Antidepressant fluvoxamine may prevent worsening of COVID-19 infections

UVA researchers Dorian A. A discovery by Rosen and Alban Gaultier recently led to clinical trials that found that an antidepressant COVID may prevent symptoms from worsening. Credit: Photos by Dan Edison, University of Virginia Communications

Antidepressant appears to stop fluvoxamine COVID-19 Deteriorating infections can help keep patients out of the hospital, a test based on research from the University of Virginia School of Medicine suggests.

The clinical trial conducted in Washington by the Washington University School of Medicine compared fluvoxamine to placebo in 152 adult patients infected with coronavirus. None of the participants receiving fluvoxamine saw a “clinical decline” after 15 days, while six patients receiving placebo did. Of those six, four were hospitalized, for periods ranging from four to 21 days. One was on ventilator for 10 days.

Although the study size was small, the researchers say the results are statistically significant and study fluvoxamine warrant further study as a COVID-19 treatment. He plans to launch a major test in the next few weeks.

MD, Eric J. of Washington University School of Medicine. “Most investigational therapies for COVID-19 have been aimed at the sickest patients, but it is also important to find treatments that prevent patients from getting sick enough or going to the hospital to require supplemental oxygen. Our study suggests that fluvoxamine may help fill that niche. “

Fluvoxamine and COVID-19

Researchers at the University of Washington commissioned randomized, double-blind trials based on the discovery of UVA’s Alban Gaultier, PhD, and former graduate student Dorian A. Rosen, PhD. Gaultier and Rosen found last year that fluvoxamine can prevent a fatal inflammation called sepsis, in which the immune response spirals out of control. The drug, he prescribed, reduced the production of cytokines, which have been linked to potentially fatal “cytokine storms” that he thought would occur in severe cases of COVID-19.

That connection prompted the University of Washington team to investigate the possibility that fluvoxamine may have a protective effect for patients with COVID-19. Perhaps, he thought, the drug could help stop the immune system triggered by this strange new coronavirus. And their work shows this.

Gaultier of UVA’s Department of Neuroscience and its Center for Brain Immunology and Glia (BIG) stated, “Because elevated cytokines levels are associated with COVID-19 severity, testing of fluvoxamine in clinical trials means a lot to us is.” “We are still unclear about the mode of action of fluvoxamine against SARS-CoV-2, But research is ongoing to find the answer. “

The University of Washington team noted that recent research has raised questions about whether cytokines are actually playing an important role in COVID-19 deaths. If not, the researchers say, fluvoxamine may have beneficial effects by some other mechanism that is not yet understood.

Angela M. Ressen of Washington University, MD, said that in many ways this drug can work to help COVID-19 patients, but we think it is most likely to reduce the production of inflammatory molecules Can be interacted with the sigma-1 receptor. “Past research has shown that fluvoxamine can reduce inflammation in animal models of sepsis, and may do something similar in our patients.”

The researchers stressed that their research had several limitations. In addition to its small size, the trial was hampered by other factors, with 20% of participants stopping responding to the surveys during the 15-day trial. (Researchers determined that none of those participants required hospitalization or emergency-department visits, but could not rule out that participants necessarily sought treatment at other locations such as treatment We do.)

Because of these limitations, the researchers say that the test results should not be considered as a measure of fluvoxamine’s effectiveness against COVID-19, but rather as an encouraging indicator that the drug warrants further testing.

“If a large clinical trial (Phase III) confirms the results, fluvoxamine will be a new treatment for COVID patients newly diagnosed,” Gaultier said. “Fluvoxamine is not an experimental drug, it is inexpensive and safe and COVID may be available as the first line of defense to remove hospitals surrounded by health crises.”

Researchers have published their findings Journal of the American Medical Association. Lenz, Kaelin Pea, Charles F. in the University of Washington team. Jormski, Angela Stevens, Julie Schweiger, Ginger E. Nicole, J. Philip Miller, Lei Yang, Michael Yingling, Michael S. Avon and Rearsen included. A list of authors’ disclosures is included in the paper.

Reference: Eric J. Fluvoxamine for placebo and clinical deterioration in outpatient with symptomatic COVID-19 by Lenze, MD; Kaelin Mater, MD; Charles F. Zormski, MD; Angela Stevens, BA; Julie Schweiger; Ginger E. Nicole, MD; J. Phillip Miller, AB; Lei Yang, MPH, MSIS; Michael Yingling, MS; Michael S. Avidan, MBBCH and Angela M. Rearsen, MD, MPE, 12 November 2020, Journal of the American Medical Association.
DOI: 10.1001 / jama.2020.22760

The clinical trial was supported by the Taylor Family Institute for Innovative Psychiatric Treatment and COVID-19 Early Treatment Fund at Washington University. Additional support was provided by the Center for Brain Research in Mood Disorders at the University of Washington, Bailey Foundation and National Institutes of Health grant UL1TR002345.

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