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Benefits of fluvoxamine confirmed in new study

Dr. Todd Lee and Dr. Emily McDonald

Montreal, April 6, 2022 – The effectiveness of fluvoxamine in preventing hospitalization following COVID-19 infection is further confirmed by the results of a systematic review conducted at the Research Institute of the McGill University Health Centre (RI-MUHC). The study, led by Dr. Todd Lee and Dr. Emily McDonald, both investigators at the RI-MUHC and Associate Professors of Medicine at McGill University, has the potential to inform clinical decision-making, policy and guidelines related to the community-based management of patients with COVID-19. It was published today in the journal JAMA Network Open. 

Fluvoxamine is an antidepressant drug that has been shown in a few studies to be effective in reducing inflammation that causes lung injury and that can lead to hospitalization. The study provides a summary and statistical analysis of the results of three placebo-controlled randomized clinical trials in which fluvoxamine was used in the outpatient setting in adults with COVID-19. It shows that there is a high probability (94.1%-98.6%) that fluvoxamine is associated with a reduced risk of hospitalization.

The researchers looked at the STOP COVID 1 trial, the Canadian and American arms of the STOP COVID 2 trial, and the TOGETHER study that was conducted in Brazil. They used statistical methods – a Bayesian and a frequentist random effects meta-analysis – to account for all the individual study results. These results were combined based on the size and effect of each study, the degree of differences between the studies, and various assumptions about the chance that any drug would be effective. A total of 2196 COVID-19 positive and vaccinated participants were involved in these studies. 

Fluvoxamine is a safe and inexpensive drug that researchers believe could be useful for vulnerable populations, particularly in countries that do not have access to more expensive treatments.

“Recently, despite the results of the STOP COVID1 trial and the TOGETHER trial, the Infectious Disease Society of America recommended against the use of fluvoxamine. Based on our analysis, and coupled with worldwide accessibility, decades of safety data, and a current price of approximately $1 per day, fluvoxamine may be a reasonable option for high-risk outpatients who do not have access to SARS CoV-2 monoclonal antibodies, direct antivirals, or clinical trials,” write the authors of the study.

The study was conducted in collaboration with researchers at McGill University, the University of Toronto, Women's College Hospital in Toronto, the University of Minnesota and Washington University in St. Louis.

About the study

The study Fluvoxamine for Outpatient Management of COVID-19 to Prevent Hospitalization : A Systematic Review and Meta-analysiswas conducted by Todd Lee, Simone Vigod, Émilie Bortolussi-Courval, Ryan Hanula, David R. Boulware, Eric J. Lenze, Angela M. Reiersen and Emily G. McDonald.

DOI: 10.1001/jamanetworkopen.2022.6269