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The antidepressant fluvoxamine appears to prevent COVID-19 infections from worsening and may help keep patients out of hospital, suggests a trial based on research from the University of Virginia School of Medicine.
This article was written by WTOP news partner, InsideNoVa.com, and republished with permission. Sign up for InsideNoVa.com’s free email subscription today.
The antidepressant fluvoxamine appears to prevent COVID-19 infections from worsening and may help keep patients out of hospital, suggests a trial based on research from the University of Virginia School of Medicine.
The clinical trial, conducted by Washington University School of Medicine in St. Louis, compared fluvoxamine with placebo in 152 adult outpatients infected with the coronavirus.
None of the 80 participants who received fluvoxamine became seriously ill after 15 days, while six patients who received a placebo did. Of those six, four were hospitalized for periods ranging from four to 21 days. One was on a ventilator for 10 days.
Although the size of the study is small, the researchers say the results are statistically significant and that fluvoxamine warrants further study as a COVID-19 treatment. They plan to launch a larger trial in the coming weeks.
“Patients who took fluvoxamine did not develop severe breathing difficulties or did not need to be hospitalized for lung function problems,” said Eric J. Lenze, MD, of Washington University School of Medicine. “Most of the experimental treatments for COVID-19 are aimed at the sickest patients, but it’s also important to find therapies that prevent patients from getting sick enough to need extra oxygen or to get to to the hospital. Our study suggests that fluvoxamine may help fill this niche. “
Researchers at the University of Washington initiated the randomized, double-blind trial based on a discovery by Alban Gaultier, PhD, U.Va., And former graduate student Dorian A Rosen, PhD. Gaultier and Rosen discovered last year that fluvoxamine can stop the deadly inflammation known as sepsis, in which the immune response gets out of hand. The drug, they determined, reduced the production of cytokines, which have been linked to life-threatening “cytokine storms” thought to occur in severe cases of COVID-19.
This connection prompted the team at the University of Washington to study the possibility that fluvoxamine may have a protective effect for patients with COVID-19. Perhaps, they thought, the drug could help prevent overreactions of the immune system triggered by this strange new coronavirus. And their work suggests it.
“Because high levels of cytokines have been associated with the severity of COVID-19, testing fluvoxamine in a clinical trial made a lot of sense to us,” said Gaultier, of UVA’s Department of Neuroscience and its Center for brain and glia immunology (BIG). “We are still unclear as to how fluvoxamine works against SARS-CoV-2, but research is ongoing to find the answer.”
The University of Washington team noted that recent research has raised the question of whether cytokines really play a significant role in deaths from COVID-19. Otherwise, the researchers say, fluvoxamine could have beneficial effects through another mechanism not yet understood.
“There are several ways this drug could work to help patients with COVID-19, but we believe it most likely interacts with the sigma-1 receptor to reduce the production of inflammatory molecules,” said Angela M Reiersen, MD from the University of Washington. “Previous research has shown that fluvoxamine can reduce inflammation in animal models of sepsis, and it can do something similar in our patients.”
The researchers pointed out that there were several limitations to their research. In addition to its small size, the trial was hampered by other factors, including the fact that 20% of participants stopped taking surveys during the 15-day trial. (The researchers determined that none of these participants required hospitalization or emergency room visits, but they could not rule out that participants sought treatment elsewhere, such as in emergency care clinics.)
Because of these limitations, the researchers say the trial results should not be treated as a measure of the effectiveness of fluvoxamine against COVID-19, but as an encouraging indicator that the drug warrants further testing.
“If a larger clinical trial (phase III) confirms the results, fluvoxamine would be a perfect treatment for newly diagnosed COVID patients,” said Gaultier. “Fluvoxamine is not an investigational drug, it is cheap and safe and could be available as a first line of defense in relieving hospitals that are overwhelmed by the COVID health crisis.”
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