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Safety and efficacy of fluvoxamine in COVID-19 ICU patients: an open label, prospective cohort trial with matched controls

Calusic et al., British Journal of Clinical Pharmacology, doi:10.1111/bcp.15126
Nov 2021  
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0 0.5 1 1.5 2+ Mortality 42% Improvement Relative Risk Fluvoxamine for COVID-19  Calusic et al.  ICU PATIENTS Is very late treatment with fluvoxamine beneficial for COVID-19? PSM prospective study of 102 patients in Croatia (Apr - May 2021) Lower mortality with fluvoxamine (p=0.027) Calusic et al., British J. Clinical Ph.., Nov 2021 Favors fluvoxamine Favors control
26th treatment shown to reduce risk in November 2021
*, now known with p = 0.00014 from 21 studies, recognized in 3 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments.
Prospective PSM study of 51 COVID-19 ICU patients in Croatia and 51 matched controls, showing significantly lower mortality with treatment.
risk of death, 42.0% lower, HR 0.58, p = 0.03, treatment 30 of 51 (58.8%), control 39 of 51 (76.5%), NNT 5.7, adjusted per study, propensity score matching.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Calusic et al., 1 Nov 2021, prospective, propensity score matching, Croatia, peer-reviewed, 7 authors, study period 1 April, 2021 - 31 May, 2021.
This PaperFluvoxamineAll
Safety and efficacy of fluvoxamine in COVID‐19 ICU patients: An open label, prospective cohort trial with matched controls
Martina Calusic, Robert Marcec, Lea Luksa, Ivan Jurkovic, Natasa Kovac, Slobodan Mihaljevic, MD Robert Likic
British Journal of Clinical Pharmacology, doi:10.1111/bcp.15126
Background: Fluvoxamine, an SSRI and sigma-1 receptor agonist, has so far shown promise in the prevention of COVID-19 progression as an early treatment option in 3 conducted trials. The aim of this study was to evaluate the safety and efficacy of fluvoxamine in COVID-19 patients if administered later in the disease's course. Methods: The study was designed as an open label, prospective cohort trial with matched controls. In April and May 2021, 51 ICU COVID-19 patients hospitalised in the
Anderson, Fluvoxamine , melatonin and COVID
Asakura, Koyama, Hosokai, Kawano, Kajii, Post-Marketing Surveillance of Fluvoxamine Maleate Used Long-Term in Patients with Social Anxiety Disorder in Japan, Drugs -Real World Outcomes, doi:10.1007/s40801-014-0005-2
Buchberger, Wagner, Fluvoxamine: Safety profile in extensive post-marketing surveillance, Pharmacopsychiatry, doi:10.1055/s-2002-31522
Carpinteiro, Edwards, Hoffmann, Pharmacological Inhibition of Acid Sphingomyelinase Prevents Uptake of SARS-CoV-2 by Epithelial Cells, Cell Reports Med, doi:10.1016/j.xcrm.2020.100142
Elbahlawan, Bissler, Morrison, Continuous Renal Replacement Therapy: A Review of Use and Application in Pediatric Hematopoietic Stem Cell Transplant Recipients, Front Oncol, doi:10.3389/fonc.2021.632263
Esfahani, Rafiee, Javanmard, Evaluation of the Effect of Antidepressant Drug, Fluvoxamine, on Cyclooxygenase-2 Protein Expression in Lipopolysaccharide-stimulated Macrophages, Adv Biomed Res, doi:10.4103/abr.abr_141_18
Hashimoto, Repurposing of CNS drugs to treat COVID-19 infection: targeting the sigma-1 receptor, Eur Arch Psychiatry Clin Neurosci, doi:10.1007/s00406-020-01231-x
Hashimoto, Suzuki, Hashimoto, Old drug fluvoxamine, new hope for COVID-19, Eur Arch Psychiatry Clin Neurosci, doi:10.1007/s00406-021-01326-z
Hassanipour, Arab-Zozani, Amani, Heidarzad, Fathalipour et al., The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials, Sci Rep, doi:10.1038/s41598-021-90551-6
