The World Health Organization (WHO) advised against the use of the antidepressant drug, fluvoxamine, and the gout drug, colchicine, in patients with mild or moderate Covid-19 citing insufficient evidence that they improve outcomes and findings that they instead carry potential harms.
The advisory by a WHO Guideline Development Group (GDG), a panel of international experts, was published in The BMJ on Wednesday.
The UN health body earlier advised against the use of convalescent plasma, ivermectin and hydroxychloroquine in patients with Covid-19 regardless of disease severity.
Fluvoxamine and colchicine are commonly used, inexpensive drugs that have received considerable interest as potential Covid-19 treatments during the pandemic, mostly from people touting observations that were not scientifically backed.
“The evidence base for therapeutics for Covid-19 is evolving with numerous randomised controlled trials (RCTs) recently completed and underway. This update adds new recommendations on fluvoxamine and colchicine in patients with non-severe Covid-19; the former was informed by data from three RCTs with 2,196 patients, and the latter by data from seven RCTs with 16,484 patients,” reads the paper.
After thoroughly reviewing this evidence, the panel concluded that almost all well-informed patients would choose not to receive either fluvoxamine or colchicine therapy.
{{/usCountry}}After thoroughly reviewing this evidence, the panel concluded that almost all well-informed patients would choose not to receive either fluvoxamine or colchicine therapy.
{{/usCountry}}The applicability of recommendations made remains uncertain regarding children, noted the panel, as none of the included studies enrolled children.
However, they did not see a reason why children with Covid-19 would respond any differently to treatment with fluvoxamine or colchicine.
For patients with severe covid-19, WHO strongly recommends corticosteroids, with the addition of IL-6 receptor blockers or baricitinib, it said in a statement.
Experts say guidelines are bound to be updated as more evidence emerges in future.
“As more scientific evidence emerges, the guidelines get updated accordingly. That is how the field of medicine works; there are no definitive recommendations,” said Dr Srikant Sharma, senior consultant, department of medicine, Moolchand Hospital.