Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial
Brazilian RCT (n=1,497) found fluvoxamine 100mg twice daily for 10 days reduced the risk of hospitalisation within 28 days in high risk patients with symptomatic confirmed COVID-19 vs placebo (11% vs 16%, RR 0.68, 95%CI 0.52 to 0.88). There was no difference in adverse effects.
Source:
Lancet Global Health
SPS commentary:
A related commentary states this study strongly suggests that fluvoxamine constitutes an effective, safe, inexpensive, and relatively well tolerated option for the management of ambulatory patients with COVID-19, which is particularly useful for (but not limited to) low-resource settings. Despite these important findings, some questions related to the efficacy and safety of fluvoxamine for patients with COVID-19 remain open. The definitive answer regarding the effects of fluvoxamine on individual outcomes such as mortality and hospitalisations still need addressing. In addition, it remains to be established whether fluvoxamine has an additive effect to other therapies such as monoclonal antibodies and budesonide, and what is the optimal fluvoxamine therapeutic scheme. Finally, it is still unclear whether the results of this trial extend to other outpatient populations with COVID-19, including those without risk factors for disease progression, those who are fully vaccinated, and those infected with the delta variant or other variants.