Hinks, Cureton, Knight, Azithromycin versus standard care in patients with mild-to-moderate COVID-19 (ATOMIC2): an open-label, randomised trial, Lancet Respir Med, doi:10.1016/s2213-2600(21)00263-0
Hoertel, Sánchez-Rico, Cougoule, Repurposing antidepressants inhibiting the sphingomyelinase acid/ceramide system against COVID-19: current evidence and potential mechanisms, Mol Psychiatry, doi:10.1038/s41380-021-01254-3
Homolak, Kodvanj, Widely available lysosome targeting agents should be considered as potential therapy for COVID-19
Hägg, Spigset, Dahlqvist, Influence of gender and oral contraceptives on CYP2D6 and CYP2C19 activity in healthy volunteers, Br J Clin Pharmacol, doi:10.1046/j.1365-2125.2001.01328
Israel, Shenhar, Green, Large-scale study of antibody titer decay following BNT162b2 mRNA vaccine or SARS-CoV-2 infection, doi:10.1101/2021.08.19.21262111v1%0A
Kornhuber, Muehlbacher, Trapp, Identification of novel functional inhibitors of acid sphingomyelinase, PLoS One, doi:10.1371/journal.pone.0023852
Lenze, Mattar, Zorumski, Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients with Symptomatic COVID-19: A Randomized Clinical Trial, JAMA -J Am Med Assoc, doi:10.1001/jama.2020.22760
Marcec, Majta, Likic, Will vaccination refusal prolong the war on SARS-CoV-2?, Postgrad Med J, doi:10.1136/postgradmedj-2020-138903
Marčec, Likić, Could fluvoxamine keep COVID-19 patients out of hospitals and intensive care units?, Croat Med J, doi:10.3325/CMJ.2021.62.95
Moiseev, Brovko, Tao, Bulanov, Akulkina et al., Sex differences in mortality in the intensive care unit patients with severe COVID-19, J Infect, doi:10.1016/j.jinf.2020.09.031
Ou-Yang, Huang, Phenotypic polymorphism and gender-related differences of CYP1A2 activity in a Chinese population, Br J Clin Pharmacol, doi:10.1046/j.1365-2125.2000.00128.x
Planas, Veyer, Baidaliuk, Reduced sensitivity of SARS-CoV-2 variant Delta to antibody neutralization, Nature, doi:10.1038/s41586-021-03777-9
Reardon, Flawed ivermectin preprint highlights challenges of COVID drug studies, Nature, doi:10.1038/d41586-021-02081-w
Rosen, Seki, Fernández-Castañeda, Modulation of the sigma-1 receptor-IRE1 pathway is beneficial in preclinical models of inflammation and sepsis, Sci Transl Med, doi:10.1126/scitranslmed.aau5266
Saha, Tanmoy, Tanni, New waves, new variants, old inequity: A continuing COVID-19 crisis, BMJ Glob Heal, doi:10.1136/bmjgh-2021-007031
Schloer, Brunotte, Goretzko, Targeting the endolysosomal host-SARS-CoV-2 interface by clinically licensed functional inhibitors of acid sphingomyelinase (FIASMA) including the antidepressant fluoxetine, Emerg Microbes Infect, doi:10.1080/22221751.2020.1829082
Seftel, Boulware, Prospective Cohort of Fluvoxamine for Early Treatment of Coronavirus Disease 19, Open Forum Infect Dis, doi:10.1093/ofid/ofab050
Servillo, Vargas, Pastore, Immunomodulatory effect of continuous venovenous hemofiltration during sepsis: Preliminary data, Biomed Res Int, doi:10.1155/2013/108951
Shrotri, Navaratnam, Nguyen, Spike-antibody waning after second dose of BNT162b2 or ChAdOx1, Lancet, doi:10.1016/S0140-6736(21)01642-1
Soldin, Mattison, Sex differences in pharmacokinetics and pharmacodynamics, Clin Pharmacokinet, doi:10.2165/00003088-200948030-00001
Sukhatme, Reiersen, Vayttaden, Sukhatme, Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19, Front Pharmacol, doi:10.3389/fphar.2021.652688
Who, COVID-19 Weekly Epidemiological Update 55
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Late treatment
is less effective
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