Diabetes drug ‘Metformin’, anthelmintic drug ‘Ivermectin’, and antidepressant ‘Fluvoxamine’, which are being prescribed indiscriminately despite the lack of evidence for the treatment effect of the novel coronavirus infection (COVID-19), prevent the progression of COVID-19 from the high-risk group to severe The results of a randomized controlled abnormality trial were published.
American researchers such as Carolyn T. Bramante of the University of Minnesota published ‘Metformin’, ‘Ivermectin’ and ‘Fluvoxamine’ in the treatment of Corona 19 in the New England Journal of Medicine (NEJM) on the 18th (local time). We published the results of a randomized controlled trial in which three drugs were evaluated compared to placebo (original title: Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19).
The researchers randomized 1,431 COVID-19 patients (high-risk group) who were overweight or obese according to a 2-by-3 factorial design.
There were 663 and 660 patients assigned to the metformin and metformin placebo groups, respectively, 410 and 398 patients were assigned to the ivermectin and ivermectin placebo groups, respectively, and 334 and 327 patients were assigned to the fluvoxamine and fluvoxamine placebo groups, respectively.
The primary endpoint was hypoxemia, emergency department visits, hospitalizations, or death events. All analyzes used co-randomized controls and adjusted for COVID-19 vaccination and administration to other test drugs.
As a result of the study, the adjusted odds ratio for major events was 0.84 for metformin, 1.05 for ivermectin, and 0.94 for fluvoxamine. All three drugs did not prevent progression to severe disease in high-risk COVID-19 patients. mightn’t
Although the prespecified secondary analysis showed an adjusted odds ratio for ’emergency room visit, hospitalization, or death’ of 0.58 for metformin of the three drugs in the prespecified secondary analysis, indicating a potential benefit in prevention of more serious events than the primary endpoint, the researchers “This is a pre-specified secondary endpoint and cannot be considered conclusive until other trial results are available,” said Dr.
Meanwhile, in an editorial, Professor Salim S. Abdool Karim of Columbia University, a world-renowned scholar in clinical epidemiology of infectious diseases, evaluated that the study contributed to proving the ineffectiveness of drugs that are indiscriminately prescribed in the era of infectious diseases. .
“Doctors should use the best currently available evidence of safety and efficacy in choosing a patient’s treatment, but during the COVID-19 pandemic, some early clinical trials have been rushed into trials, leading to poorly performed or too few patient studies,” he said. “As a result, although these treatments were not cited as initial evidence of efficacy, they were already widely used, and some clinicians were reluctant to switch to proven effective alternatives.”
“Evidence is steadily accumulating that ivermectin and fluvoxamine are not particularly effective once morest COVID-19, but they are still widely prescribed,” he said. .
Not only does this practice prevent patients from getting the right treatment, but it can also lead to drug shortages in patients who need it with potential side effects and other diseases.
“Therefore, it is important to obtain reliable evidence of ineffectiveness and to publish these studies in a journal,” he said. do,” he added.
