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Evaluating fluvoxamine for the outpatient treatment of COVID-19: A systematic review and meta-analysis.
Deng, Jiawen; Moskalyk, Myron; Zuo, Qi Kang; Garcia, Cristian; Abbas, Umaima; Ramaraju, Harikrishnaa Ba; Rayner, Daniel; Park, Ye-Jean; Heybati, Kiyan; Zhou, Fangwen; Lohit, Simran.
Afiliación
  • Deng J; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Moskalyk M; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
  • Zuo QK; Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
  • Garcia C; UBC Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
  • Abbas U; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Ramaraju HB; Schulich School of Medicine & Dentistry (Windsor), Western University, Windsor, Ontario, Canada.
  • Rayner D; VCU School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
  • Park YJ; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
  • Heybati K; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Zhou F; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
  • Lohit S; Mayo Clinic Alix School of Medicine (Jacksonville), Mayo Clinic, Jacksonville, Florida, USA.
Rev Med Virol ; 34(1): e2501, 2024 01.
Article en En | MEDLINE | ID: mdl-38148036
ABSTRACT
This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to evaluate the efficacy, safety, and tolerability of fluvoxamine for the outpatient management of COVID-19. We conducted this review in accordance with the PRISMA 2020 guidelines. Literature searches were conducted in MEDLINE, EMBASE, International Pharmaceutical Abstracts, CINAHL, Web of Science, and CENTRAL up to 14 September 2023. Outcomes included incidence of hospitalisation, healthcare utilization (emergency room visits and/or hospitalisation), mortality, supplemental oxygen and mechanical ventilation requirements, serious adverse events (SAEs) and non-adherence. Fluvoxamine 100 mg twice a day was associated with reductions in the risk of hospitalisation (risk ratio [RR] 0.75, 95% confidence interval [CI] 0.58-0.97; I 2  = 0%) and reductions in the risk of healthcare utilization (RR 0.68, 95% CI 0.53-0.86; I 2  = 0%). While no increased SAEs were observed, fluvoxamine 100 mg twice a day was associated with higher treatment non-adherence compared to placebo (RR 1.61, 95% CI 1.22-2.14; I 2  = 53%). In subgroup analyses, fluvoxamine reduced healthcare utilization in outpatients with BMI ≥30 kg/m2 , but not in those with lower BMIs. While fluvoxamine offers potential benefits in reducing healthcare utilization, its efficacy may be most pronounced in high-risk patient populations. The observed non-adherence rates highlight the need for better patient education and counselling. Future investigations should reassess trial endpoints to include outcomes relating to post-COVID sequelaes. Registration This review was prospectively registered on PROSPERO (CRD42023463829).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 Tipo de estudio: Systematic_reviews Límite: Humans Idioma: En Revista: Rev Med Virol Asunto de la revista: VIROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 Tipo de estudio: Systematic_reviews Límite: Humans Idioma: En Revista: Rev Med Virol Asunto de la revista: VIROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido