The international panel of experts developing the WHO Guidelines advises against the use of the antidepressant drug fluvoxamine and the gout drug colchicine for patients with a mild or moderate form of Covid-19.
According to experts, there is currently insufficient evidence that these two drugs actually improve symptoms while both are known to carry potential harm. Due to lack of data, no recommendations have been made on the use of the two drugs in patients with severe disease or critical conditions.
The new opinion is reported today on a dedicated page of the British Medical Journal and is part of the so-called ‘living’ guidelines that are continuously updated by the WHO Guideline Development Group, an international panel made up of experts and patients.
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No effect on the risk of hospitalization and mechanical ventilation
Fluvoxamine and colchicine are commonly used inexpensive drugs that have been the subject of considerable interest as potential treatments for Covid-19 during the pandemic. However, the recommendations arrived today by WHO experts reflect the many doubts about the effectiveness of these drugs, but also the evidence of little or no effect on survival and other important indicators, such as the risk of hospitalization and the need for mechanical ventilation. There is also a lack of reliable data on the serious Covid-19-related harm associated with these drugs.
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Over 18 thousand patients under examination
In the recommendation, WHO experts suggest using fluvoxamine only in clinical trials. Their opinion was based on data from three randomized controlled trials involving over 2,000 patients while the one on colchicine was based on data from seven studies involving 16,484 patients.
After examining these data thoroughly, the panel, which includes experts from around the world including four people who have contracted the infection, concluded that almost all well-informed patients would choose to receive neither fluvoxamine nor colchicine therapy. for Covid-19 on the basis of scientific data currently available. Although none of the studies examined were conducted in children, the WHO panel believes that there is no reason to hypothesize a different response to treatment with fluvoxamine or colchicine in the pediatric range.
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What are the ‘Living’ Guidelines
Today’s recommendations are part of the ‘living’ Guidelines, developed by the World Health Organization with the methodological support of Magic Evidence Ecosystem Foundation. It is an ever-evolving document that provides reliable guidance on managing Covid-19 and helps doctors make better decisions for their patients.
Previously, WHO made a strong recommendation for the use of nirmatrelvir and ritonavir and conditional recommendations for sotrovimab, remdesivir, and molnupiravir for high-risk patients with non-severe covid-19.
For patients with severe disease, WHO strongly recommends corticosteroids, with the addition of IL-6 receptor blockers or baricitinib, but does not recommend the use of convalescent plasma, ivermectin and hydroxychloroquine regardless of disease severity.