Thailand - Early treatment with fluvoxamine prevented hospitalization from COVID

[Red Phoenix]

A new trial out of Thailand recently published in the medical peer-reviewed literature with 995 participants showed that treatment with fluvoxamine and at least one other drug was 100% successful in preventing hospitalization from COVID.

For those receiving standard of care, 37.5% required hospitalization.

 

Source: https://www.sciencedirect.com/science/article/pii/S2589537024000968

Summary

Background

Repurposed drugs with host-directed antiviral and immunomodulatory properties have shown promise in the treatment of COVID-19, but few trials have studied combinations of these agents. The aim of this trial was to assess the effectiveness of affordable, widely available, repurposed drugs used in combination for treatment of COVID-19, which may be particularly relevant to low-resource countries...

 

Findings

Among 1900 recruited, a total of 995 participants completed the trial. No participants had clinical deterioration by day 9, 14, or 28 days among those treated with fluvoxamine plus bromhexine (0%), fluvoxamine plus cyproheptadine (0%), or niclosamide plus bromhexine (0%).

 

Nine participants (5.6%) in the fluvoxamine arm had clinical deterioration by day 28, requiring low-flow oxygen. In contrast, most standard care arm participants had clinical deterioration by 9, 14, and 28 days. By day 9, 32.7% (110) of patients in the standard care arm had been hospitalized without requiring supplemental oxygen but needing ongoing medical care. By day 28, this percentage increased to 37.5% (21)....

Interpretation

Early treatment with these combinations among outpatients diagnosed with COVID-19 was associated with lower likelihood of clinical deterioration, and with significant and rapid reduction in the viral load and serum cytokines, and with lower burden of PASC symptoms. When started very soon after symptom onset, these repurposed drugs have high potential to prevent clinical deterioration and death in vaccinated and unvaccinated COVID-19 patients.

 

(more)

Edited March 17 by stats
shortened per forum fair use quoting rules

[flyingtlger]

Warning....

 

https://www.healthline.com/health/drugs/fluvoxamine-oral-capsule

[TallGuyJohninBKK]

It looks like there was consideration given at least to fluvoxamine as a solo treatment for COVID early in the pandemic (not in combination with other drugs as was addressed in the Thai study), but it was not approved in the U.S. at least. And then seemingly not much more after that.

FDA declines to authorize common antidepressant as COVID treatment

May 17, 2022

 

May 16 (Reuters) - The U.S. Food and Drug Administration has decided not to authorize the antidepressant fluvoxamine to treat COVID-19, saying that the data has not shown the drug to be an effective therapeutic for fighting the virus.

 

"Based on the review of available scientific evidence, the FDA has determined that the data are insufficient to conclude that fluvoxamine may be effective in the treatment of nonhospitalized patients with COVID-19 to prevent progression to severe disease and/or hospitalization," the agency said in a document, opens new tab

published on Monday.

 

University of Minnesota professor Dr. David Boulware submitted the emergency use authorization request to the FDA that would have allowed doctors to prescribe fluvoxamine maleate to treat COVID-19 in non-hospitalized patients...

 

https://www.reuters.com/business/healthcare-pharmaceuticals/fda-declines-authorize-common-antidepressant-covid-treatment-2022-05-16/

 

Likewise, from the Infectious Diseases Society of America and its recommended COVID treatment guidelines:

 

Section last reviewed and updated 11/8/2021

Last literature search conducted 10/31/2021

Conclusions and research needs for this recommendation

The guideline panel recommends fluvoxamine only in the context of a clinical trial to better delineate the effects of fluvoxamine on disease progression, such as need for hospital admission, ICU care, and ultimately, mortality.

 

https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/#null

 

And again, just regarding fluvoxamine as a solo COVID treatment, the WHO came to the same conclusion back in 2022.

WHO Rules Out 2 Drugs as COVID Treatments

• It also no longer recommends the use of fluvoxamine for COVID-19, except in clinical trials.
• There's insufficient evidence that the drugs are of any benefit when it comes to reducing the risk of severe infection or hospitalization from COVID.
• Paxlovid is a better option.

https://www.verywellhealth.com/who-recommends-against-two-drugs-for-covid-19-6374305

 

Again, all of the above pertained to fluvoxamine as a solo COVID treatment, not as part of a combination drugs treatment as done in the OP's cited Thai study.