In a recent paper, scientists from WHO suggest that the antidepressant drug fluvoxamine and the gout drug colchicine are not recommended for patients with mild or moderate COVID-19.
This is because there is currently insufficient evidence that they improve important outcomes for patients, and both drugs carry potential harm.
Fluvoxamine and colchicine are commonly used, inexpensive drugs that have received considerable interest as potential COVID-19 treatments during the pandemic.
However, these recommendations against their use reflect ongoing uncertainty about how the drugs produce an effect on the body, and evidence of little or no effect on survival and other important measures, such as the risk of hospital admission and the need for mechanical ventilation.
There is also a lack of reliable data on COVID-19-related serious harms associated with these drugs.
The WHO’s advice against the use of fluvoxamine except in clinical trials was informed by data from three randomized controlled trials (RCTs) involving over 2,000 patients, and their strong advice against colchicine was based on data from seven RCTs involving 16,484 patients.
After thoroughly reviewing this evidence, the team concluded that almost all well-informed patients would choose not to receive either fluvoxamine or colchicine therapy for COVID-19 based on available evidence.
The panel noted that none of the included studies enrolled children, so the applicability of these recommendations to children is uncertain.
However, they did not see a reason why children with COVID-19 would respond any differently to treatment with fluvoxamine or colchicine.
For patients with severe COVID-19, WHO strongly recommends corticosteroids, with the addition of IL-6 receptor blockers or baricitinib, but advises against the use of convalescent plasma, ivermectin, and hydroxychloroquine in patients with COVID-19, regardless of disease severity.
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The research was published in The BMJ.
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