WHO Rules Out 2 Drugs as COVID Treatments

Two drugs prevoiusly studied for use against mild or moderate COVID-19 infections don’t work well enough to be recommended, according to the World Health Organization (WHO).

Luvox (fluvoxamine) should not be used except in a clinical trials, while Colcrys (colchicine) received a strong recommendation against any use for COVID-19.

Fluvoxamine is a drug approved in the United States to treat obsessive-compulsive disorder (OCD) and depression.

Colchicine is an anti-inflammatory drug used to treat gout, pericarditis, and familial Mediterranean fever.

The WHO came to these decisions because there is insufficient evidence from clinical trials that either drug helps prevent serious illness or hospitalization from COVID-19. This means the risk of side effects outweighs any potential benefit.

Both drugs are widely available and relatively inexpensive. At the beginning of the pandemic, researchers were exploring the possibility that these medications could modulate the immune system in order to prevent it from overreacting to a COVID-19 infection.

The new advice against the use of these drugs is in the latest update to what is called A Living WHO Guideline on Drugs for COVID-19. A living guideline is a development process that allows researchers and clinicians to update the best practices related to drugs and treatments as soon as new evidence becomes available.

Updates to the guidelines are published in The BMJ, a medical journal, and made by the WHO Guideline Development Group. This group includes infectious disease experts from around the world, as well as a handful of patients who have had COVID-19.

For fluvoxamine, the group looked at data from three randomized controlled trials involving more than 2,000 patients. The advice against using colchicine was based on data from seven trials involving 16,484 patients.

These changes in recommendation are for patients with mild-to-moderate COVID-19. The Guideline Development Group made no recommendations for the use of these two drugs in cases of severe COVID-19 because there was limited or no data.

Do the Updated Guidelines Support Other Drugs?

The guidelines gives conditional recommendations for the use of sotrovimab, remdesivir, and molnupiravir (Merck's antiviral pill) for patients with underlying health problems who have mild-to-moderate COVID-19.

WHO has already strongly recommended the antiviral Paxlovid (Pfizer's antiviral pill) for high-risk patients who have mild-to-moderate COVID-19.

For patients with severe COVID-19, WHO strongly recommends using corticosteroids, along with IL-6 receptor blockers or baricitinib.

Better Treatments Now Exist

Another reason the WHO is only advising against fluvoxamine and colchicine at this point in the game: There's been enough time and research to develop safer, more effective treatments.

"When you have no drugs and a novel infectious disease, there's going to be trial and error," Amesh Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health, told Verywell.

"Some of us had thought in the era before Paxlovid that a drug like fluvoxamine might have some promise, but there was nothing definitive there," he said. "But now we have Paxlovid—an oral antiviral that's highly effective—so that makes the case much harder for anything else that doesn't have really striking data behind it."

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.