They are among the drugs that have been evaluated during the pandemic as potential weapons against Covid for their anti-inflammatory properties. Protagonists of several studies now the antidepressant fluvoxamine and the gout drug colchicine are advised against by the World Health Organization (WHO), which has decided not to recommend them for patients with mild or moderate Covid, as there is currently insufficient evidence that their use leads to improvements in outcomes that are important to patients. Both drugs, on the other hand, have potential harm. This is the verdict, reported on ‘BMJ’, of the international experts who make up a group for the development of WHO guidelines.
No position was expressed for either drug with respect to patients with severe or critical illness, given that for these patients the data are limited or nil. Fluvoxamine and colchicine are low cost and commonly used. And also for this reason they have aroused considerable interest as potential treatments for Covid-19 in full pandemic. Today’s recommendations against their use reflect uncertainty about how the two drugs affect the body and evidence of little or no effect on survival and other aspects, such as the risk of hospitalization and the need for mechanical ventilation. There is also a lack, for experts, of reliable data on serious damage related to Covid associated with these drugs.
The two molecules have also been discussed in several circumstances in Italy (on colchicine up to July 2020 there were 3 trials authorized in our country by the Aifa drug agency to evaluate its potential in addition to standard therapies).
The WHO advice against the use of the two drugs was based on the analysis of data from clinical trials and randomized controlled trials. After thoroughly examining the evidence, the panel of experts from around the world (and also 4 patients who have had Covid) concluded that almost all well-informed people would choose not to receive either fluvoxamine or colchicine therapy for Covid based on available data. None of the studies included in the analysis enrolled children, the experts finally pointed out, so the applicability of these recommendations to them is uncertain, it is explained. However, no reason was seen why young Covid patients might have responded differently to these two treatments.