Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial

Reis, Gilmar; Moreira-Silva, Eduardo Augusto dos Santos; Silva, Daniela Carla Medeiros; Thabane, Lehana; Milagres, Aline Cruz; Ferreira, Thiago Santiago; Santos, Castilho Vitor Quirino dos; Campos, Vitoria Helena de Souza; Nogueira, Ana Maria Ribeiro; Almeida, Ana Paula Figueiredo Guimarães de; Callegari, Eduardo Diniz; Neto, Adhemar Dias de Figueiredo; Savassi, Leonardo Cançado Monteiro; Simplicio, Maria Izabel Campos; Ribeiro, Luciene Barra; Oliveira, Rosemary; Harari, Ofir; Forrest, Jamie I; Ruton, Hinda; Sprague, Sheila; McKay, Paula; Глущенко, А. В.; Rayner, Craig R.; Lenze, Eric J.; Reiersen, Angela M.; Guyatt, Gordon; Mills, Edward J.

doi:10.1016/s2214-109x(21)00448-4

Cited by 336 publications

(515 citation statements)

References 24 publications

Supporting

Mentioning

488

Contrasting

Unclassified

Order By: Relevance

“…During the 2014–2017 Ebola epidemic, an advisory panel to the WHO provided a seven-point list to guide conditions of investigational agent use, which urged minimal interference with the conduct of high quality clinical investigations ( https://www.who.int/ebola/drc-2018/notes-for-the-record-meuri-ebola.pdf ). During the COVID-19 pandemic, widespread clinical use, including through nonprescribed access, and uncontrolled studies has operationally precluded high-quality clinical trials for several repurposed agents, including hydroxycholorquine, ivermectin, and fluvoxamine ( 154 , 155 ) (NCT04668950, NCT 04885530, and NCT 04510194, but see reference 156 for fluvoxamine). Numerous other small studies used various doses and combinations of proposed synergistic drugs, with each underpowered to meaningfully assess efficacy.…”

Section: Clinical Considerationsmentioning

confidence: 99%

Drug Combinations as a First Line of Defense against Coronaviruses and Other Emerging Viruses

White

Schiffer

Ignacio

et al. 2021

mBio

View full text Add to dashboard Cite

show abstract

Section: Clinical Considerationsmentioning

confidence: 99%

Drug Combinations as a First Line of Defense against Coronaviruses and Other Emerging Viruses

White

Schiffer

Ignacio

et al. 2021

mBio

View full text Add to dashboard Cite

show abstract

“…6 In addition, a large randomised multicentre placebo-controlled TOGETHER trial showed significant benefit of fluvoxamine in n = 1472 patients with COVID-19 infection, preventing severe complications. 7 Another clinical open-label trial with fluvoxamine in n = 51 intensive care unit-treated patients showed a 42% reduction in mortality compared with matched controls. 8…”

Section: Impact On Disease Coursementioning

confidence: 99%

Antidepressant drug treatment protecting from COVID-19: one more piece in the repurposing puzzle

Stingl

2021

BJPsych open

View full text Add to dashboard Cite

In the article Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort, Catherine L. Clelland and colleagues for the first time suggest a protective effect of antidepressants against infection with coronavirus disease 2019 (COVID-19) itself. During the observation period of the first wave of the pandemic in New York, more than 50% of patients in the psychiatric hospital studied were infected. From retrospective analysis of the hospital medical records, the authors found a significantly lower risk for infection in patients with antidepressant medication compared to treatment with other psychiatric drugs. The findings of a reduced infection incidence in patients who were already on antidepressant drug therapy underlines a preventive efficacy of antidepressants against COVID-19. Taken together with the prior obtained data of efficacy against deterioration of COVID-19 disease, this study adds a piece of evidence to the positive benefit-risk of antidepressants in repurposing condition against COVID-19.

show abstract

“…The authors mentioned that the rationale for administering fluvoxamine is its agonistic effect in attenuating the damaging effects of the inflammatory response ( 18 ). A larger randomized placebo-controlled study conducted in Brazil found that patients administered fluvoxamine had a lower risk of hospitalization in a COVID-19 emergency setting or transfer to a tertiary hospital due to COVID-19 deterioration ( 19 ). Further, a large observational study conducted in France showed that the use of antidepressants (SSRIs) was significantly and substantially associated with a reduced risk of intubation or death ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of Plasma 5 Hydroxyindoleacetic Acid, a Serotonin Metabolite, on Clinical Severity in Acute Respiratory Distress Syndrome

et al. 2021

View full text Add to dashboard Cite

Acute respiratory distress syndrome (ARDS) is characterized by dysregulated vascular permeability. The clinical outcomes remain poor, and the disease burden is widespread. We demonstrated that plasma 5-hydroxyindoleacetic acid (5-HIAA), a serotonin metabolite, is a pivotal severity indicator of ARDS. Serotonin is an effector of cellular contraction and a modulator of vascular permeability. Plasma 5-HIAA levels were significantly elevated in severe ARDS cases with shock status (p = 0.047) and positively correlated with SOFA (p < 0.0001) and APACHE-II score (p < 0.0001). In the longitudinal analysis, plasma 5-HIAA levels were also a strong independent predictor of mortality rate (p = 0.005). This study indicates that plasma 5-HIAA is a biomarker of ARDS severity and highlights the importance of evaluating vascular leakage levels for ARDS treatment.

show abstract

Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial

Cited by 336 publications

References 24 publications

Drug Combinations as a First Line of Defense against Coronaviruses and Other Emerging Viruses

Drug Combinations as a First Line of Defense against Coronaviruses and Other Emerging Viruses

Antidepressant drug treatment protecting from COVID-19: one more piece in the repurposing puzzle

Impact of Plasma 5 Hydroxyindoleacetic Acid, a Serotonin Metabolite, on Clinical Severity in Acute Respiratory Distress Syndrome

Contact Info

Product

Resources

About