addition, there was one death in the fluvoxamine group compared to 12 in the placebo group, per a Lancet news release.
"Fluvoxamine is, so far, the only treatment that if administered early can prevent COVID-19 from becoming a life-threatening illness," Edward Mills, PhD, of McMaster University in Ontario, Canada, and one of the coauthors, said in a statement.
However, the researchers concluded that more research is needed. It's unclear, for example, whether fluvoxamine would prove as beneficial in a vaccinated population.
People Are Taking Ivermectin, a Deworming Drug for Animals, to Treat COVID—Here's Why That's a Bad Idea
What prior research on fluvoxamine has revealed
In an interview with 60 Minutes that aired in March, Angela Reiersen, MD, associate professor of psychiatry at Washington University in St. Louis, who is one of the investigators in the fluvoxamine trials, explained that she first got the idea that the drug could potentially treat COVID-19 after seeing research that fluvoxamine prevented sepsis in mice.
"I thought, well, I wonder if we could use fluvoxamine to treat COVID and prevent that clinical deterioration," Dr. Reiersen told 60 Minutes.
Dr. Reiersen is coauthor of a November 2020 study published in the Journal of the American Medical Association (JAMA) regarding the use of fluvoxamine in COVID-19 patients. She and her colleagues—including Eric Lenze, MD, a fellow psychiatrist at Washington University who also specializes in finding new uses for drugs that are already approved by the Food and Drug Administration (FDA)—went on to conduct the small randomized clinical trial on fluvoxamine and COVID-19 patients.
Here's How Monoclonal Antibody Treatments Fight COVID-19, Plus How to Know If You're Eligible
The results of that JAMA study found that participants with symptomatic COVID-19 who were treated with fluvoxamine "had a lower likelihood of clinical deterioriation" than those who were given a placebo. "The results were really pretty incredible," Dr. Lenze told 60 Minutes Correspondent Sharyn Alfonsi. "Out of the 80 people who received fluvoxamine, none, zero of them deteriorated versus 8% of the people who got [the] placebo."
Of course, since the study was only preliminary, researchers declared that more research was needed to determine "clinical efficacy" of the drug in COVID-19 patients. But that research sparked even more research on fluvoxamine's role in preventing serious disease in those with COVID-19 infections.
David Seftel, MD, a physician in Berkeley, California, opted to offer a 15-day prescription to his own COVID-19 patients, who fell victim to an outbreak in the Golden Gate Fields race track community. (FYI: His decision to use a prescription drug off-label is an accepted medical practice, provided the patient consents. "Off-label" simply means it hasn't been approved by the FDA for that particular condition.)
The results of Dr. Seftel's real world study, which were published in Open Forum Infectious Diseases, showed that, of 65 of those patients who chose to take fluvoxamine, none were hospitalized, while of the 48 who declined the prescription, 12.5% ended up hospitalized, and one died.
One of them, the generic drug fluvoxamine, has shown significant potential. Developed 40 years ago as an antidepressant, fluvoxamine—sometimes known as Luvox—has been used mainly to treat obsessive-compulsive disorder (OCD), per the National Alliance on Mental Illness (NAMI). Recently, researchers have been taking a closer look at how the medication could be an important treatment to prevent patients who test positive for COVID-19 from getting seriously ill with the infection.
And now, in the largest randomized trial to date, researchers suggest it might have a role to play for people with early-diagnosed, symptomatic COVID-19.
What the new research tells us about treating early COVID-19 with fluvoxamine
Researchers from Canada, the US, and Brazil conducted the latest study, reported in the Lancet Global Health on October 27. It's part of a larger trial designed to investigate the potential of repurposing existing drugs against COVID-19.
Nearly 1,500 largely unvaccinated Brazilian adults with symptomatic COVID-19 and underlying health issues, such as diabetes and heart disease, were enrolled in the study and treated in one of 11 outpatient clinics. Because of their health status, they were all considered at high risk of developing severe COVID. Half of the study participants were treated with fluvoxamine, while the other half received a placebo, and patients were observed for 28 days after treatment.
Of the people who took 100 milligrams of fluvoxamine twice daily for 10 days, roughly 11% needed an "extended" stay (meaning more than six hours) in an emergency care setting or required hospitalization. That compares with nearly 16% of those taking the sham treatment.
The bottom line: the treatment was associated with a 5% reduction in the "absolute" risk of hospitalization or prolonged emergency care. There was a 30% reduction in the "relative" risk of hospitalization among those receiving fluvoxamine compared to people taking the placebo. In addition, there was one death in the fluvoxamine group compared to 12 in the placebo group, per a Lancet news release.
"Fluvoxamine is, so far, the only treatment that if administered early can prevent COVID-19 from becoming a life-threatening illness," Edward Mills, PhD, of McMaster University in Ontario, Canada, and one of the coauthors, said in a statement.
However, the researchers concluded that more research is needed. It's unclear, for example, whether fluvoxamine would prove as beneficial in a vaccinated population.
People Are Taking Ivermectin, a Deworming Drug for Animals, to Treat COVID—Here's Why That's a Bad Idea
What prior research on fluvoxamine has revealed
In an interview with 60 Minutes that aired in March, Angela Reiersen, MD, associate professor of psychiatry at Washington University in St. Louis, who is one of the investigators in the fluvoxamine trials, explained that she first got the idea that the drug could potentially treat COVID-19 after seeing research that fluvoxamine prevented sepsis in mice.
"I thought, well, I wonder if we could use fluvoxamine to treat COVID and prevent that clinical deterioration," Dr. Reiersen told 60 Minutes.
Dr. Reiersen is coauthor of a November 2020 study published in the Journal of the American Medical Association (JAMA) regarding the use of fluvoxamine in COVID-19 patients. She and her colleagues—including Eric Lenze, MD, a fellow psychiatrist at Washington University who also specializes in finding new uses for drugs that are already approved by the Food and Drug Administration (FDA)—went on to conduct the small randomized clinical trial on fluvoxamine and COVID-19 patients.
Here's How Monoclonal Antibody Treatments Fight COVID-19, Plus How to Know If You're Eligible
The results of that JAMA study found that participants with symptomatic COVID-19 who were treated with fluvoxamine "had a lower likelihood of clinical deterioriation" than those who were given a placebo. "The results were really pretty incredible," Dr. Lenze told 60 Minutes Correspondent Sharyn Alfonsi. "Out of the 80 people who received fluvoxamine, none, zero of them deteriorated versus 8% of the people who got [the] placebo."
Of course, since the study was only preliminary, researchers declared that more research was needed to determine "clinical efficacy" of the drug in COVID-19 patients. But that research sparked even more research on fluvoxamine's role in preventing serious disease in those with COVID-19 infections.
David Seftel, MD, a physician in Berkeley, California, opted to offer a 15-day prescription to his own COVID-19 patients, who fell victim to an outbreak in the Golden Gate Fields race track community. (FYI: His decision to use a prescription drug off-label is an accepted medical practice, provided the patient consents. "Off-label" simply means it hasn't been approved by the FDA for that particular condition.)
The results of Dr. Seftel's real world study, which were published in Open Forum Infectious Diseases, showed that, of 65 of those patients who chose to take fluvoxamine, none were hospitalized, while of the 48 who declined the prescription, 12.5% ended up hospitalized, and one died.
