philipn authored on Feb. 1, 2021, 3:17 p.m. | | Additions are marked like this |
Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) which is being trialed for possible therapeutic use in COVID-19. COVID-19 clinical trialsFluvoxamine showed promise in a randomized, placebo-controlled trial of 152 COVID-19 positive outpatients. In a paper published in November, 2020 in the Journal of the American Medical Association: Clinical deterioration occurred in 0 of 80 patients in the fluvoxamine group and in 6 of 72 patients in the placebo group (absolute difference, 8.7% [95% CI, 1.8%-16.4%] from survival analysis; log-rank P = .009). The fluvoxamine group had 1 serious adverse event and 11 other adverse events, whereas the placebo group had 6 serious adverse events and 12 other adverse events. -JAMA In a prospective cohort study of fluvoxamine for an outbreak at the Golden Gate Fields racetrack: Overall, 65 persons opted to receive fluvoxamine 50mg twice daily and 48 declined. Incidence of hospitalization was 0% (0/65) with fluvoxamine and 12.5% (6/48) with observation alone. At 14 days, residual symptoms persisted in 0% (0/65) with fluvoxamine and 60% (29/48) with observation. More on the Golden Gate Fields outbreak can be found in this Berkeleyside article. Trials in progress
Mechanism of possible benefit?Sigma-1 receptorMechanisms of potential benefit in COVID-19 may include sigma-1 receptor agonism. See "Fluvoxamine alleviates ER stress via induction of Sigma-1 receptor" and "Modulation of the sigma-1 receptor–IRE1 pathway is beneficial in preclinical models of inflammation and sepsis". As SSRIAn observational study of 7,345 hospitalized COVID-19 patients hinted at possible benefit of prior SSRI usage. As an anti-viralIn an October, 2020 preprint, fluoxetine, a related SSRI, showed in vitro anti-SARS-CoV-2 activity in Vero and Calu-3 cells. News coverageSee also | Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) which is being trialed for possible therapeutic use in COVID-19. 
COVID-19 clinical trialsFluvoxamine showed promise in a randomized, placebo-controlled trial of 152 COVID-19 positive outpatients. In a paper published in November, 2020 in the Journal of the American Medical Association: Clinical deterioration occurred in 0 of 80 patients in the fluvoxamine group and in 6 of 72 patients in the placebo group (absolute difference, 8.7% [95% CI, 1.8%-16.4%] from survival analysis; log-rank P = .009). The fluvoxamine group had 1 serious adverse event and 11 other adverse events, whereas the placebo group had 6 serious adverse events and 12 other adverse events. -JAMA In a prospective cohort study of fluvoxamine for an outbreak at the Golden Gate Fields racetrack: Overall, 65 persons opted to receive fluvoxamine 50mg twice daily and 48 declined. Incidence of hospitalization was 0% (0/65) with fluvoxamine and 12.5% (6/48) with observation alone. At 14 days, residual symptoms persisted in 0% (0/65) with fluvoxamine and 60% (29/48) with observation. More on the Golden Gate Fields outbreak can be found in this Berkeleyside article. Trials in progress
Mechanism of possible benefit?Sigma-1 receptorMechanisms of potential benefit in COVID-19 may include sigma-1 receptor agonism. See "Fluvoxamine alleviates ER stress via induction of Sigma-1 receptor" and "Modulation of the sigma-1 receptor–IRE1 pathway is beneficial in preclinical models of inflammation and sepsis". As SSRIAn observational study of 7,345 hospitalized COVID-19 patients hinted at possible benefit of prior SSRI usage. As an anti-viralIn an October, 2020 preprint, fluoxetine, a related SSRI, showed in vitro anti-SARS-CoV-2 activity in Vero and Calu-3 cells. News coverageSee also |
