Fluvoxamine for the Early Treatment of COVID-19: A Meta-analysis of Randomized Clinical Trials

被引:13
作者
Guo, Christina M. [1 ]
Harari, Ofir [2 ]
Chernecki, Cameron [2 ]
Thorlund, Kristian [2 ,3 ]
Forrest, Jamie, I [4 ]
机构
[1] Univ Aberdeen, Dept Publ Hlth, Aberdeen, Scotland
[2] Cytel Inc, Vancouver, BC, Canada
[3] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
[4] Univ British Columbia, Fac Med, Sch Populat & Publ Hlth, Vancouver, BC, Canada
关键词
D O I
10.4269/ajtmh.21-1310
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Fluvoxamine is widely prescribed as an antidepressant. Recent studies show the drug may have a clinical benefit in treating COVID-19. We aimed to perform a meta-analysis of the existing randomized trials of fluvoxamine compared with placebo on the early treatment of COVID-19 patients. We included only randomized clinical trials enrolling ambulatory patients with early-stage disease (symptoms < 7 days) for the prevention of hospitalization. We searched MEDLINE and clinicaltrials.gov databases to identify trials and extract data with clarifications from the study investigators. We performed a fixed-effects meta-analysis and sensitivity analyses via R to evaluate the pooled estimate of hospitalization. We included three randomized trials: STOP COVID 1 and 2, and the TOGETHER Trial. The studies included a total of 2,196 patients. The STOP COVID trials measured clinical deterioration whereas the TOGETHER Trial measured hospitalization as the primary outcome. All trials reported on hospitalization up to day 28. The meta-analysis results show that patients receiving fluvoxamine were 31 % less likely to experience clinical deterioration or hospitalization compared with placebo (risk ratio, 0.69; 95% CI, 0.54-0.88). A sensitivity analysis using the definition of hospitalization resulted in a risk reduction of 21% (95% CI, 0.60-1.03). Data from three randomized controlled trials show that fluvoxamine was associated with a reduction in the primary outcome measure (either clinical deterioration or composite outcome of hospitalization or extended emergency setting observation), although analysis of hospitalization-only was not statistically significant. More evidence from future trials is still needed to support the findings of this meta-analysis.
引用
收藏
页码:1315 / 1320
页数:6
相关论文
共 13 条
[1]  
[Anonymous], 2021, PFIZ NOV COVID 19 OR
[2]  
Burki T, 2021, LANCET INFECT DIS, V21, P922, DOI 10.1016/S1473-3099(21)00344-3
[3]  
Forrest JI, 2020, INFECT DIS THER, V9, P715, DOI 10.1007/s40121-020-00349-8
[4]  
FREEMAN CP, 1991, J PSYCHIATR NEUROSCI, V16, P19
[5]   Sigma-1 receptor chaperones at the ER-Mitochondrion interface regulate Ca2+ signaling and cell survival [J].
Hayashi, Teruo ;
Su, Tsung-Ping .
CELL, 2007, 131 (03) :596-610
[7]   Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19 A Randomized Clinical Trial [J].
Lenze, Eric J. ;
Mattar, Caline ;
Zorumski, Charles F. ;
Stevens, Angela ;
Schweiger, Julie ;
Nicol, Ginger E. ;
Miller, J. Philip ;
Yang, Lei ;
Yingling, Michael ;
Avidan, Michael S. ;
Reiersen, Angela M. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 324 (22) :2292-2300
[8]  
Merck, 2021, MERCK RIDG INV OR AN
[9]   Mortality Risk Among Patients With COVID-19 Prescribed Selective Serotonin Reuptake Inhibitor Antidepressants [J].
Oskotsky, Tomiko ;
Maric, Ivana ;
Tang, Alice ;
Oskotsky, Boris ;
Wong, Ronald J. ;
Aghaeepour, Nima ;
Sirota, Marina ;
Stevenson, David K. .
JAMA NETWORK OPEN, 2021, 4 (11) :E2133090
[10]  
Reis G., 2021, Gates Open Res, V5, P117, DOI [10.12688/gatesopenres.13304.2, DOI 10.12688/GATESOPENRES.13304.2]